1.Minimal clinically important difference of mouth opening in oral submucous fibrosis patients: a retrospective study
Amanjot KAUR ; Neeti RUSTAGI ; Aparna GANESAN ; Nihadha PM ; Pravin KUMAR ; Kirti CHAUDHRY
Journal of the Korean Association of Oral and Maxillofacial Surgeons 2022;48(3):167-173
Objectives:
The purpose of this study was to estimate the minimal clinically important difference (MCID) of mouth opening (MO) and patient satisfaction in surgically treated oral submucous fibrosis (OSMF) patients.
Materials and Methods:
The status of MO was collected preoperatively (T0), postoperatively at 3 months (T1), and at a minimum of 6 months postoperatively (T2). MCID was determined through the anchor-based approach with the change difference method, mean change method, and receiver operator characteristic curve (ROC) method.
Results:
In this study, 35 patients enrolled and completed postoperative follow-up (T2) averaging a duration of 18.1 months. At T1, using the change difference method, MO was 14.89 mm and the ROC curve exhibited a 11.5 gain in MO (sensitivity 81.8% and specificity 100%, area under the curve [AUC] of 0.902) and was classified as MCID as reported by patients. At T2, MCID of MO was 9.75 mm using the change difference method and 11.75 mm by the mean change method. The ROC curve revealed that the MCID of MO at T2 was 10.5 mm with 73.9% sensitivity and 83.3% specificity (AUC of 0.873). The kappa value was 0.91, confirming reliability of the data.
Conclusion
This study demonstrated MCID values that indicate the clinical relevance of surgical treatment of OSMF if the minimum possible gain in MO is approximately 10 mm.
2.Validity of ultrasound with color Doppler to differentiate between benign and malignant ovarian tumours
Nina MAHALE ; Neeti KUMAR ; Ajit MAHALE ; Sonali ULLAL ; Merwyn FERNANDES ; Sonali PRABHU
Obstetrics & Gynecology Science 2024;67(2):227-234
Objective:
To assess the utility of ultrasound and color Doppler and the Accuracy of International Ovarian Tumor Analysis (IOTA) group classification in the preoperative evaluation of ovarian neoplasms to assess benign or malignant histopathology in the diagnosis of ovarian tumors.
Methods:
This observational longitudinal prospective analysis of 60 patients was performed over a period of 2 years (2017- 2019). The mean age of the patients was 43.75 years. Ultrasonography of ovarian masses were evaluated, and cancer antigen-125 (CA-125) levels were evaluated. Based on the IOTA classification, the B and M features of adnexal masses were studied. Color Doppler imaging was performed to evaluate the patterns of vascularity and indices.
Results:
Sixty patients with 35 benign, 23 malignant, and two borderline lesions were included in the study. In malignant lesions, 17 women (73.9%) were above the age of 45. The CA-125 cut off was ≥35 internatioal units/mL. Based on the IOTA classification, 27/35 (77.1%) benign cases, were correctly identified as benign, 6/35 (17.1%) benign cases were incorrectly identified as malignant, and two (5.7%) were found to be inconclusive. In the malignant group, 17 of the 23 patients were identified as having malignancy. Color Doppler showed three (18.8%) benign tumors had a pulsatality index (PI) of <0.8 and 21 malignant tumors had a PI of <0.8. Four benign tumors had an resistive index (RI) of <0.6 and 100% of malignant tumors had an RI <0.6.
Conclusion
The IOTA classification is a reliable scoring system for adnexal masses, and color Doppler can help to minimize interobserver variation.