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Oliveira MC, Scharan KO, Thomés BI, Bernardelli RS, Reese FB, Kozesinski-Nakatani AC, Martins CC, Lobo SMA, Réa-Neto Á. Diagnostic accuracy of a set of clinical and radiological criteria for screening of COVID-19 using RT-PCR as the reference standard. BMC Pulm Med 2023; 23:81. [PMID: 36894945 PMCID: PMC9997428 DOI: 10.1186/s12890-023-02369-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2022] [Accepted: 02/22/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND The gold-standard method for establishing a microbiological diagnosis of COVID-19 is reverse-transcriptase polymerase chain reaction (RT-PCR). This study aimed to evaluate the accuracy, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of a set of clinical-radiological criteria for COVID-19 screening in patients with severe acute respiratory failure (SARF) admitted to intensive care units (ICUs), using reverse-transcriptase polymerase chain reaction (RT-PCR) as the reference standard. METHODS Diagnostic accuracy study including a historical cohort of 1009 patients consecutively admitted to ICUs across six hospitals in Curitiba (Brazil) from March to September, 2020. The sample was stratified into groups by the strength of suspicion for COVID-19 (strong versus weak) using parameters based on three clinical and radiological (chest computed tomography) criteria. The diagnosis of COVID-19 was confirmed by RT-PCR (referent). RESULTS With respect to RT-PCR, the proposed criteria had 98.5% (95% confidence interval [95% CI] 97.5-99.5%) sensitivity, 70% (95% CI 65.8-74.2%) specificity, 85.5% (95% CI 83.4-87.7%) accuracy, PPV of 79.7% (95% CI 76.6-82.7%) and NPV of 97.6% (95% CI 95.9-99.2%). Similar performance was observed when evaluated in the subgroups of patients admitted with mild/moderate respiratory disfunction, and severe respiratory disfunction. CONCLUSION The proposed set of clinical-radiological criteria were accurate in identifying patients with strong versus weak suspicion for COVID-19 and had high sensitivity and considerable specificity with respect to RT-PCR. These criteria may be useful for screening COVID-19 in patients presenting with SARF.
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Affiliation(s)
- Mirella Cristine Oliveira
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Karoleen Oswald Scharan
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil
| | - Bruna Isadora Thomés
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil
| | - Rafaella Stradiotto Bernardelli
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,School of Medicine and Life Sciences, Pontifical Catholic University of Paraná, Imaculada Conceição Street, 1155, Curitiba, Paraná, 80215-901, Brazil
| | - Fernanda Baeumle Reese
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Amanda Christina Kozesinski-Nakatani
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Hospital Santa Casa de Curitiba, Praça Rui Barbosa, 694, Curitiba, Paraná, 80010-030, Brazil
| | - Cintia Cristina Martins
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil.,Complexo Hospitalar do Trabalhador (CHT), República Argentina Street, 4406, Curitiba, Paraná, 81050-000, Brazil
| | - Suzana Margareth Ajeje Lobo
- Departament of Medicine, São José do Rio Preto Medical School, Brigadeiro Faria Lima avenue, 5416, São José do Rio Preto, São Paulo, 15090-000, Brazil
| | - Álvaro Réa-Neto
- Center for Studies and Research in Intensive Care Medicine - CEPETI, Monte Castelo Street, 366, Curitiba, Paraná, 82590-300, Brazil. .,Internal Medicine Department, Hospital de Clínicas, Federal University of Paraná, General Carneiro Street, 181, Curitiba, Paraná, 80060-900, Brazil.
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Scharan KO, Bernardelli RS, Corrêa KP, Moser ADDL. Instrumentos da prática clínica com versão em português e a abrangência de seus conteúdos usando a CIF como referência: uma revisão sistemática. Fisioter Pesqui 2020. [DOI: 10.1590/1809-2950/18032527032020] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
RESUMO A prática clínica tem sido subsidiada por instrumentos que permitem acessar e registrar informações de funcionalidade e saúde dos indivíduos. Uma forma de conhecer qual conteúdo da Classificação Internacional de Funcionalidade, Incapacidade e Saúde (CIF) os instrumentos contemplam é usá-la como referência para auxiliar o profissional na escolha do mais adequado para acessar informações biopsicossociais. O objetivo foi identificar instrumentos da prática clínica em saúde que tiveram seu conteúdo ligado com a CIF e a existência de versão na língua portuguesa deles. Para tanto foi realizada uma revisão sistemática nas bases de dados SciELO Brasil, Lilacs e PubMed com os descritores “CIF”, “questionário” e “regra de ligação” em português e inglês. Três pesquisadores independentes realizaram a seleção, e o nível de concordância foi obtido pelo coeficiente Kappa. Os critérios de elegibilidade foram: estudos primários de ligação de conteúdo de questionários, escalas, índices e checklists com a CIF publicados após 2001 em língua portuguesa ou inglesa. Foram incluídos 61 artigos, sendo 19 de origem brasileira. Dos 250 instrumentos ligados à CIF, 158 (63,2%) apresentaram versão em português sendo que dos 37 que mais se repetiram nos estudos, dois não apresentam essa versão. O coeficiente Kappa mostrou concordância entre moderada e boa (p<0,001). Este estudo apresentou um panorama da ligação de conteúdo de instrumentos da prática clínica à CIF identificando quais têm versão em língua portuguesa, o que contribuirá para o potencial fortalecimento da abordagem biopsicossocial dos profissionais de saúde.
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Bernardelli RS, Santos BC, Scharan KO, Corrêa KP, Silveira MIB, Moser ADDL. Application of the refinements of ICF linking rules to the Visual Analogue Scale, Roland Morris questionnaire and SF-36. Cien Saude Colet 2019; 26:1137-1152. [PMID: 33729366 DOI: 10.1590/1413-81232021263.03502019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/19/2017] [Accepted: 06/07/2019] [Indexed: 12/13/2022] Open
Abstract
The Visual Analogue Scale (VAS), Roland Morris Disability Questionnaire (RMDQ), Short Form Health Survey (SF-36) are broadly used and had their content linked to ICF by the linking rules of 2002 and 2005. In 2016 were refined and were not applied yet. To apply the refinements of ICF linking rules to VAS, RMDQ, and SF-36. Two health professionals identified the meaningful concepts and linked to the most precise ICF categories and a third triggered in divergences. The degree of agreement was calculated by kappa statistic. There was almost perfect agreement (Kappa=0.93 p<0,001). The main concept of VAS was linked to ICF category b280, the 24 main concepts of RMDQ linked to b28013, and 27 additional linked to other categories. The SF-36 had 36 main concepts and 30 additional concepts identified which 27 were definable by the ICF and 17 do not. From the total of ICF linked concepts, 39 refer to Body Functions, 57 to Activities and Participation and 4 to Environmental Factors. The refinements of linking rules propitiated more clarity in the process to identify, to link instruments content with ICF and to expose the results. Thus, increased the number of identified and linked concepts as well as the categories in the instruments.
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Affiliation(s)
- Rafaella Stradiotto Bernardelli
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
| | - Bárbara Cordeiro Santos
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
| | - Karoleen Oswald Scharan
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
| | - Katren Pedroso Corrêa
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
| | - Maria Isabel Barboza Silveira
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
| | - Auristela Duarte de Lima Moser
- Programa de Pós-Graduação de Tecnologia em Saúde, Pontifícia Universidade Católica do Paraná. R. Imaculada Conceição 1155, Prado Velho. 80215-901 Curitiba PR Brasil.
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Moser ADDL, Knaut LAM, Zotz TG, Scharan KO. Validity and reliability of the Portuguese version of the American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form. Rev Bras Reumatol 2012; 52:348-356. [PMID: 22641589] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2011] [Indexed: 06/01/2023] Open
Abstract
INTRODUCTION The American Shoulder and Elbow Surgeons Standardized Shoulder Assessment Form (ASES), often used in research in Brazil, although translated and adapted to the Portuguese language, had not had its validity and reliability tested yet. OBJECTIVE To assess the validity, reliability, and internal consistency of the ASES-PT for shoulder dysfunction. MATERIALS AND METHODS Fifty individuals (26 women; mean age, 39 ± 13 years) participated in the validity assessment, and 38 (19 women; mean age, 37 ± 13 years old) in the reliability assessment, all having shoulder dysfunction. The participants completed the 36-Item Short-Form Health Survey (SF-36), the Disabilities of the Arm, Shoulder and Hand Questionnaire (DASH), and the ASES-PT on two occasions with an interval of seven days. The convergent validity was assessed by use of the Spearman's rank correlation coefficient (ρ), and the analysis of the intrarater reliability used the intraclass correlation coefficient (ICC). The internal consistency was assessed by using Cronbach's alpha. RESULTS The ASES-PT scores correlated with the DASH scores (ρ = -0.69, P = 0.000) and with the "physical functioning" (ρ = 0.50, P = 0.000), "role limitation due to physical health" (ρ = 0.43, P = 0.002) and "bodily pain" domains (ρ = 0.60, P = 0.000) of the SF-36. The intrarater reliability of the ASES-PT proved to be adequate (ICC = 0.75, P = 0.000). The internal consistency (0.794) was satisfactory. CONCLUSION The validity and reliability study of the ASES-PT supports its use for assessing shoulder dysfunction.
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