http://www.mdpi.com/journal/diagnostics Latest open access articles published in Diagnostics at http://www.mdpi.com/journal/diagnostics http://www.mdpi.com/2075-4418/2/2/2 Objective: To evaluate the intra-/interobserver agreement of the visual interpretation of contrast-enhanced ultrasound (CEUS) of pancreatic head lesions and its concordance with the histological test results. Material and Methods: Two observers (A + B) evaluated by simple visual interpretation 40 consecutive CEUS examinations of pancreatic head lesions and one of the observers evaluated the examinations twice (A1 + A2). The examinations were evaluated according to the criteria outlined in EFSUMB guidelines. The two experienced observers were blinded to histological evidence and clinical information of tumor type and to each other’s results. Results: The kappa value for the intraobserver evaluation between observer A1 and A2 was 0.89, equating to almost perfect agreement. The kappa value for the interobserver evaluation between observer A1 and B was 0.76 and between observer A2 and B it was 0.75, both equating to substantial agreement. Evaluation of the visual interpretation compared to the histological test result showed a positive predictive value for A1, A2 and B versus biopsy of 97%, 94% and 90% respectively and an accuracy of 83%, 88% and 73% respectively. Conclusions: Visual interpretation for assessment of contrast enhancement of pancreatic head lesions seemed to be an accurate method with reproducible results and good concordance with the histological test results. http://www.mdpi.com/2075-4418/2/2/2 Fri, 20 Apr 2012 00:00:00 CEST Diagnostics 2012-04-20 2 2 Article 2 9 2075-4418 Intra-/Interobserver Agreement of Enhancement Pattern for Pancreatic Head Lesions Using Contrast-Enhanced Ultrasound: According to EFSUMB Guidelines 2012-04-20 doi: 10.3390/diagnostics2020002 Hanne Sønder Grossjohann Caroline Ewertsen Lars Bo Svendsen Michael Bachmann Nielsen http://www.mdpi.com/2075-4418/2/1/1 The field of microfluidics has seen breath-taking progress since its beginnings in the 1980s and early 1990s. While much of the initial work was a by-product of mainstream micro-electro-mechanical systems (MEMS) and silicon based fabrication schemes, soon a specialized research field developed. Over the last decade a strong, highly interdisciplinary microfluidics community emerged with roots in classical silicon microfabrication as well as chemistry, physics, biotechnology, medicine and various engineering disciplines. [...] http://www.mdpi.com/2075-4418/2/1/1 Tue, 20 Mar 2012 00:00:00 CET Diagnostics 2012-03-20 2 1 Announcement 1 1 2075-4418 Special Issue: Microfluidic Lab-on-a-Chip Platforms for High-Performance Diagnostics 2012-03-20 doi: 10.3390/diagnostics2010001 Jens Ducrée http://www.mdpi.com/2075-4418/1/1/53 This presentation will emphasize the estimation of the combined accuracy of two or more tests when verification bias is present. Verification bias occurs when some of the subjects are not subject to the gold standard. The approach is Bayesian where the estimation of test accuracy is based on the posterior distribution of the relevant parameter. Accuracy of two combined binary tests is estimated employing either “believe the positive” or “believe the negative” rule, then the true and false positive fractions for each rule are computed for two tests. In order to perform the analysis, the missing at random assumption is imposed, and an interesting example is provided by estimating the combined accuracy of CT and MRI to diagnose lung cancer. The Bayesian approach is extended to two ordinal tests when verification bias is present, and the accuracy of the combined tests is based on the ROC area of the risk function. An example involving mammography with two readers with extreme verification bias illustrates the estimation of the combined test accuracy for ordinal tests. http://www.mdpi.com/2075-4418/1/1/53 Thu, 15 Dec 2011 00:00:00 CET Diagnostics 2011-12-15 1 1 Article 53 76 2075-4418 Bayesian Estimation of Combined Accuracy for Tests with Verification Bias 2011-12-15 doi: 10.3390/diagnostics1010053 Lyle D. Broemeling http://www.mdpi.com/2075-4418/1/1/38 Objective: Intensive medical treatment of heart failure (HF) patients with diabetes may reduce the endothelial dysfunction and the accelerated atherosclerotic process seen in these patients. To study this, we investigated the endothelial function and the presence of atherosclerosis as measured by flow-mediated vasodilatation (FMD) and intima-media thickness (IMT) in intensively treated patients with coexisting HF and diabetes. Research Design and Method: FMD of the brachial artery and IMT of the common carotid arteries were determined in 26 patients with systolic HF and diabetes who were in intensive medical therapy, as well as in 19 healthy controls. The two groups were matched according to age and sex. In all subjects left ventricular ejection fraction was measured by two-dimensional echocardiography. Biochemical parameters including serum cholesterol, HDL and LDL, triglyceride, glucose, hemoglobin/hemoglobin-A1C (HbA1C), brain natriuretic peptide (BNP) and N-terminal pro-BNP were also assessed. Results: Mean FMD and IMT did not differ significantly between patients and controls. Left ventricular ejection fraction was lower in patients compared to controls (P < 0.001). The patients had a higher mean BNP, NT pro-BNP, triglyceride, HbA1C and glucose in comparison to controls. Cholesterol, HDL-cholesterol and LDL-cholesterol were lower in patients compared to controls. Conclusions: Intensively treated patients with coexisting systolic HF and diabetes seem to have normal endothelial function as measured by FMD and they have no sign of accelerated atherosclerosis as measured by IMT. This suggests a positive effect of medication on the cardiovascular alterations in this group of patients. http://www.mdpi.com/2075-4418/1/1/38 Thu, 08 Dec 2011 00:00:00 CET Diagnostics 2011-12-08 1 1 Article 38 52 2075-4418 Flow-Mediated Vasodilatation and Intima-Media Thickness in Patients with Coexisting Heart Failure and Diabetes Receiving Medical Therapy 2011-12-08 doi: 10.3390/diagnostics1010038 Lisbeth Vestergaard Andersen Niels Wiinberg Christian Tuxen Andreas Kjær http://www.mdpi.com/2075-4418/1/1/36 Diagnostic methods in medicine are currently rapidly evolving and constantly improving. This is true for areas such as molecular diagnostics, biomarkers, as well as medical imaging. As one example, positron emission tomography (PET) has been called the fastest growing medical technology ever. Also, molecular diagnostics, at both the gene and protein levels, are developing rapidly due to advances in technology and, thereby, creating new possibilities. Early and valid diagnosis is crucial for proper treatment of patients. Moreover, advanced diagnostic methods are crucial for the upcoming era of tailored therapy. From an economic viewpoint, the cost of advanced treatments are increasingly indicating the need for better stratification and therapy monitoring of treatment, in order that these advanced treatments are limited to patients able to respond favorably. Collectively, the exciting area of medical diagnostics seems never to have been more important for patients and society. [...] http://www.mdpi.com/2075-4418/1/1/36 Wed, 23 Nov 2011 00:00:00 CET Diagnostics 2011-11-23 1 1 Editorial 36 37 2075-4418 Welcome to Diagnostics: a New Open Access Journal for the Fast-Growing Field of Medical Diagnostics 2011-11-23 doi: 10.3390/diagnostics1010036 Andreas Kjaer http://www.mdpi.com/2075-4418/1/1/1 Bayesian methods for medical test accuracy are presented, beginning with the basic measures for tests with binary scores: true positive fraction, false positive fraction, positive predictive values, and negative predictive value. The Bayesian approach is taken because of its efficient use of prior information, and the analysis is executed with a Bayesian software package WinBUGS®. The ROC (receiver operating characteristic) curve gives the intrinsic accuracy of medical tests that have ordinal or continuous scores, and the Bayesian approach is illustrated with many examples from cancer and other diseases. Medical tests include X-ray, mammography, ultrasound, computed tomography, magnetic resonance imaging, nuclear medicine and tests based on biomarkers, such as blood glucose values for diabetes. The presentation continues with more specialized methods suitable for measuring the accuracies of clinical studies that have verification bias, and medical tests without a gold standard. Lastly, the review is concluded with Bayesian methods for measuring the accuracy of the combination of two or more tests. http://www.mdpi.com/2075-4418/1/1/1 Thu, 05 May 2011 00:00:00 CEST Diagnostics 2011-05-05 1 1 Review 1 35 2075-4418 Bayesian Methods for Medical Test Accuracy 2011-05-05 doi: 10.3390/diagnostics1010001 Lyle D. Broemeling