Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus
The idiopathic normal pressure hydrocephalus (iNPH) Radscale was developed to standardize the evaluation of radiological signs in iNPH. The purpose of this study was to estimate the diagnostic accuracy of the iNPH Radscale in a sample of "true positive" and "true negative" cases....
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| Veröffentlicht in: | PloS one 2020-04, Vol.15 (4), p.e0232275 |
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| creator | Kockum, Karin Virhammar, Johan Riklund, Katrine Söderström, Lars Larsson, Elna-Marie Laurell, Katarina |
| description | The idiopathic normal pressure hydrocephalus (iNPH) Radscale was developed to standardize the evaluation of radiological signs in iNPH. The purpose of this study was to estimate the diagnostic accuracy of the iNPH Radscale in a sample of "true positive" and "true negative" cases.
Seventy-five patients with definite iNPH, i.e. who had improved at clinical follow-up one year after ventriculoperitoneal shunt surgery, were compared with 55 asymptomatic individuals from the general population. A radiologist assessed the seven radiological features of the iNPH Radscale in computed tomography of the brain in the patients (preoperatively) and controls.
The iNPH Radscale score was significantly higher in the iNPH group (Median = 10, interquartile range 9-11) than in the control group (Median = 1, interquartile range 1-2) (p |
| doi_str_mv | 10.1371/journal.pone.0232275 |
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Seventy-five patients with definite iNPH, i.e. who had improved at clinical follow-up one year after ventriculoperitoneal shunt surgery, were compared with 55 asymptomatic individuals from the general population. A radiologist assessed the seven radiological features of the iNPH Radscale in computed tomography of the brain in the patients (preoperatively) and controls.
The iNPH Radscale score was significantly higher in the iNPH group (Median = 10, interquartile range 9-11) than in the control group (Median = 1, interquartile range 1-2) (p <0.001). Receiver operated characteristics analysis yielded an area under the curve of 99.7%, and an iNPH Radscale score ≤ 4 identified those without iNPH, with a sensitivity of 100%, specificity of 96% and overall accuracy of 98.5%.
In this study, iNPH Radscale could accurately discriminate between patients with definite iNPH and asymptomatic individuals over 65 years old. According to the results, a diagnosis of iNPH is very likely in patients with an iNPH Radscale score above 8 and corresponding clinical symptoms. On the other hand, the diagnosis should be questioned when the iNPH Radscale score is below the cut-off level of 4. We conclude that the iNPH Radscale could work as a diagnostic screening tool to detect iNPH. Whether the scale also can be used to predict shunt outcome needs further studies.</description><identifier>ISSN: 1932-6203</identifier><identifier>EISSN: 1932-6203</identifier><identifier>DOI: 10.1371/journal.pone.0232275</identifier><identifier>PMID: 32330190</identifier><language>eng</language><publisher>United States: Public Library of Science</publisher><subject>Accuracy ; Alzheimer's disease ; Biology and Life Sciences ; Brain research ; CAT scans ; Comparative analysis ; Computed tomography ; Diagnosis ; Diagnostic imaging ; Diagnostic software ; Diagnostic systems ; Ethics ; Hospitals ; Hydrocephalus ; Medical diagnosis ; Medicine and Health Sciences ; Neurosciences ; Normal pressure hydrocephalus ; Patients ; People and Places ; Population ; Pressure ; Research and Analysis Methods ; Studies ; Surgery ; Tomography ; Ventriculoperitoneal shunt</subject><ispartof>PloS one, 2020-04, Vol.15 (4), p.e0232275</ispartof><rights>COPYRIGHT 2020 Public Library of Science</rights><rights>2020 Kockum et al. This is an open access article distributed under the terms of the Creative Commons Attribution License: http://creativecommons.org/licenses/by/4.0/ (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License.</rights><rights>2020 Kockum et al 2020 Kockum et al</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c767t-c9a6eead387ae5b4c4f92072b9db3c931430afa9a98de7226bcf1b3aa67264f93</citedby><cites>FETCH-LOGICAL-c767t-c9a6eead387ae5b4c4f92072b9db3c931430afa9a98de7226bcf1b3aa67264f93</cites><orcidid>0000-0002-7504-8354 ; 0000-0002-4686-0941</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182203/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC7182203/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,552,727,780,784,864,885,2102,2928,23866,27924,27925,53791,53793,79600,79601</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/32330190$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:umu:diva-169522$$DView record from Swedish Publication Index$$Hfree_for_read</backlink><backlink>$$Uhttps://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-412957$$DView record from Swedish Publication Index$$Hfree_for_read</backlink></links><search><contributor>Burger, Michael C.</contributor><creatorcontrib>Kockum, Karin</creatorcontrib><creatorcontrib>Virhammar, Johan</creatorcontrib><creatorcontrib>Riklund, Katrine</creatorcontrib><creatorcontrib>Söderström, Lars</creatorcontrib><creatorcontrib>Larsson, Elna-Marie</creatorcontrib><creatorcontrib>Laurell, Katarina</creatorcontrib><title>Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus</title><title>PloS one</title><addtitle>PLoS One</addtitle><description>The idiopathic normal pressure hydrocephalus (iNPH) Radscale was developed to standardize the evaluation of radiological signs in iNPH. The purpose of this study was to estimate the diagnostic accuracy of the iNPH Radscale in a sample of "true positive" and "true negative" cases.
Seventy-five patients with definite iNPH, i.e. who had improved at clinical follow-up one year after ventriculoperitoneal shunt surgery, were compared with 55 asymptomatic individuals from the general population. A radiologist assessed the seven radiological features of the iNPH Radscale in computed tomography of the brain in the patients (preoperatively) and controls.
The iNPH Radscale score was significantly higher in the iNPH group (Median = 10, interquartile range 9-11) than in the control group (Median = 1, interquartile range 1-2) (p <0.001). Receiver operated characteristics analysis yielded an area under the curve of 99.7%, and an iNPH Radscale score ≤ 4 identified those without iNPH, with a sensitivity of 100%, specificity of 96% and overall accuracy of 98.5%.
In this study, iNPH Radscale could accurately discriminate between patients with definite iNPH and asymptomatic individuals over 65 years old. According to the results, a diagnosis of iNPH is very likely in patients with an iNPH Radscale score above 8 and corresponding clinical symptoms. On the other hand, the diagnosis should be questioned when the iNPH Radscale score is below the cut-off level of 4. We conclude that the iNPH Radscale could work as a diagnostic screening tool to detect iNPH. Whether the scale also can be used to predict shunt outcome needs further studies.</description><subject>Accuracy</subject><subject>Alzheimer's disease</subject><subject>Biology and Life Sciences</subject><subject>Brain research</subject><subject>CAT scans</subject><subject>Comparative analysis</subject><subject>Computed tomography</subject><subject>Diagnosis</subject><subject>Diagnostic imaging</subject><subject>Diagnostic software</subject><subject>Diagnostic systems</subject><subject>Ethics</subject><subject>Hospitals</subject><subject>Hydrocephalus</subject><subject>Medical diagnosis</subject><subject>Medicine and Health Sciences</subject><subject>Neurosciences</subject><subject>Normal pressure hydrocephalus</subject><subject>Patients</subject><subject>People and Places</subject><subject>Population</subject><subject>Pressure</subject><subject>Research and Analysis 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one</jtitle><addtitle>PLoS One</addtitle><date>2020-04-24</date><risdate>2020</risdate><volume>15</volume><issue>4</issue><spage>e0232275</spage><pages>e0232275-</pages><issn>1932-6203</issn><eissn>1932-6203</eissn><abstract>The idiopathic normal pressure hydrocephalus (iNPH) Radscale was developed to standardize the evaluation of radiological signs in iNPH. The purpose of this study was to estimate the diagnostic accuracy of the iNPH Radscale in a sample of "true positive" and "true negative" cases.
Seventy-five patients with definite iNPH, i.e. who had improved at clinical follow-up one year after ventriculoperitoneal shunt surgery, were compared with 55 asymptomatic individuals from the general population. A radiologist assessed the seven radiological features of the iNPH Radscale in computed tomography of the brain in the patients (preoperatively) and controls.
The iNPH Radscale score was significantly higher in the iNPH group (Median = 10, interquartile range 9-11) than in the control group (Median = 1, interquartile range 1-2) (p <0.001). Receiver operated characteristics analysis yielded an area under the curve of 99.7%, and an iNPH Radscale score ≤ 4 identified those without iNPH, with a sensitivity of 100%, specificity of 96% and overall accuracy of 98.5%.
In this study, iNPH Radscale could accurately discriminate between patients with definite iNPH and asymptomatic individuals over 65 years old. According to the results, a diagnosis of iNPH is very likely in patients with an iNPH Radscale score above 8 and corresponding clinical symptoms. On the other hand, the diagnosis should be questioned when the iNPH Radscale score is below the cut-off level of 4. We conclude that the iNPH Radscale could work as a diagnostic screening tool to detect iNPH. Whether the scale also can be used to predict shunt outcome needs further studies.</abstract><cop>United States</cop><pub>Public Library of Science</pub><pmid>32330190</pmid><doi>10.1371/journal.pone.0232275</doi><tpages>e0232275</tpages><orcidid>https://orcid.org/0000-0002-7504-8354</orcidid><orcidid>https://orcid.org/0000-0002-4686-0941</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Accuracy Alzheimer's disease Biology and Life Sciences Brain research CAT scans Comparative analysis Computed tomography Diagnosis Diagnostic imaging Diagnostic software Diagnostic systems Ethics Hospitals Hydrocephalus Medical diagnosis Medicine and Health Sciences Neurosciences Normal pressure hydrocephalus Patients People and Places Population Pressure Research and Analysis Methods Studies Surgery Tomography Ventriculoperitoneal shunt |
| title | Diagnostic accuracy of the iNPH Radscale in idiopathic normal pressure hydrocephalus |
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