A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment ...A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment effect and interim result.For hypotheses and reversed hypotheses under normal models,we obtain analytical expressions of the ROC curves of the CCP,find optimal ROC curves of the CCP,investigate the superiority of the ROC curves of the CCP,calculate critical values of the False Positive Rate(FPR),True Positive Rate(TPR),and cutoff of the optimal CCP,and give go/no go decisions at the interim of the optimal CCP.In addition,extensive numerical experiments are carried out to exemplify our theoretical results.Finally,a real data example is performed to illustrate the go/no go decisions of the optimal CCP.展开更多
Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR wer...Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.展开更多
Objective: To determine the endemic values of cutaneous leishmaniasis in different cities of Fars province, Iran. Methods: Totally, 29 201 cases registered from 2010 to 2015 in Iranian Fars province were selected, and...Objective: To determine the endemic values of cutaneous leishmaniasis in different cities of Fars province, Iran. Methods: Totally, 29 201 cases registered from 2010 to 2015 in Iranian Fars province were selected, and the endemic values of cutaneous leishmaniasis were determined by retrospective clusters derived from spatiotemporal permutation modeling on a time-series design. The accuracy of the values was assessed using receiver operating characteristic(ROC) curve. SPSS version 22, Arc GIS, and ITSM 2002 software tools were used for analysis. Results: Nine statistically significant retrospective clusters(P<0.05) resulted in finding seven significant and accurate endemic values(P<0.1). These valid endemic scores were generalized to the other 18 cities based on 6 different climates in the province. Conclusions: Retrospectively detected clusters with the help of ROC curve analysis could help determine cutaneous leishmaniasis endemic values which are essential for future prediction and prevention policies in the area.展开更多
BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese ado...BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression,examine the effects of binge eating,physical activity,and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction.METHODS We conducted a cross-sectional survey of 1286 college students in South China.Physical activity level,depressive symptoms,and binge eating behavior were assessed using the Physical Activity Scale-3,Zung Self-Rating Depression Scale,and Dutch Eating Behavior Questionnaire,respectively.The absolute difference between actual body mass index(BMI)and ideal BMI was used to indicate the level of body dissatisfaction.Structural equation modeling(SEM)and receiver operating characteristic(ROC)curve analysis were used to examine the relationships between these variables and depression.RESULTS The findings showed that female college students reported higher levels of depression.Physical activity,body dissatisfaction,and binge eating behavior were significantly associated with depression.SEM revealed that body dissatisfaction played a mediating role.A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression,with an area under the ROC curve of 70.0%,providing a basis for targeted interventions.CONCLUSION This study demonstrated a significant positive correlation between body dissatisfaction and depression.Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression.Therefore,promoting physical activity and healthy eating habits among adolescents is essential.Additionally,the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening.Future longitudinal studies are recommended to further refine this diagnostic criterion.展开更多
BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumo...BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.展开更多
Chinese men should have a higher prostate-specific antigen (PSA) "gray zone" than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer (PCa) in Chinese men is relative low. We hypothe...Chinese men should have a higher prostate-specific antigen (PSA) "gray zone" than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer (PCa) in Chinese men is relative low. We hypothesized that PSA density (PSAD) could improve the rate of PCa detection in Chinese men with a PSA higher than the traditional PSA "gray zone." A total of 461 men with a PSA between 2.5 and 20.0 ng ml-1, who had undergone prostatic biopsy at two Chinese centers were included in the analysis. The men were then further divided into groups with a PSA between 2.5-10.0 ng ml-1 and 10.1-20.0 ng ml-1. Receiver operating characteristic (ROC) curve was used to evaluate the efficacy of PSA and PSAD for the diagnosis of PCa. In men with a PSA of 2.5-10.0 ng ml-1 or 10.1-20.0 ng ml-z, the areas under the ROC curve were higher for PSAD than for PSA. This was consistent across both centers and the cohort overall. When the entire cohort was considered, the optimal PSAD cut-off for predicting PCa in men with a PSA of 2.5-10.0 ng m1-1 was 0.15 ng ml-2 ml-2, with a sensitivity of 64.4% and specificity of 64.6%. The optimal cut-off for PSAD in men with a PSA of 10.1-20.0 ng m1-1 was 0.33 ng ml-1 ml-1, with a sensitivity of 60.3% and specificity of 82.7%. PSAD can improve the effectiveness for PCa detection in Chinese men with a PSA of 2.5-10.0 ng ml-1 (traditional Western PSA "gray zone") and 10.1-20.0 ng ml-2 (Chinese PSA "gray zone").展开更多
Objective: To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases ...Objective: To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers. Methods: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted. Results: Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined: in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 (SE=0.05), with a significance level of P〈0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 (SE=0.0S), with a significance level of P〈0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 (SE=0.04), with a significance level of P〈0.0001. The sensitivity of CA19-9 was also evaluated: in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 (SE=0.05), with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE=0.05), with a significance level of P〈0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.S80 (SE=0.05), with a significance level ofP=0.1670. The following were the sensitivities of CEA/CA19-9 combined: in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 (95% CI: 0.0159-0.322); gastric cancer, sensitivity=S8%, NPV=70.42%, SE=0.072 (9$% CI: -0.0866-0.198); and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 (9S% CI: 0.137-0.415). Conclusion: CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.展开更多
基金supported by the National Social Science Fund of China(Grand No.21XTJ001).
文摘A Receiver Operating Characteristic(ROC)analysis of a power is important and useful in clinical trials.A Classical Conditional Power(CCP)is a probability of a classical rejection region given values of true treatment effect and interim result.For hypotheses and reversed hypotheses under normal models,we obtain analytical expressions of the ROC curves of the CCP,find optimal ROC curves of the CCP,investigate the superiority of the ROC curves of the CCP,calculate critical values of the False Positive Rate(FPR),True Positive Rate(TPR),and cutoff of the optimal CCP,and give go/no go decisions at the interim of the optimal CCP.In addition,extensive numerical experiments are carried out to exemplify our theoretical results.Finally,a real data example is performed to illustrate the go/no go decisions of the optimal CCP.
文摘Objective To evaluate the sensitivity and specificity of body mass index (BMI), waist circumference (WC) and waist-to-hip ratio (WHR) measurements in diagnosing abdominal visceral obesity. Methods BMI, WC, and WHR were assessed in 690 Chinese adults (305 men and 385 women) and compared with magnetic resonance imaging (MRI) measurements of abdominal visceral adipose tissue (VA). Receiver operating characteristic (ROC) curves were generated and used to determine the threshold point for each anthropometric parameter. Results 1) MRI showed that 61.7% of overweight/obese individuals (BMI≥25 kg/m2) and 14.2% of normal weight (BMI<25 kg/m2) individuals had abdominal visceral obesity (VA≥100 cm2). 2) VA was positively correlated with each anthropometric variable, of which WC showed the highest correlation (r=0.73-0.77, P<0.001). 3) The best cut-off points for assessing abdominal visceral obesity were as followed: BMI of 26 kg/m2, WC of 90 cm, and WHR of 0.93, with WC being the most sensitive and specific factor. 4) Among subjects with BMI≥28 kg/m2 or WC≥95 cm, 95% of men and 90% of women appeared to have abdominal visceral obesity. Conclusion Measurements of BMI, WC, and WHR can be used in the prediction of abdominal visceral obesity, of which WC was the one with better accuracy.
文摘Objective: To determine the endemic values of cutaneous leishmaniasis in different cities of Fars province, Iran. Methods: Totally, 29 201 cases registered from 2010 to 2015 in Iranian Fars province were selected, and the endemic values of cutaneous leishmaniasis were determined by retrospective clusters derived from spatiotemporal permutation modeling on a time-series design. The accuracy of the values was assessed using receiver operating characteristic(ROC) curve. SPSS version 22, Arc GIS, and ITSM 2002 software tools were used for analysis. Results: Nine statistically significant retrospective clusters(P<0.05) resulted in finding seven significant and accurate endemic values(P<0.1). These valid endemic scores were generalized to the other 18 cities based on 6 different climates in the province. Conclusions: Retrospectively detected clusters with the help of ROC curve analysis could help determine cutaneous leishmaniasis endemic values which are essential for future prediction and prevention policies in the area.
基金Supported by Starting Research Fund from the Gannan Medical University,No.QD202121。
文摘BACKGROUND With the increasing global incidence of mental illness,depression has become a serious problem among college students.AIM To investigate the relationship between depression and its correlates in Chinese adolescents and to identify diagnostic predictors of depression,examine the effects of binge eating,physical activity,and body dissatisfaction on depression among college students and to determine a diagnostic cutoff value for depression based on body dissatisfaction.METHODS We conducted a cross-sectional survey of 1286 college students in South China.Physical activity level,depressive symptoms,and binge eating behavior were assessed using the Physical Activity Scale-3,Zung Self-Rating Depression Scale,and Dutch Eating Behavior Questionnaire,respectively.The absolute difference between actual body mass index(BMI)and ideal BMI was used to indicate the level of body dissatisfaction.Structural equation modeling(SEM)and receiver operating characteristic(ROC)curve analysis were used to examine the relationships between these variables and depression.RESULTS The findings showed that female college students reported higher levels of depression.Physical activity,body dissatisfaction,and binge eating behavior were significantly associated with depression.SEM revealed that body dissatisfaction played a mediating role.A body dissatisfaction score of 1.73 was identified as the diagnostic cutoff value for predicting depression,with an area under the ROC curve of 70.0%,providing a basis for targeted interventions.CONCLUSION This study demonstrated a significant positive correlation between body dissatisfaction and depression.Low levels of physical activity and binge eating behaviors were found to heighten the risk of depression.Therefore,promoting physical activity and healthy eating habits among adolescents is essential.Additionally,the identification of a diagnostic threshold for body dissatisfaction represents a novel finding with important implications for early screening.Future longitudinal studies are recommended to further refine this diagnostic criterion.
基金Supported by Science and Technology Program of Guangzhou,No.2024A03J1029Science and Technology Program of Chinese Medicine and Integrated Chinese and Western Medicine in Guangzhou,No.20252A010001.
文摘BACKGROUND Contrast-enhanced ultrasonography(CEUS)is utilized to assess the therapeutic efficacy of interventional therapy in liver cancer patients,offering insights into tumor blood flow changes,angiogenesis,and tumor markers.AIM To evaluate the use of CEUS in examining the effectiveness of interventional therapy for liver cancer,we aim to investigate its diagnostic utility for tumor perfusion patterns,microvessel density,perfusion recovery,blood flow enhancement response,and alterations in tumor markers among patients receiving interventional therapy for liver cancer.METHODS The study involved 124 patients who underwent interventional therapy for liver cancer at Guangzhou First People’s Hospital from January 2022 to February 2024.All patients were examined using CEUS before treatment and at 1 month,3 months,and 6 months,and the concentrations of tumor markers were collected and statistically analyzed using Statistical Package for the Social Sciences 25.0.Receiver operating characteristic(ROC)curves were used to evaluate the diagnostic efficacy of CEUS and analyze its sensitivity,specificity,and correlation with clinical indicators.RESULTS Before treatment,tumor blood flow was primarily enhanced.After treatment,enhanced perfusion declined,while uniform and non-uniform perfusion increased,indicating reduced tumor activity.Enhanced perfusion decreased from 68.25%before treatment to 53.75%at 6 months post-treatment(F=6.123,P=0.016),indicating reduced tumor activity.The microvessel density of the tumors decreased significantly after treatment(P<0.05),and the proportion of low microvessel density increased.After treatment,perfusion recovery in the tumor area improved,the proportion of complete and partial responses gradually increased,and the proportion of stable lesions decreased(P<0.05).The levels of alphafetoprotein,carcinoembryonic antigen,and carbohydrate antigen 19-9 decreased by 68.7%,30.4%,and 41.6%,respectively,at 6 months post-treatment(P<0.05).CEUS showed a sensitivity of 85.72%,specificity of 92.31%,and area under the curve of 0.911(95%CI:0.883–0.939)for evaluating treatment response.ROC curve analysis showed that CEUS had high sensitivity and specificity and could effectively evaluate the efficacy of interventional therapy for liver cancer.CONCLUSION CEUS has high diagnostic value in evaluating therapeutic effects in patients with liver cancer following interventional therapy.It can reflect changes in tumor blood flow,angiogenesis,and tumor marker levels,providing an effective basis for real-time monitoring of treatment outcomes.
文摘Chinese men should have a higher prostate-specific antigen (PSA) "gray zone" than the traditional value of 2.5-10.0 ng ml-1 since the incidence of prostate cancer (PCa) in Chinese men is relative low. We hypothesized that PSA density (PSAD) could improve the rate of PCa detection in Chinese men with a PSA higher than the traditional PSA "gray zone." A total of 461 men with a PSA between 2.5 and 20.0 ng ml-1, who had undergone prostatic biopsy at two Chinese centers were included in the analysis. The men were then further divided into groups with a PSA between 2.5-10.0 ng ml-1 and 10.1-20.0 ng ml-1. Receiver operating characteristic (ROC) curve was used to evaluate the efficacy of PSA and PSAD for the diagnosis of PCa. In men with a PSA of 2.5-10.0 ng ml-1 or 10.1-20.0 ng ml-z, the areas under the ROC curve were higher for PSAD than for PSA. This was consistent across both centers and the cohort overall. When the entire cohort was considered, the optimal PSAD cut-off for predicting PCa in men with a PSA of 2.5-10.0 ng m1-1 was 0.15 ng ml-2 ml-2, with a sensitivity of 64.4% and specificity of 64.6%. The optimal cut-off for PSAD in men with a PSA of 10.1-20.0 ng m1-1 was 0.33 ng ml-1 ml-1, with a sensitivity of 60.3% and specificity of 82.7%. PSAD can improve the effectiveness for PCa detection in Chinese men with a PSA of 2.5-10.0 ng ml-1 (traditional Western PSA "gray zone") and 10.1-20.0 ng ml-2 (Chinese PSA "gray zone").
基金the financial support provided by the Biotechnology Information Service–Sub-Distributed Information Centre(supported by the Department of Biotechnology,Government of India)Advanced Bioinformatics Centre(supported by the Government of Rajasthan)at Birla Institute of Scientific Research for the infrastructure and facilities for conducting statistical work
文摘Objective: To determine the clinical serum levels of carcinoembryonic antigen (CEA) and carbohydrate antigen 19-9 (CA19-9), individually and in combination, for the diagnosis of 50 healthy subjects and 150 cases of esophageal, gastric, and colon cancers. Methods: The sensitivities of the two markers were compared individually and in combination, with specificity set at 100%. Receiver operating characteristic (ROC) curves were plotted. Results: Serum CEA levels were significantly higher in cancer patients than in the control group. The sensitivity of CEA was determined: in esophageal cancer, sensitivity=28%, negative predictive value (NPV)=61.72%, and AUC=0.742 (SE=0.05), with a significance level of P〈0.0001; in gastric cancer, sensitivity=30%, NPV=58.82%, and AUC=0.734 (SE=0.0S), with a significance level of P〈0.0001; in colon cancer, sensitivity=74%, NPV=79.36%, and AUC=0.856 (SE=0.04), with a significance level of P〈0.0001. The sensitivity of CA19-9 was also evaluated: in esophageal cancer, sensitivity=18%, NPV=54.94%, and AUC=0.573 (SE=0.05), with a significance level of P=0.2054. In gastric cancer, sensitivity=42%, NPV=63.29%, and AUC=0.679 (SE=0.05), with a significance level of P〈0.0011. In colon cancer, sensitivity=26%, NPV=57.47%, and AUC=0.S80 (SE=0.05), with a significance level ofP=0.1670. The following were the sensitivities of CEA/CA19-9 combined: in esophageal cancer, sensitivity=42%, NPV=63.29%, SE=0.078 (95% CI: 0.0159-0.322); gastric cancer, sensitivity=S8%, NPV=70.42%, SE=0.072 (9$% CI: -0.0866-0.198); and colon cancer, sensitivity=72%, NPV=78.12%, SE=0.070 (9S% CI: 0.137-0.415). Conclusion: CEA exhibited the highest sensitivity for colon cancer, and CA19-9 exhibited the highest sensitivity for gastric cancer. Combined analysis indicated an increase in diagnostic sensitivity in esophageal and gastric cancer compared with that in colon cancer.