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Articles
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Article
October 2009
D-dimer testing in the treatment and monitoring of septic patients
Sepsis and septic shock lead to local and systemic
activation of different response systems, including coagulation and
fibrinolysis.
Despite numerous attempts the high mortality rate of
these patients has remained stable over the last 20
years.
In this overview the pathophysiological insights and
possible...
Coagulation/fibrinolysis
D-dimer
Article
October 2009
Low troponin I concentrations and clinical decision making
Troponin values above the 99th percentile and increasing/falling values found by serial testing in addition to signs and symptoms of myocardial ischemia means AMI.
Low troponin values, near or below the 99th percentile, can be used for prognosis. Highest hazard ratios were found when using the 90th percentile,...
Cardiac markers
Troponins
Natriuretic peptide
Article
October 2009
Diagnostic accuracy – Part 2
Predictive value and likelihood ratio
Sensitivity and specificity define the discriminative power of a diagnostic procedure, whereas predictive values relate to the predictive ability of a test to identify disease or its absence in individuals.
Predictive values are greatly influenced by the prevalence of the disease and should not be generalized beyond ...
Information management
Article
October 2009
Clinical aspects of pleural fluid pH
Pleural effusion, defined as excess fluid in the pleural space, can complicate the course of a large and pathologically diverse range of pulmonary and non-pulmonary diseases. Laboratory analysis of pleural fluid provides much useful information for the clinician whose diagnostic challenge is the patient presenting...
Point-of-care testing
Blood gases/acid-base
Glucose
Lactate
Hemoglobins
Article
July 2009
Clinical aspects of the anion gap
The anion gap (AG) is a calculated parameter derived from measured serum/plasma electrolyte concentrations. The clinical value of this calculated parameter is the main focus of this article.
Both increased and reduced anion gap have clinical significance, but the deviation from normal that has most clinical...
Electrolytes
Blood gases/acid-base
Glucose
Lactate
Creatinine/urea
Kidneys/fluids
Article
June 2009
Diagnostic accuracy – Part 1
Basic concepts: sensitivity and specificity, ROC analysis, STARD statement
The discriminative ability of a diagnostic procedure is called diagnostic accuracy, and a number of quantitative measures out of which sensitivity and specificity are mostly used in the biomedical literature can express it.
Each diagnostic-accuracy measure relates to some specific aspects of a diagnostic procedure....
Information management
Article
June 2009
Acute care testing at the point-of-care: now and in the future
The field of point-of-care testing (POCT) is entering a period of rapid expansion. This expansion is being driven by new evidence for clinical effectiveness of POCT, and new technologies that allow consolidation of testing onto smaller platforms.
Technological improvements will also lead to increased accuracy for...
Glucose
Blood gases/acid-base
Point-of-care testing
Quality assurance
Lactate
Creatinine/urea
Hemoglobins
Kidneys/fluids
Article
June 2009
D-dimer as a rule-out test for deep venous thrombosis: Gold standards and bias in negative predictive value
Recent studies of D-dimer as a “rule-out” test for deep venous thrombosis (DVT) frequently have used duplex ultrasound rather than venography as the gold standard.
Because duplex ultrasound has limited ability to image the calf veins, there is potential for ultrasound studies to classify patients with calf DVT as...
Coagulation/fibrinolysis
Hemoglobins
D-dimer
Article
June 2009
The utility of natriuretic peptide in the management of patients with acute and chronic heart failure: Insights from randomized controlled trials
Patients with heart failure (HF) experience significant morbidity and mortality and those admitted for acute decompensated HF are at particularly high risk for adverse events.
Hospitalization represents the major component of the high cost associated with the management of patients with HF. Accordingly, early and...
Cardiac markers
Article
April 2009
Reference intervals (2) - some practical considerations
This is the second of two articles focusing on the reference interval, the most widely used tool for interpretation of patient test results.
The first [1] was an introduction to the theoretical concepts that underpin the significance, construction and use of reference intervals. Here consideration is given to the...
Quality assurance
Information management
Point-of-care testing
Hemoglobins