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Concept: Gold standard


A high-quality gold standard is vital for supervised, machine learning-based, clinical natural language processing (NLP) systems. In clinical NLP projects, expert annotators traditionally create the gold standard. However, traditional annotation is expensive and time-consuming. To reduce the cost of annotation, general NLP projects have turned to crowdsourcing based on Web 2.0 technology, which involves submitting smaller subtasks to a coordinated marketplace of workers on the Internet. Many studies have been conducted in the area of crowdsourcing, but only a few have focused on tasks in the general NLP field and only a handful in the biomedical domain, usually based upon very small pilot sample sizes. In addition, the quality of the crowdsourced biomedical NLP corpora were never exceptional when compared to traditionally-developed gold standards. The previously reported results on medical named entity annotation task showed a 0.68 F-measure based agreement between crowdsourced and traditionally-developed corpora.

Concepts: Costs, Linguistics, Gold, Cost, Task, Gold standard, Web 2.0, Natural language processing


Milligan-Morgan and Ferguson haemorrhoidectomy has been the gold standard treatment for symptomatic haemorrhoids for many years. However, escisional techniques are associated with a significant morbidity rate. In recent years, diverse techniques have been described in an attempt to decrease these complications. The guided transanal haemorrhoidal dearterialization THD) doppler is one of these techniques. We report our experience with this new technique.

Concepts: Creativity techniques, Gold, Gold standard, Hemorrhoid


The authors analyzed the effect of fatigue on the survival rate and fracture load of monolithic and bi-layer CAD/CAM lithium-disilicate posterior three-unit fixed dental prostheses (FDPs) in comparison to the metal-ceramic gold standard.

Concepts: Fracture, Fracture mechanics, Gold, Gold standard


OBJECTIVES: The current gold standard for diagnosing vesicoureteric reflux in unsedated infants is the X-ray-based Micturating CystoUrethroGram (MCUG). The aim of this study was to assess the diagnostic performance of interactive MRI for voiding cysto-urethrography (iMRVC). METHODS: 25 infants underwent conventional MCUG followed by iMRVC. In iMRVC, patients were examined using a real-time MR technique, which allows interactive control of image contrast and imaging plane location, before, during and after micturition. Images were assessed for presence and grade of VUR. Parental feedback on both procedures was evaluated. RESULTS: iMRVC gave a sensitivity of 100%, specificity of 90.5% (95% CI: 81.6-99.4%), PPV of 66.7% and NPV of 100% in this population. There was 88% concordance (44/50 renal units) according to the presence of VUR between the two methods, with iMRVC up-grading VUR in 6 units (12%). There was very good agreement regarding VUR grade: Kappa=0.66±0.11 (95% CI 0.43-0.88). 60% of parents preferred the MRI, but did not score the two tests differently. CONCLUSION: Interactive MRI allows dynamic imaging of the whole urinary tract without ionising radiation exposure. iMRVC gives comparable results to the MCUG, and is acceptable to parents.

Concepts: X-ray, Medical imaging, Nuclear magnetic resonance, Magnetic resonance imaging, Radiology, Gold standard, Vesicoureteral reflux, Voiding cystourethrogram


Bone grafts are commonly used for the treatment of segmental bone defects and fracture non-unions. Recently, osseous particles obtained during intermedullary canal reaming (using a Reamer-Irrigator-Aspirator (RIA) device) have been evaluated as graft material during in vitro and clinical studies. The aim of this study was to evaluate and quantify new bone formation after implantation of bone graft material obtained after reaming of the tibia in a bilateral critical-sized iliac wing defect in sheep and to investigate the effect of the augmentation of this graft. A reamer bone graft alone, or after short term incubation in a dexamethasone enriched solution, and a reamer graft collected using beta-tricalcium phosphate (β-TCP) granules in the filter of the RIA collection device were compared to autologous iliac wing graft. In addition, reamer graft was combined with the cellular fraction collected from the irrigation fluid with and without short-term incubation in a dexamethasone enriched solution. It was hypothesized that the amount of physical bone in the reamer bone graft groups would be higher than the amount in the autologous iliac wing graft group and that augmentation of a reamer bone graft would increase bone formation. Three months after implantation, the amount of new bone formation (as percentage of the total defect volume) in the defects was evaluated ex-vivo by means of micro-CT and histomorphometry. The mean amount of bone in the autologous iliac wing graft group was 17.7% and 16.8% for micro-CT and histomorphometry, respectively. The mean amount of bone in all reamer graft groups ranged between 20.4 - 29.2% (micro-CT) and 17.0 - 25.4% (histomorphometry). Reamer graft collected using β-TCP granules (29.2 ± 1.7%) in the filter produced a significantly higher amount of bone in comparison to an autologous iliac wing graft evaluated by micro-CT. RIA bone grafts added a small increase in bone volume to the 3 month graft volume in this preclinical sheep model. The current model does not support the use of short-term high concentration dexamethasone for augmentation of a graft volume. If avoidance of an iliac wing graft is desirable, or a reaming procedure is required, then a RIA graft or RIA graft plus β-TCP granules are as good as the current gold standard for this model. HIGHLGIHTS: We investigated bone formation in a sheep iliac wing model using a RIA bone graft Augmentation with beta-tricalcium biphosphonate granules increases bone formation Other augmentation techniques showed no significant difference.

Concepts: Bone fracture, Surgery, Orthopedic surgery, Arithmetic mean, Gold standard, Bone morphogenetic protein, Artificial bone, Bone grafting


The aim of this study was to compare surface imaging, portal imaging, and skin marker set-up in radiotherapy of thoracic and pelvic regions, using cone beam computed tomography (CBCT) data as the gold standard.

Concepts: Medical imaging, Chest, Gold, Pelvis, Abdomen, Thorax, Gold standard, Electron beam tomography


While cytosine methylation has been widely studied in extant populations, relatively few studies have analyzed methylation in ancient DNA. Most existing studies of epigenetic marks in ancient DNA have inferred patterns of methylation in highly degraded samples using post-mortem damage to cytosines as a proxy for cytosine methylation levels. However, this approach limits the inference of methylation compared with direct bisulfite sequencing, the current gold standard for analyzing cytosine methylation at single nucleotide resolution. In this study, we used direct bisulfite sequencing to assess cytosine methylation in ancient DNA from the skeletal remains of 30 Native Americans ranging in age from approximately 230 to 4500 years before present. Unmethylated cytosines were converted to uracils by treatment with sodium bisulfite, bisulfite products of a CpG-rich retrotransposon were pyrosequenced, and C-to-T ratios were quantified for a single CpG position. We found that cytosine methylation is readily recoverable from most samples, given adequate preservation of endogenous nuclear DNA. In addition, our results indicate that the precision of cytosine methylation estimates is inversely correlated with aDNA preservation, such that samples of low DNA concentration show higher variability in measures of percent methylation than samples of high DNA concentration. In particular, samples in this study with a DNA concentration above 0.015 ng/μL generated the most consistent measures of cytosine methylation. This study presents evidence of cytosine methylation in a large collection of ancient human remains, and indicates that it is possible to analyze epigenetic patterns in ancient populations using direct bisulfite sequencing approaches.

Concepts: DNA, Molecular biology, Epigenetics, DNA methylation, Methylation, Native Americans in the United States, Gold standard, Ancient DNA


Body temperature measurement in children is of clinical relevance. Although rectal measurement is the gold standard, less invasive tools have become available. We aimed to describe the accuracy of tympanic, infrared skin, or temporal artery scan thermometers compared with rectal measurement to reflect core temperature.

Concepts: Thermoregulation, Temperature, Hyperthermia, Psychometrics, Gold, Gold standard, Normal human body temperature, Humans


Policymakers and healthcare stakeholders are increasingly seeking evidence to inform the policymaking process, and often use existing or commissioned systematic reviews to inform decisions. However, the methodologies that make systematic reviews authoritative take time, typically 1 to 2 years to complete. Outside the traditional SR timeline, “rapid reviews” have emerged as an efficient tool to get evidence to decision-makers more quickly. However, the use of rapid reviews does present challenges. To date, there has been limited published empirical information about this approach to compiling evidence. Thus, it remains a poorly understood and ill-defined set of diverse methodologies with various labels. In recent years, the need to further explore rapid review methods, characteristics, and their use has been recognized by a growing network of healthcare researchers, policymakers, and organizations, several with ties to Cochrane, which is recognized as representing an international gold standard for high-quality, systematic reviews.

Concepts: Time, Scientific method, Evidence-based medicine, Gold, Policy, Gold standard


The relationship between early onset eczema and food allergy among infants has never been examined in a population-based sample using the gold standard for diagnosis, oral food challenge.

Concepts: Asthma, Allergy, Gold, Food allergy, Eczema, Gold standard