Academic literature on the topic 'Diagnostic bias'

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Journal articles on the topic "Diagnostic bias"

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Ford, Michael H. "Diagnostic Bias?" Psychiatric Services 36, no. 11 (November 1985): 1218–19. http://dx.doi.org/10.1176/ps.36.11.1218.

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Chaturvedi, Santosh K. "Munchausen by Proxy: Diagnostic Bias?" Annals of Saudi Medicine 12, no. 1 (January 1992): 107. http://dx.doi.org/10.5144/0256-4947.1992.107.

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Armenakis, A. "Diagnostic bias in organizational consultation." Omega 18, no. 6 (1990): 563–72. http://dx.doi.org/10.1016/0305-0483(90)90048-e.

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Escobar, Javier I. "Diagnostic Bias: Racial and Cultural Issues." Psychiatric Services 63, no. 9 (September 2012): 847. http://dx.doi.org/10.1176/appi.ps.20120p847.

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Heijenbrok-Kal, Majanka H., and M. G. Myriam Hunink. "Adjusting for bias in diagnostic reports." American Journal of Medicine 112, no. 4 (March 2002): 322–24. http://dx.doi.org/10.1016/s0002-9343(02)01042-2.

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Shah, Hasmukh C. "Diagnostic bias in occupational epidemiologic studies." American Journal of Industrial Medicine 24, no. 2 (August 1993): 249–50. http://dx.doi.org/10.1002/ajim.4700240214.

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Hughes, J. M., C. Penney, S. Boyd, and P. Daley. "Risk of bias and limits of reporting in diagnostic accuracy studies for commercial point-of-care tests for respiratory pathogens." Epidemiology and Infection 146, no. 6 (March 21, 2018): 747–56. http://dx.doi.org/10.1017/s0950268818000596.

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AbstractCommercial point-of-care (POC) diagnostic tests for Group A Streptococcus, Streptococcus pneumoniae, and influenza virus have large potential diagnostic and financial impact. Many published reports on test performance, often funded by diagnostics companies, are prone to bias. The Standards for Reporting of Diagnostic Accuracy (STARD 2015) are a protocol to encourage accurate, transparent reporting. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool evaluates risk of bias and transportability of results. We used these tools to evaluate diagnostic test accuracy studies of POC studies for three respiratory pathogens. For the 96 studies analysed, compliance was <25% for 14/34 STARD 2015 standards, and 3/7 QUADAS-2 domains showed a high risk of bias. All reports lacked reporting of at least one criterion. These biases should be considered in the interpretation of study results.
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Furukawa, T. A. "Sources of bias in diagnostic accuracy studies and the diagnostic process." Canadian Medical Association Journal 174, no. 4 (February 14, 2006): 481–82. http://dx.doi.org/10.1503/cmaj.060014.

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Kleijnen, Jos, Marie Westwood, and Penny Whiting. "Applicability of diagnostic studies – statistics, bias and estimates of diagnostic accuracy." Zeitschrift für Evidenz, Fortbildung und Qualität im Gesundheitswesen 105, no. 7 (January 2011): 498–503. http://dx.doi.org/10.1016/j.zefq.2011.07.025.

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Field, Morton H. "Cognitive bias and diagnostic error (November 2015)." Cleveland Clinic Journal of Medicine 83, no. 6 (June 2016): 407–8. http://dx.doi.org/10.3949/ccjm.83c.06003.

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Dissertations / Theses on the topic "Diagnostic bias"

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LaRue, Gillian Christina. "Misdiagnosing Borderline Personality Disorder: Does Setting Bias and Gender Bias Influence Diagnostic Decision-Making?" Wright State University Professional Psychology Program / OhioLINK, 2020. http://rave.ohiolink.edu/etdc/view?acc_num=wsupsych1562840248763243.

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Parmley, Meagan Carleton Herbert James D. "The effects of the confirmation bias on diagnostic decision making /." Philadelphia, Pa. : Drexel University, 2006. http://hdl.handle.net/1860/1164.

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Perry, Sharon. "The role of diagnostic spectrum bias in cost-effectiveness analysis /." Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 1999. http://wwwlib.umi.com/cr/ucsd/fullcit?p9944225.

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Thomas, Richard. "A comparison of methodologies in a diagnostic overshadowing study : clinical impressions of short case presentations." Thesis, University of Southampton, 2003. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.288441.

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Lu, Ying 1968. "Bayesian estimation of diagnostic test parameters in the presence of verification bias." Thesis, McGill University, 2006. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=98755.

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The statistical evaluation of diagnostic tests may be affected by several potential biases. These biases include those caused by a study design that results in a non-representative sub-sample who are further verified by the reference test (verification bias), and those caused by the absence of a definitive diagnostic test (gold standard test) for many diseases and conditions. In practice, an imperfect reference test is often assumed to be a perfect gold standard, potentially resulting in a large bias. Both Bayesian and frequentist methods have been proposed to adjust for each of these biases independently. To our knowledge, there is no Bayesian solution for that adjusts for both of these biases simultaneously. The objective of this thesis is to present a Bayesian method for the evaluation of diagnostic tests when both of these potential biases may be operating simultaneously. We develop a likelihood function that models both sources of bias, and suggest convenient prior distributions that simplify deriving posterior distributions. The models are based on dichotomous test results and the parameters of interest are estimated using a Gibbs sampler. Using both simulated and real data examples, we demonstrate that the method presented here can correct the verification bias even when a perfect gold standard test does not exist.
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Alonzo, Todd Allen. "Assessing accuracy of a continuous medical diagnostic or screening test in the presence of verification bias /." Thesis, Connect to this title online; UW restricted, 2000. http://hdl.handle.net/1773/9600.

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Kan, Hongjun. "Does the Medicare principal inpatient diagnostic cost group model adequately adjust for selection bias?" Santa Monica, CA : RAND Graduate School, 2002. http://catalog.hathitrust.org/api/volumes/oclc/50711061.html.

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Adams, Pamela (Pamela Ann). "Bias in the Diagnosis and Treatment of Gay Males." Thesis, University of North Texas, 1996. https://digital.library.unt.edu/ark:/67531/metadc278199/.

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The purpose of this study was to explore heterosexual bias in the diagnosis and treatment of gay males. Two hundred-fifty (134 males and 116 females) mental health professionals from the Division of Psychotherapy (29) of the American Psychological Association participated in the study. Participants were randomly assigned to one of two case history conditions, which presented a 35-year-old male seeking therapy. Both conditions were equivalent with regards to the presenting problem (i.e., diagnostic symptoms) with the exception of his significant other (i.e., gay vs. non-gay condition). Potential bias was measured through a diagnostic rating Likert scale and a treatment plan questionnaire. Other independent variables that could potentially have an effect on diagnostic ratings were explored, such as gender, year of graduation, and theoretical orientation of the respondents. Results of the statistical analyses failed to confirm evidence of heterosexual bias. Implications for further research and training are discussed.
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Wang, Binhuan. "Statistical Evaluation of Continuous-Scale Diagnostic Tests with Missing Data." Digital Archive @ GSU, 2012. http://digitalarchive.gsu.edu/math_diss/8.

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The receiver operating characteristic (ROC) curve methodology is the statistical methodology for assessment of the accuracy of diagnostics tests or bio-markers. Currently most widely used statistical methods for the inferences of ROC curves are complete-data based parametric, semi-parametric or nonparametric methods. However, these methods cannot be used in diagnostic applications with missing data. In practical situations, missing diagnostic data occur more commonly due to various reasons such as medical tests being too expensive, too time consuming or too invasive. This dissertation aims to develop new nonparametric statistical methods for evaluating the accuracy of diagnostic tests or biomarkers in the presence of missing data. Specifically, novel nonparametric statistical methods will be developed with different types of missing data for (i) the inference of the area under the ROC curve (AUC, which is a summary index for the diagnostic accuracy of the test) and (ii) the joint inference of the sensitivity and the specificity of a continuous-scale diagnostic test. In this dissertation, we will provide a general framework that combines the empirical likelihood and general estimation equations with nuisance parameters for the joint inferences of sensitivity and specificity with missing diagnostic data. The proposed methods will have sound theoretical properties. The theoretical development is challenging because the proposed profile log-empirical likelihood ratio statistics are not the standard sum of independent random variables. The new methods have the power of likelihood based approaches and jackknife method in ROC studies. Therefore, they are expected to be more robust, more accurate and less computationally intensive than existing methods in the evaluation of competing diagnostic tests.
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Wang, Zhuoyu. "Bias from a missing covariate in the analysis of diagnostic test data in the absence of a gold-standard." Thesis, McGill University, 2013. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=119705.

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Covariates that influence the sensitivity and/or specificity of different diagnostic tests can create correlations between these tests, conditional on disease status. Thus, ignoring such covariates in a latent class analysis of imperfect tests would amount to ignoring conditional dependence, potentially leading to biased estimates of the prevalence of the condition under study and the accuracies of the tests. In the case of a dichotomous covariate affecting two imperfect tests, we derive an expression showing that the conditional covariance is a function of the product of the change in test sensitivity (or specificity) within subgroups defined by the covariate. For a uniformly or normally distributed continuous covariate, similar results are obtained numerically. Using series of simulated datasets, we study whether in the absence of covariate, unbiased estimates may be obtained by fitting a latent class model that allows for conditional dependence. We found that bias induced by ignoring the dependence and using a conditional independence model is not large in most cases. In cases where bias is present, a conditional dependence model, which places no constraints on the covariance between the tests, works well in adjusting for all three types of missing covariates. Our methods are applied to diagnostic testing data for the detection of tuberculosis which varies by the covariate HIV status.
Les covariables qui influencent la sensibilité et/ou la spécificité des différents tests de diagnostic peuvent créer des corrélations entre ces tests, conditionnellement à l'état de la maladie. Ainsi, en ignorant ces variables dans une analyse de classe latente de tests imparfaits, on en reviendrait à ignorer la dépendance conditionnelle pouvant conduire à des estimations biaisées de la prévalence de la condition sous étude ainsi qu'à la précision des tests. Dans le cas d'une covariable dichotomique affectant deux essais imparfaits, nous dérivons une expression qui montre que la covariance conditionnelle est une fonction du produit de la variation de la sensibilité du test (ou de la spécificité) dans les sous-groupes définis par la covariable. Pour une covariable continue distribuée uniformément ou normalement des résultats similaires sont obtenus numériquement. En utilisant des séries de données simulées, nous étudions si, avec l'absence de covariable, des estimations impartiales peuvent être obtenues en ajustant un modèle de classe latente permettant la dépendance conditionnelle. Nous avons constaté, en ignorant la dépendance et en utilisant un modèle d'indépendance conditionnelle, que le biais induit n'est pas grand dans la plupart des cas. Dans les cas où le biais est présent, un modèle de dépendance conditionnelle qui n'impose pas de contraintes sur la covariance entre les tests fonctionne bien en ajustant tous les trois types de variables manquantes. Nos méthodes sont appliquées aux données des tests diagnostiques pour le dépistage de la tuberculose qui varient en fonction du statut de la covariable du VIH.
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Books on the topic "Diagnostic bias"

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Kan, Hongjun. Does the Medicare Principal Inpatient Diagnostic Cost Group model adequately adjust for selection bias? Santa Monica, Calif: RAND Graduate School, 2002.

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Zhong yi zhen duan biao jie. Nanjing Shi: Jiangsu ke xue ji shu chu ban she, 2008.

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J, Caplan Paula, and Cosgrove Lisa, eds. Bias in psychiatric diagnosis / edited by Paula J. Caplan and Lisa Cosgrove. Lanham: Jason Aronson, 2004.

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Roades, Laurie Ann. Gender and race bias in the diagnosis of major depressive episode and alcohol dependence. Ann Arbor: UMI, 1994.

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Krouwer, Jan S. Method comparison and bias estimation using patient samples: Approved guidelines. 2nd ed. Wayne, Pa: Clinical and Laboratory Standards Institute, 2010.

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Zhong yi bian zheng de ji qi tui yan. Beijing: Ke xue chu ban she, 2009.

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Jianzhang, Chen, ed. Zhong yi 150 zheng hou bian zheng lun zhi ji yao. Beijing Shi: Xue yuan chu ban she, 2003.

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Yongkun, Ding, ed. Ji guang guan xing yue shu ju bian zhen duan xue: Laser Inertial Confinement Fusion Diagnostics. Beijing: Guo fang gong ye chu ban she, 2012.

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Zhong yi zhi he: Bian zheng lun zhi de sheng ming zhe xue = Zhongyi zhi he : bianzheng lunzhi de shengming zhexue. Guilin Shi: Guangxi shi fan da xue chu ban she, 2011.

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Zhong yi xin bing zhen duan liao xiao biao zhun yu yong yao gui fan. Beijing: Beijing chu ban she, 2002.

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Book chapters on the topic "Diagnostic bias"

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Howard, Jonathan. "Hindsight Bias and Outcome Bias." In Cognitive Errors and Diagnostic Mistakes, 247–64. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_14.

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Howard, Jonathan. "Information Bias." In Cognitive Errors and Diagnostic Mistakes, 303–6. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_17.

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Howard, Jonathan. "Omission Bias." In Cognitive Errors and Diagnostic Mistakes, 321–44. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_19.

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Howard, Jonathan. "Overconfidence Bias." In Cognitive Errors and Diagnostic Mistakes, 351–67. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_21.

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Howard, Jonathan. "Representativeness Bias." In Cognitive Errors and Diagnostic Mistakes, 425–43. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_24.

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Howard, Jonathan. "Financial Bias." In Cognitive Errors and Diagnostic Mistakes, 109–38. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_8.

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Howard, Jonathan. "Blind Spot Bias." In Cognitive Errors and Diagnostic Mistakes, 525–35. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_29.

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Howard, Jonathan. "Selection Bias and Endowment Effect." In Cognitive Errors and Diagnostic Mistakes, 457–66. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_26.

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Howard, Jonathan. "Bandwagon Effect and Authority Bias." In Cognitive Errors and Diagnostic Mistakes, 21–56. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_3.

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Howard, Jonathan. "Confirmation Bias, Motivated Cognition, the Backfire Effect." In Cognitive Errors and Diagnostic Mistakes, 57–88. Cham: Springer International Publishing, 2018. http://dx.doi.org/10.1007/978-3-319-93224-8_4.

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Conference papers on the topic "Diagnostic bias"

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Sirse, N., S. K. Karkari, and M. M. Turner. "Electro-negative plasma diagnostic using pulse bias hairpin probe." In 2012 IEEE 39th International Conference on Plasma Sciences (ICOPS). IEEE, 2012. http://dx.doi.org/10.1109/plasma.2012.6383656.

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Manservigi, Lucrezia, Mauro Venturini, Giuseppe Fabio Ceschini, Giovanni Bechini, and Enzo Losi. "A General Diagnostic Methodology for Sensor Fault Detection, Classification and Overall Health State Assessment." In ASME Turbo Expo 2019: Turbomachinery Technical Conference and Exposition. American Society of Mechanical Engineers, 2019. http://dx.doi.org/10.1115/gt2019-90055.

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Abstract Sensor fault detection and classification is a key challenge for machine monitoring and diagnostics. To this purpose, a comprehensive approach for Detection, Classification and Integrated Diagnostics of Gas Turbine Sensors (named DCIDS), previously developed by the authors, is improved in this paper to detect and classify different fault classes. For a single sensor or redundant/correlated sensors, the improved diagnostic tool, called I-DCIDS, can identify seven classes of fault, i.e. out of range, stuck signal, dithering, standard deviation, trend coherence, spike and bias. Fault detection is performed by means of basic mathematical laws that require some user-defined input parameters, i.e. acceptability thresholds and windows of observation. This paper presents in detail the I-DCIDS methodology for sensor fault detection and classification. Moreover, this paper reports some examples of application of the methodology to simulated data to highlight its capability to detect sensor faults which can be commonly encountered in field applications.
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King, K. B., O. Ashraf, A. Virani, and E. Bihler. "Pott’s Disease Masquerading as Musculoskeletal Back Pain: A Lesson in Diagnostic Bias." In American Thoracic Society 2021 International Conference, May 14-19, 2021 - San Diego, CA. American Thoracic Society, 2021. http://dx.doi.org/10.1164/ajrccm-conference.2021.203.1_meetingabstracts.a4023.

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Romessis, C., and K. Mathioudakis. "Setting Up of a Probabilistic Neural Network for Sensor Fault Detection Including Operation With Component Faults." In ASME Turbo Expo 2002: Power for Land, Sea, and Air. ASMEDC, 2002. http://dx.doi.org/10.1115/gt2002-30030.

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The diagnostic ability of Probabilistic Neural Networks (PNN) for detecting sensor faults on gas turbines is examined. The structure and the features of a PNN, for sensor fault detection, are presented. It is shown that with the proposed formulation, a powerful tool for sensor fault identification is produced. A particular feature of the PNN produced is the ability to detect sensor faults even in the presence of engine component malfunction, as well as on deteriorated engines. In such situations, the size of bias that can be identified increases. The way to establish the limits of sensor bias that can be detected is presented along with results from application to test cases with realistic noise magnitudes. The diagnostic procedure proposed here is also supported by an engine performance model. The data used for setting up and testing the PNN are generated by such a model.
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Ballal, D. R., T. H. Chen, and W. J. Schmoll. "Laser Diagnostics for Gas Turbine Combustion Research." In ASME 1988 International Gas Turbine and Aeroengine Congress and Exposition. American Society of Mechanical Engineers, 1988. http://dx.doi.org/10.1115/88-gt-128.

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Gas turbine combustors pose many modeling and design difficulties. This has created an urgent need for experimental research using laser diagnostics to validate and refine computer design models of combustors. In this paper, key practical problems, limitations, and our operational experience with laser diagnostic systems for gas turbine combustion research are described. It is found that unavailability of a good LDA seeder design and an unambiguous particle bias correction scheme present the main obstacles to using LDA in gas turbine combustor measurements. The practical problems of the Raman/Rayleigh system, particularly above 1200 K are high background luminosity, beam steering due to unmixedness, and high Poisson uncertainty in temperature and concentration measurements. The integration of LDA-Raman systems is beset by optical and data acquisition difficulties. Therefore, considerable work is still required to make the applications of advanced laser diagnostics to measurements in a practical gas turbine combustor a reality.
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Verbist, Michel L., Wilfried P. J. Visser, Jos P. van Buijtenen, and Rob Duivis. "Gas Path Analysis on KLM In-Flight Engine Data." In ASME 2011 Turbo Expo: Turbine Technical Conference and Exposition. ASMEDC, 2011. http://dx.doi.org/10.1115/gt2011-45625.

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Gas-path-analysis (GPA) based diagnostic techniques enable health estimation of individual gas turbine components without the need for engine disassembly. Currently, the Gas turbine Simulation Program (GSP) gas path analysis tool is used at KLM Engine Services to assess component conditions of the CF6-50, CF6-80 and CFM56-7B engine families during post-overhaul performance acceptance tests. The engine condition can be much more closely followed if on-wing (i.e., in-flight) performance data are analyzed also. By reducing unnecessary maintenance due to incorrect diagnosis, maintenance costs can be reduced, safety improved and engine availability increased. Gas path analysis of on-wing performance data is different in comparison to gas path analysis with test cell data. Generally fewer performance parameters are recorded on-wing and the available data are more affected by measurement uncertainty including sensor noise, sensor bias and varying operating conditions. Consequently, this reduces the potential and validity of the diagnostic results. In collaboration with KLM Engine Services, the feasibility of gas path analysis with on-wing performance data is assessed. In this paper the results of the feasibility study are presented, together with some applications and case studies of preliminary GPA results with on-wing data.
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Vieira, Daniella Serafin Couto, Sandro Wopereis, Laura Otto Walter, and Maria Claudia Santos da Silva. "VALIDATION OF IMMUNOPHENOTYPING BY FLOW CYTOMETRY IN THE INVESTIGATION OF DIAGNOSTIC AND PROGNOSTIC MARKERS FOR BREAST CANCER." In Scientifc papers of XXIII Brazilian Breast Congress - 2021. Mastology, 2021. http://dx.doi.org/10.29289/259453942021v31s1021.

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Introduction: Due to the high prevalence of breast cancer, it has a major financial impact on health systems. Currently, the diagnosis is made by morphological and immunohistochemical analysis (IHC). However, this methodology has some limitations. Therefore, methodologies capable of rapid and safe detection of tumor cells are needed, which can assist those already in use. Objectives: To validate immunophenotyping by flow cytometry (FC) in the investigation of diagnostic and prognostic markers for breast cancer; and to investigate lymphocytes subtypes infiltrated in the tumor and their relationship with tumor development. Methods: 52 breast tumor samples were sectioned and macerated in phosphatesaline buffer and stained with antibodies against estradiol (RE), progesterone (RP), HER2, Ki67, CD3, CD4, CD8 and CD45 receptors and analyzed by FC. All results were compared with IHC (reference method) in relation to sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), except for Ki67, where bias was compared between methodologies and correlation between lymphocyte subtypes and tumor characteristics. Results: The comparison of the FC with the IHC for each marker presented the RE analysis (sensitivity: 75%, specificity: 90%, PPV: 96.7%, VPN: 47.4%); PR analysis (sensitivity: 72%, specificity: 70%, PPV: 79.3%, VPN: 60.8%); analysis of HER2 (sensitivity: 80%, specificity: 90.2%, PPV: 66.7%, VPN: 94.9%). The analysis of Ki67 by FC was shown to be equivalent to IHC, with the advantage of not having an observational bias. No correlations were observed between the molecular subtype intratumor lymphocyte population profile and the tumor histological grade. Conclusion: The results show the FC’s ability to safely and quickly detect breast cancer markers used in clinical practice. It is believed that the use of FC, in conjunction with morphological analysis and IHC, can overcome the individual limitations of each of the methodologies and provide reliable results in a faster and more efficient way, which will result in faster diagnoses and more accurate prognoses, directly benefiting patients.
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Tipa, Andrea, Alessandro Sorce, Matteo Pascenti, and Alberto Traverso. "A New Sensor Diagnostic Technique Applied to a Micro Gas Turbine Rig." In ASME Turbo Expo 2012: Turbine Technical Conference and Exposition. American Society of Mechanical Engineers, 2012. http://dx.doi.org/10.1115/gt2012-68580.

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This paper describes the development and testing of a new algorithm to identify faulty sensors, based on a statistical model using quantitative statistical process history. Two different mathematical models were used and the results were analyzed to highlight the impact of model approximation and random error. Furthermore, a case study was developed based on a real micro gas turbine facility, located at the University of Genoa. The diagnostic sensor algorithm aims at early detection of measurement errors such as drift, bias, and accuracy degradation (increase of noise). The process description is assured by a database containing the measurements selected under steady state condition and without faults during the operating life of the plant. Using an invertible statistical model and a combinatorial approach, the algorithm is able to identify sensor fault. This algorithm could be applied to plants in which historical data are available and quasi steady state conditions are common (e.g. Nuclear, Coal Fired, Combined Cycle).
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DePold, Hans, Jason Seigel, Allan Volponi, and Jonthan Hull. "Validation of Diagnostic Data With Statistical Analysis and Embedded Knowledge." In ASME Turbo Expo 2003, collocated with the 2003 International Joint Power Generation Conference. ASMEDC, 2003. http://dx.doi.org/10.1115/gt2003-38764.

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The method described in this paper is intended to improve data stability and reduce dispersion of a given parameter signal by replacing any point deemed to be noise (e.g. an outlier) with an estimate of the parameter based on its recent history. This method determines a point is an outlier by utilizing learning and analytical elements that automatically adjust to the dispersion of the input data and automatically model the underlying process. The analytical elements of this method contain two types of embedded knowledge. The first is physics based engineering knowledge based on known interrelationships between the parameters to provide evidence when a parameter data point is physically unexplainable. It also contains the rule-based knowledge of real gas turbine trend characteristics such as persistency, polarity, and monotonic direction. Once a parameter data point is suspected to be noise, the system validates that assessment with a persistency check. If no parameter trend shift is occurring, as determined by a lack of persistency, the parameter is deemed noise and is replaced with the parameter’s last good state. Persistency checks enable removing noise without obscuring shifts in data that could be occurring due to real system changes. The process is designed to decide within two points if a data point should be considered noise. The goal of the process presented here for improving the quality of gas generator data is to automatically replace all probable noise without distorting the underlying parameter signals. The metrics for success are a 25% reduction in the dispersion (e.g. scatter) of the data with no bias in the parameter central tendency (e.g. mean value), with no reduction the granularity of the parameter signal (visibility of anomalies), and with no delay in the detection of a real trend change.
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Ogaji, S. O. T., Y. G. Li, S. Sampath, and R. Singh. "Gas Path Fault Diagnosis of a Turbofan Engine From Transient Data Using Artificial Neural Networks." In ASME Turbo Expo 2003, collocated with the 2003 International Joint Power Generation Conference. ASMEDC, 2003. http://dx.doi.org/10.1115/gt2003-38423.

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Transient and steady state data may contain the same essential fault information but some faults have been shown to be more easily detectable from transient data because the transient records provide significant diagnostic content especially as the fault effects are magnified under transient. Various traditional and conventional techniques such as fault trees, fault matrixes, gas path analysis and its variants have been applied to gas path fault diagnosis of gas turbines. Recently, artificial intelligence techniques such as artificial neural networks (ANN) as well as optimization techniques such as genetic algorithm (GA) are being explored for fault diagnosis activities. In this paper, a novel approach to gas path fault diagnosis is proposed. The method involves the use of ANN with engine transient data. A set of nested neural networks designed to estimate independent parameter (efficiencies and flow capacities) changes due to faults within single or multiple components of a turbofan engine are presented. The approach involves classification and approximation type networks. Measurements from the engine are first assessed by a trained network and if a fault is diagnosed, are then classified into two groups — those originating from sensor faults and those from component faults, by another trained network. Other trained networks continue the fault isolation process and finally the magnitude of the fault(s) is quantified. A computer simulation of the process shows that results from a batched process of these networks can be obtained in less than three seconds. Four of the gas path components — intermediate pressure compressor (IPC), high pressure compressor (HPC), high pressure turbine (HPT) and low pressure turbine (LPT) — and measurements from eight sensors are considered. Sensor noise and bias are also considered in this analysis. The comparison of fault signatures from a steady state and transient process show that diagnosis with transient data can improve the accuracy of gas turbine fault diagnosis.
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Reports on the topic "Diagnostic bias"

1

Newman-Toker, David E., Susan M. Peterson, Shervin Badihian, Ahmed Hassoon, Najlla Nassery, Donna Parizadeh, Lisa M. Wilson, et al. Diagnostic Errors in the Emergency Department: A Systematic Review. Agency for Healthcare Research and Quality (AHRQ), December 2022. http://dx.doi.org/10.23970/ahrqepccer258.

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Objectives. Diagnostic errors are a known patient safety concern across all clinical settings, including the emergency department (ED). We conducted a systematic review to determine the most frequent diseases and clinical presentations associated with diagnostic errors (and resulting harms) in the ED, measure error and harm frequency, as well as assess causal factors. Methods. We searched PubMed®, Cumulative Index to Nursing and Allied Health Literature (CINAHL®), and Embase® from January 2000 through September 2021. We included research studies and targeted grey literature reporting diagnostic errors or misdiagnosis-related harms in EDs in the United States or other developed countries with ED care deemed comparable by a technical expert panel. We applied standard definitions for diagnostic errors, misdiagnosis-related harms (adverse events), and serious harms (permanent disability or death). Preventability was determined by original study authors or differences in harms across groups. Two reviewers independently screened search results for eligibility; serially extracted data regarding common diseases, error/harm rates, and causes/risk factors; and independently assessed risk of bias of included studies. We synthesized results for each question and extrapolated U.S. estimates. We present 95 percent confidence intervals (CIs) or plausible range (PR) bounds, as appropriate. Results. We identified 19,127 citations and included 279 studies. The top 15 clinical conditions associated with serious misdiagnosis-related harms (accounting for 68% [95% CI 66 to 71] of serious harms) were (1) stroke, (2) myocardial infarction, (3) aortic aneurysm and dissection, (4) spinal cord compression and injury, (5) venous thromboembolism, (6/7 – tie) meningitis and encephalitis, (6/7 – tie) sepsis, (8) lung cancer, (9) traumatic brain injury and traumatic intracranial hemorrhage, (10) arterial thromboembolism, (11) spinal and intracranial abscess, (12) cardiac arrhythmia, (13) pneumonia, (14) gastrointestinal perforation and rupture, and (15) intestinal obstruction. Average disease-specific error rates ranged from 1.5 percent (myocardial infarction) to 56 percent (spinal abscess), with additional variation by clinical presentation (e.g., missed stroke average 17%, but 4% for weakness and 40% for dizziness/vertigo). There was also wide, superimposed variation by hospital (e.g., missed myocardial infarction 0% to 29% across hospitals within a single study). An estimated 5.7 percent (95% CI 4.4 to 7.1) of all ED visits had at least one diagnostic error. Estimated preventable adverse event rates were as follows: any harm severity (2.0%, 95% CI 1.0 to 3.6), any serious harms (0.3%, PR 0.1 to 0.7), and deaths (0.2%, PR 0.1 to 0.4). While most disease-specific error rates derived from mainly U.S.-based studies, overall error and harm rates were derived from three prospective studies conducted outside the United States (in Canada, Spain, and Switzerland, with combined n=1,758). If overall rates are generalizable to all U.S. ED visits (130 million, 95% CI 116 to 144), this would translate to 7.4 million (PR 5.1 to 10.2) ED diagnostic errors annually; 2.6 million (PR 1.1 to 5.2) diagnostic adverse events with preventable harms; and 371,000 (PR 142,000 to 909,000) serious misdiagnosis-related harms, including more than 100,000 permanent, high-severity disabilities and 250,000 deaths. Although errors were often multifactorial, 89 percent (95% CI 88 to 90) of diagnostic error malpractice claims involved failures of clinical decision-making or judgment, regardless of the underlying disease present. Key process failures were errors in diagnostic assessment, test ordering, and test interpretation. Most often these were attributed to inadequate knowledge, skills, or reasoning, particularly in “atypical” or otherwise subtle case presentations. Limitations included use of malpractice claims and incident reports for distribution of diseases leading to serious harms, reliance on a small number of non-U.S. studies for overall (disease-agnostic) diagnostic error and harm rates, and methodologic variability across studies in measuring disease-specific rates, determining preventability, and assessing causal factors. Conclusions. Although estimated ED error rates are low (and comparable to those found in other clinical settings), the number of patients potentially impacted is large. Not all diagnostic errors or harms are preventable, but wide variability in diagnostic error rates across diseases, symptoms, and hospitals suggests improvement is possible. With 130 million U.S. ED visits, estimated rates for diagnostic error (5.7%), misdiagnosis-related harms (2.0%), and serious misdiagnosis-related harms (0.3%) could translate to more than 7 million errors, 2.5 million harms, and 350,000 patients suffering potentially preventable permanent disability or death. Over two-thirds of serious harms are attributable to just 15 diseases and linked to cognitive errors, particularly in cases with “atypical” manifestations. Scalable solutions to enhance bedside diagnostic processes are needed, and these should target the most commonly misdiagnosed clinical presentations of key diseases causing serious harms. New studies should confirm overall rates are representative of current U.S.-based ED practice and focus on identified evidence gaps (errors among common diseases with lower-severity harms, pediatric ED errors and harms, dynamic systems factors such as overcrowding, and false positives). Policy changes to consider based on this review include: (1) standardizing measurement and research results reporting to maximize comparability of measures of diagnostic error and misdiagnosis-related harms; (2) creating a National Diagnostic Performance Dashboard to track performance; and (3) using multiple policy levers (e.g., research funding, public accountability, payment reforms) to facilitate the rapid development and deployment of solutions to address this critically important patient safety concern.
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Robin Lynn Treptow, Robin Lynn Treptow. Does bias about medical diagnosis link to expectations of mental health problems for infants and their parents? Experiment, December 2016. http://dx.doi.org/10.18258/8721.

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3

McCarthy, Noel, Eileen Taylor, Martin Maiden, Alison Cody, Melissa Jansen van Rensburg, Margaret Varga, Sophie Hedges, et al. Enhanced molecular-based (MLST/whole genome) surveillance and source attribution of Campylobacter infections in the UK. Food Standards Agency, July 2021. http://dx.doi.org/10.46756/sci.fsa.ksj135.

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This human campylobacteriosis sentinel surveillance project was based at two sites in Oxfordshire and North East England chosen (i) to be representative of the English population on the Office for National Statistics urban-rural classification and (ii) to provide continuity with genetic surveillance started in Oxfordshire in October 2003. Between October 2015 and September 2018 epidemiological questionnaires and genome sequencing of isolates from human cases was accompanied by sampling and genome sequencing of isolates from possible food animal sources. The principal aim was to estimate the contributions of the main sources of human infection and to identify any changes over time. An extension to the project focussed on antimicrobial resistance in study isolates and older archived isolates. These older isolates were from earlier years at the Oxfordshire site and the earliest available coherent set of isolates from the national archive at Public Health England (1997/8). The aim of this additional work was to analyse the emergence of the antimicrobial resistance that is now present among human isolates and to describe and compare antimicrobial resistance in recent food animal isolates. Having identified the presence of bias in population genetic attribution, and that this was not addressed in the published literature, this study developed an approach to adjust for bias in population genetic attribution, and an alternative approach to attribution using sentinel types. Using these approaches the study estimated that approximately 70% of Campylobacter jejuni and just under 50% of C. coli infection in our sample was linked to the chicken source and that this was relatively stable over time. Ruminants were identified as the second most common source for C. jejuni and the most common for C. coli where there was also some evidence for pig as a source although less common than ruminant or chicken. These genomic attributions of themselves make no inference on routes of transmission. However, those infected with isolates genetically typical of chicken origin were substantially more likely to have eaten chicken than those infected with ruminant types. Consumption of lamb’s liver was very strongly associated with infection by a strain genetically typical of a ruminant source. These findings support consumption of these foods as being important in the transmission of these infections and highlight a potentially important role for lamb’s liver consumption as a source of Campylobacter infection. Antimicrobial resistance was predicted from genomic data using a pipeline validated by Public Health England and using BIGSdb software. In C. jejuni this showed a nine-fold increase in resistance to fluoroquinolones from 1997 to 2018. Tetracycline resistance was also common, with higher initial resistance (1997) and less substantial change over time. Resistance to aminoglycosides or macrolides remained low in human cases across all time periods. Among C. jejuni food animal isolates, fluoroquinolone resistance was common among isolates from chicken and substantially less common among ruminants, ducks or pigs. Tetracycline resistance was common across chicken, duck and pig but lower among ruminant origin isolates. In C. coli resistance to all four antimicrobial classes rose from low levels in 1997. The fluoroquinolone rise appears to have levelled off earlier and among animals, levels are high in duck as well as chicken isolates, although based on small sample sizes, macrolide and aminoglycoside resistance, was substantially higher than for C. jejuni among humans and highest among pig origin isolates. Tetracycline resistance is high in isolates from pigs and the very small sample from ducks. Antibiotic use following diagnosis was relatively high (43.4%) among respondents in the human surveillance study. Moreover, it varied substantially across sites and was highest among non-elderly adults compared to older adults or children suggesting opportunities for improved antimicrobial stewardship. The study also found evidence for stable lineages over time across human and source animal species as well as some tighter genomic clusters that may represent outbreaks. The genomic dataset will allow extensive further work beyond the specific goals of the study. This has been made accessible on the web, with access supported by data visualisation tools.
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4

Payment Systems Report - June of 2021. Banco de la República, February 2022. http://dx.doi.org/10.32468/rept-sist-pag.eng.2021.

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Banco de la República provides a comprehensive overview of Colombia’s finan¬cial infrastructure in its Payment Systems Report, which is an important product of the work it does to oversee that infrastructure. The figures published in this edition of the report are for the year 2020, a pandemic period in which the con¬tainment measures designed and adopted to alleviate the strain on the health system led to a sharp reduction in economic activity and consumption in Colom¬bia, as was the case in most countries. At the start of the pandemic, the Board of Directors of Banco de la República adopted decisions that were necessary to supply the market with ample liquid¬ity in pesos and US dollars to guarantee market stability, protect the payment system and preserve the supply of credit. The pronounced growth in mone¬tary aggregates reflected an increased preference for liquidity, which Banco de la República addressed at the right time. These decisions were implemented through operations that were cleared and settled via the financial infrastructure. The second section of this report, following the introduction, offers an analysis of how the various financial infrastructures in Colombia have evolved and per¬formed. One of the highlights is the large-value payment system (CUD), which registered more momentum in 2020 than during the previous year, mainly be¬cause of an increase in average daily remunerated deposits made with Banco de la República by the General Directorate of Public Credit and the National Treasury (DGCPTN), as well as more activity in the sell/buy-back market with sovereign debt. Consequently, with more activity in the CUD, the Central Securi¬ties Depository (DCV) experienced an added impetus sparked by an increase in the money market for bonds and securities placed on the primary market by the national government. The value of operations cleared and settled through the Colombian Central Counterparty (CRCC) continues to grow, propelled largely by peso/dollar non-deliverable forward (NDF) contracts. With respect to the CRCC, it is important to note this clearing house has been in charge of managing risks and clearing and settling operations in the peso/dollar spot market since the end of last year, following its merger with the Foreign Exchange Clearing House of Colombia (CCDC). Since the final quarter of 2020, the CRCC has also been re¬sponsible for clearing and settlement in the equities market, which was former¬ly done by the Colombian Stock Exchange (BVC). The third section of this report provides an all-inclusive view of payments in the market for goods and services; namely, transactions carried out by members of the public and non-financial institutions. During the pandemic, inter- and intra-bank electronic funds transfers, which originate mostly with companies, increased in both the number and value of transactions with respect to 2019. However, debit and credit card payments, which are made largely by private citizens, declined compared to 2019. The incidence of payment by check contin¬ue to drop, exhibiting quite a pronounced downward trend during the past last year. To supplement to the information on electronic funds transfers, section three includes a segment (Box 4) characterizing the population with savings and checking accounts, based on data from a survey by Banco de la República con-cerning the perception of the use of payment instruments in 2019. There also is segment (Box 2) on the growth in transactions with a mobile wallet provided by a company specialized in electronic deposits and payments (Sedpe). It shows the number of users and the value of their transactions have increased since the wallet was introduced in late 2017, particularly during the pandemic. In addition, there is a diagnosis of the effects of the pandemic on the payment patterns of the population, based on data related to the use of cash in circu¬lation, payments with electronic instruments, and consumption and consumer confidence. The conclusion is that the collapse in the consumer confidence in¬dex and the drop in private consumption led to changes in the public’s pay¬ment patterns. Credit and debit card purchases were down, while payments for goods and services through electronic funds transfers increased. These findings, coupled with the considerable increase in cash in circulation, might indicate a possible precautionary cash hoarding by individuals and more use of cash as a payment instrument. There is also a segment (in Focus 3) on the major changes introduced in regulations on the retail-value payment system in Colombia, as provided for in Decree 1692 of December 2020. The fourth section of this report refers to the important innovations and tech¬nological changes that have occurred in the retail-value payment system. Four themes are highlighted in this respect. The first is a key point in building the financial infrastructure for instant payments. It involves of the design and im¬plementation of overlay schemes, a technological development that allows the various participants in the payment chain to communicate openly. The result is a high degree of interoperability among the different payment service providers. The second topic explores developments in the international debate on central bank digital currency (CBDC). The purpose is to understand how it could impact the retail-value payment system and the use of cash if it were to be issued. The third topic is related to new forms of payment initiation, such as QR codes, bio¬metrics or near field communication (NFC) technology. These seemingly small changes can have a major impact on the user’s experience with the retail-value payment system. The fourth theme is the growth in payments via mobile tele¬phone and the internet. The report ends in section five with a review of two papers on applied research done at Banco de la República in 2020. The first analyzes the extent of the CRCC’s capital, acknowledging the relevant role this infrastructure has acquired in pro¬viding clearing and settlement services for various financial markets in Colom¬bia. The capital requirements defined for central counterparties in some jurisdic¬tions are explored, and the risks to be hedged are identified from the standpoint of the service these type of institutions offer to the market and those associated with their corporate activity. The CRCC’s capital levels are analyzed in light of what has been observed in the European Union’s regulations, and the conclusion is that the CRCC has a scheme of security rings very similar to those applied internationally and the extent of its capital exceeds what is stipulated in Colombian regulations, being sufficient to hedge other risks. The second study presents an algorithm used to identify and quantify the liquidity sources that CUD’s participants use under normal conditions to meet their daily obligations in the local financial market. This algorithm can be used as a tool to monitor intraday liquidity. Leonardo Villar Gómez Governor
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