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Article: Receiver operating characteristic curve analysis in diagnostic accuracy studies: A guide to interpreting the area under the curve value.

Çorbacıoğlu, Şeref Kerem / Aksel, Gökhan

Turkish journal of emergency medicine

2023 Volume 23, Issue 4, Page(s) 195–198

Abstract: This review article provides a concise guide to interpreting receiver operating characteristic (ROC) curves and area under the curve (AUC) values in diagnostic accuracy studies. ROC analysis is a powerful tool for assessing the diagnostic performance of ... ...

Abstract	This review article provides a concise guide to interpreting receiver operating characteristic (ROC) curves and area under the curve (AUC) values in diagnostic accuracy studies. ROC analysis is a powerful tool for assessing the diagnostic performance of index tests, which are tests that are used to diagnose a disease or condition. The AUC value is a summary metric of the ROC curve that reflects the test's ability to distinguish between diseased and nondiseased individuals. AUC values range from 0.5 to 1.0, with a value of 0.5 indicating that the test is no better than chance at distinguishing between diseased and nondiseased individuals. A value of 1.0 indicates perfect discrimination. AUC values above 0.80 are generally consideredclinically useful, while values below 0.80 are considered of limited clinical utility. When interpreting AUC values, it is important to consider the 95% confidence interval. The confidence interval reflects the uncertainty around the AUC value. A narrow confidence interval indicates that the AUC value is likely accurate, while a wide confidence interval indicates that the AUC value is less reliable. ROC analysis can also be used to identify the optimal cutoff value for an index test. The optimal cutoff value is the value that maximizes the test's sensitivity and specificity. The Youden index can be used to identify the optimal cutoff value. This review article provides a concise guide to interpreting ROC curves and AUC values in diagnostic accuracy studies. By understanding these metrics, clinicians can make informed decisions about the use of index tests in clinical practice.
Language	English
Publishing date	2023-10-03
Publishing country	India
Document type	Journal Article
ISSN	2452-2473
ISSN	2452-2473
DOI	10.4103/tjem.tjem_182_23
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Article ; Online: May hemoglobin measurement by blood gas analyzer lead to severe adverse clinical consequences? Reply to letter to the editor.

Aksel, Gökhan

The American journal of emergency medicine

2019 Volume 38, Issue 2, Page(s) 395

MeSH term(s)	Glucose ; Hematocrit ; Hemoglobins/analysis ; Potassium ; Sodium
Chemical Substances	Hemoglobins ; Sodium (9NEZ333N27) ; Glucose (IY9XDZ35W2) ; Potassium (RWP5GA015D)
Language	English
Publishing date	2019-08-13
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2019.158395
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Article: Factors affecting seizure recurrence in the emergency department.

Dolek, Umit Can / Gokce, Mustafa / Islam, Mehmet Muzaffer / Ozdemir, Serdar / Aksel, Gokhan / Algin, Abdullah

Heliyon

2024 Volume 10, Issue 5, Page(s) e26833

Abstract: Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited.: Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of ... ...

Abstract	Background: Information on Emergency Department (ED) follow-up of patients presenting with epileptic seizures is limited. Objectives: It was planned to investigate the factors affecting the recurrence of epileptic seizures in the follow-up of patients presenting to the ED with the complaint of epileptic seizures. Materials and methods: This prospective, observational, single-center study was carried out in an adult population presenting to the ED. The study included patients older than 18 years of age presenting to the ED with the complaint of epileptic seizures. Results: Of the 205 patients included in the study, 68 (33.2%) had seizure recurrence during the 6 h. In the univariable analysis, advanced age, prolonged post-ictal duration, increased seizure duration, generalized tonic clonic seizure, alcohol consumption within past 24 h, hypertension, coronary artery disease, Alzheimer's disease, prior ischemic cerebrovascular disease, low Glascow Coma Scale (GCS), high glucose, high C-Reactive Protein, high phosphorus, low potassium, high blood urea nitrogen, high lactate, increased anion gap, high osmolarity were statistically significant in predicting recurrent seizure recurrence within 6 h. According to the logistic regression, postictal duration, GCS score, and age were independent predictors in our model. The cut-off value of postictal duration in predicting seizure recurrence at the highest sensitivity (66.2%) and specificity (89.8%) was 22.5 min. Conclusion: A prolonged postictal state, low GCS score, advanced age may be an indication of seizure recurrence. Therefore, patients with a long postictal duration, low GCS score, advanced age should be followed up more carefully in terms of recurrent seizures in the ED.
Language	English
Publishing date	2024-02-22
Publishing country	England
Document type	Journal Article
ZDB-ID	2835763-2
ISSN	2405-8440
ISSN	2405-8440
DOI	10.1016/j.heliyon.2024.e26833
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Article ; Online: Trauma-related oral lesions; Angina bullosa haemorrhagica: a rare case presentation.

Satici, Merve Osoydan / İslam, Mehmet Muzaffer / Aksel, Gokhan / Eroglu, Serkan Emre

Malawi medical journal : the journal of Medical Association of Malawi

2022 Volume 34, Issue 3, Page(s) 204–205

Abstract: Angina bullosa haemorrhgica is a relatively uncommon condition characterized by blood-filled subepithelial lesions in the oral mucosa that is idiopathic and not caused by a systemic disease or a hemostatic abnormality. Middle-aged and elderly patients ... ...

Abstract	Angina bullosa haemorrhgica is a relatively uncommon condition characterized by blood-filled subepithelial lesions in the oral mucosa that is idiopathic and not caused by a systemic disease or a hemostatic abnormality. Middle-aged and elderly patients are usually affected and lesions heal spontaneously without scarring. A rapidly expanding hemorrhagic blister in the oropharynx can induce upper airway obstruction, so recognizing the lesion as soon as possible is essential. Because of its rarity, we wanted to highlight a 42-year-old male patient who presented with hemorrhagic bullae associated with insignificant local trauma in the oral mucosa and to emphasize that Angina bullosa haemorrhagica is a rare but recognizable lesion that clinicians should be aware of.
MeSH term(s)	Middle Aged ; Aged ; Male ; Humans ; Adult ; Mouth Mucosa/injuries ; Mouth Mucosa/pathology ; Blister/etiology ; Blister/pathology
Language	English
Publishing date	2022-11-04
Publishing country	Malawi
Document type	Case Reports
ZDB-ID	2491952-4
ISSN	1995-7270 ; 1995-7270
ISSN (online)	1995-7270
ISSN	1995-7270
DOI	10.4314/mmj.v34i3.10
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Article ; Online: Effects of spinal immobilization at a 20° angle on cerebral oxygen saturations measured by INVOS™.

Aksel, Gökhan

The American journal of emergency medicine

2017

Abstract: Background and aim of the study: In this study, we aimed to investigate whether performing the immobilization at 20° instead of 0° changes cerebral oxygenation.: Materials and methods: 33 volunteers were put in a hard cervical collar and backboard at ...

Abstract	Background and aim of the study: In this study, we aimed to investigate whether performing the immobilization at 20° instead of 0° changes cerebral oxygenation. Materials and methods: 33 volunteers were put in a hard cervical collar and backboard at 0° and immobilized for 30min. The cerebral oxygen saturations of the volunteers were measured at 1, 5, and 30min after the start of the procedure (Group 1). The volunteers were asked to return the day after the Group 1 procedure but at the same time. Serial cerebral oxygen saturations were obtained at the same time intervals as in Group 1, but for Group 2, the backboard was set to 20°. Results: When the cerebral oxygen saturations of the two groups were compared, there was a slight decrease when the backboard position was changed from 0° to 20°, but it was not statistically significant (P=0.220 and P=0.768, respectively). The results revealed that immobilizing the patients with a spinal backboard at 20° instead of 0° did not alter the cerebral oxygen saturations. Conclusion: Our study results revealed that spinal immobilization at 20°, which was a new suggestion for spinal immobilization following a report that this position reduced the decrease in pulmonary function secondary to spinal immobilization, did not alter the cerebral oxygenation, so this suggestion is safe at least from the standpoint of cerebral oxygenation.
Language	English
Publishing date	2017-07-13
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2017.07.034
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Article: Rare Traumatic Pulmonary Pseudocyst in a Seven-year-old Child.

Ademoğlu, Enis / İslam, Mehmet Muzaffer / Aksel, Gökhan / Eroğlu, Serkan Emre

Oman medical journal

2023 Volume 38, Issue 4, Page(s) e536

Abstract: Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary pseudocyst in a seven-year-old boy who presented with a chest injury from a traffic ... ...

Abstract	Traumatic pulmonary pseudocyst is a rare type of parenchymal injury, estimated to occur in 0.1% of all chest traumas. We report a rare case of traumatic pulmonary pseudocyst in a seven-year-old boy who presented with a chest injury from a traffic accident. He had a scapula fracture, multiple abrasions on his body, and decreased respiratory sounds in the left hemithorax. His Glasgow Coma Scale score was 15. Chest X-ray suggested a 3 × 3.5 cm cavitary lesion. Computed tomography scan revealed a pulmonary pseudocyst in addition to parenchymal contusion and pneumothorax. A Velpeau bandage was applied to the scapula fracture. After five days of in-hospital observation without any thoracic intervention, the patient was discharged free of complications.
Language	English
Publishing date	2023-07-31
Publishing country	Oman
Document type	Case Reports
ZDB-ID	2571431-4
ISSN	2070-5204 ; 1999-768X
ISSN (online)	2070-5204
ISSN	1999-768X
DOI	10.5001/omj.2023.34
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Article ; Online: Is frontal QRS-T angle a valid predictor of COVID-19 severity?

Özdemir, Serdar / Aksel, Gökhan / İslam, Mehmet Muzaffer

The American journal of emergency medicine

2022 Volume 57, Page(s) 211–212

MeSH term(s)	COVID-19 ; Electrocardiography ; Humans ; Prognosis ; Risk Factors
Language	English
Publishing date	2022-01-22
Publishing country	United States
Document type	Letter ; Comment
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2022.01.027
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Article: A Rare Case of Metformin Intoxication with Mortal Course.

Osoydan Satici, Merve / Algin, Abdullah / Aksel, Gokhan / Eroglu, Serkan Emre

Medeniyet medical journal

2020 Volume 35, Issue 2, Page(s) 175–178

Abstract: Metformin-associated lactic acidosis is a rare side effect in metformin poisoning. There is conflicting data about mortality rates changing from 3% to 83%. We aimed to discuss a case that developed lactic acidosis and acute renal failure progressing to ... ...

Abstract	Metformin-associated lactic acidosis is a rare side effect in metformin poisoning. There is conflicting data about mortality rates changing from 3% to 83%. We aimed to discuss a case that developed lactic acidosis and acute renal failure progressing to mortality due to metformin intoxication. A 33 year-old female patient was admitted to the emergency department, with nausea and vomiting after taking 30 tablets of 1000 mg metformin. In the 2nd hour of follow-up, patient was observed to develop lactic acidosis which did not recover despite the infusion replacement treatments and hemodialysis. Following the development of respiratory failure, under mechanical ventilation, the patient developed cardiac arrest at the 48th hour of her admission. In metformin intoxications, it should be remembered that acidosis deepens very quickly and can progress with mortality despite optimal supportive therapy. More specific recommendations and further studies are required for the management and treatment of acute metformin-associated lactic acidosis.
Language	English
Publishing date	2020-06-30
Publishing country	Turkey
Document type	Case Reports
ZDB-ID	3035195-9
ISSN	2149-4606 ; 2149-2042
ISSN (online)	2149-4606
ISSN	2149-2042
DOI	10.5222/MMJ.2020.96641
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Article ; Online: The role of a noninvasive index 'Spo2/ Fio2' in predicting mortality among patients with COVID-19 pneumonia.

Satici, Merve Osoydan / Islam, Mehmet Muzaffer / Satici, Celal / Uygun, Cemre Nur / Ademoglu, Enis / Altunok, İbrahim / Aksel, Gokhan / Eroglu, Serkan Emre

The American journal of emergency medicine

2022 Volume 57, Page(s) 54–59

Abstract: Introduction: Noninvasive risk assessment is crucial in patients with COVID-19 in emergency department. Since limited data is known about the role of noninvasive parameters, we aimed to evaluate the role of a noninvasive parameter 'SpO2/FiO2' in ... ...

Abstract	Introduction: Noninvasive risk assessment is crucial in patients with COVID-19 in emergency department. Since limited data is known about the role of noninvasive parameters, we aimed to evaluate the role of a noninvasive parameter 'SpO2/FiO2' in independently predicting 30-day mortality in patients with COVID-19 and its prognostic utility in combination with a noninvasive score 'CRB-65'. Methods: A retrospective study was performed in a tertiary training and research hospital, which included 272 patients with COVID-19 pneumonia diagnosed with polymerase chain reaction in emergency department. Data on characteristics, vital signs, and laboratory parameters were recorded from electronic medical records. The primary outcome of the study was 30-day mortality, and we assessed the discriminative ability of SpO2/FiO2 in predicting mortality in patients with COVID-19 pneumonia and its prognostic utility in combination with conventional pneumonia risk assessment scores. Results: Multivariate analysis revealed that only SpO2/FiO2 level was found to be an independent parameter associated with 30-day mortality (OR:0.98, 95% CI: 0.98-0.99, p = 0.003). PSI and CURB-65 were found to be better scores than CRB-65 in predicting 30-day mortality (AUC: 0.79 vs 0.72, p = 0.04; AUC: 0.76 vs 0.72, p = 0.01 respectively). Both SpO2/FiO2 combined with CRB-65 and SpO2/FiO2 combined with CURB-65 have good discriminative ability and seemed to be more favorable than PSI in predicting 30-days mortality (AUC: 0.83 vs 0.75; AUC: 0.84 vs 0.75), however no significant difference was found (p = 0.21 and p = 0.06, respectively). Conclusion: SpO2/FiO2 is a promising index in predicting mortality. Addition of SpO2/FiO2 to CRB-65 improved the role of CRB-65 alone, however it performed similar to PSI. The combined noninvasive model of SpO2/FiO2 and CRB-65 may help physicians quickly stratify COVID-19 patients on admission, which is expected to be particularly important in hospitals still stressed by pandemic volumes.
MeSH term(s)	COVID-19/diagnosis ; Hospital Mortality ; Humans ; Oxygen Saturation ; Pandemics ; Pneumonia/diagnosis ; Prognosis ; Retrospective Studies ; Severity of Illness Index
Language	English
Publishing date	2022-04-27
Publishing country	United States
Document type	Journal Article
ZDB-ID	605890-5
ISSN	1532-8171 ; 0735-6757
ISSN (online)	1532-8171
ISSN	0735-6757
DOI	10.1016/j.ajem.2022.04.036
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Article ; Online: Can 1st and 6th month pulmonary function test follow-ups give an idea about the long-term respiratory effects of COVID-19 pneumonia?

Eroglu, Serkan Emre / Ademoglu, Enis / Baslilar, Seyma / Aksel, Gokhan / Eker, Aysen / Algın, Abdullah / Islam, Mehmet Muzaffer / Ozdemir, Serdar

Revista da Associacao Medica Brasileira (1992)

2022 Volume 68, Issue 2, Page(s) 183–190

Abstract: Objective: The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months.: Methods: Our study was conducted between August 1, 2020 and April 30, 2021. ... ...

Abstract	Objective: The aim of this study was to ascertain the long-term respiratory effects of COVID-19 pneumonia through pulmonary function tests in follow-ups at 1 and 6 months. Methods: Our study was conducted between August 1, 2020 and April 30, 2021. At 1 month after discharge, follow-up evaluations, PFTs, and lung imaging were performed on patients aged above 18 years who had been diagnosed with COVID-19 pneumonia. In the 6th month, the PFTs were repeated for those with pulmonary dysfunction. Results: A total of 219 patients (mean age, 49±11.9 years) were included. Pathological PFT results were noted in the 1st month for 80 patients and in the 6th month for 46 (7 had obstructive disorder, 15 had restrictive disorder, and 28 had small airway obstruction) patients. A significant difference was found between abnormal PFT results and patient-described dyspnea in the 1st month of follow-up. The 6-month PFT values (especially those for forced vital capacity) were statistically significantly lower in the patients for whom imaging did not indicate complete radiological improvement at the 1-month follow-up. No statistically significant difference was found between the severity of the first computed tomography findings or clinical condition on emergency admission and pulmonary dysfunction (Pearson's chi-square test, P=0.904; Fisher's exact test, P=0.727). Conclusion: It is important that patients with COVID-19 pneumonia be followed up for at least 1 month after discharge to be monitored for potential long-term lung damage. PFTs should be administered to those in whom ongoing dyspnea, which started with COVID-19, and/or full recovery were not identified in pulmonary imaging.
MeSH term(s)	Adult ; Aged ; COVID-19 ; Follow-Up Studies ; Humans ; Lung/diagnostic imaging ; Middle Aged ; Respiratory Function Tests ; SARS-CoV-2 ; Vital Capacity
Language	English
Publishing date	2022-02-25
Publishing country	Brazil
Document type	Journal Article
ZDB-ID	731969-1
ISSN	1806-9282 ; 0104-4230 ; 0004-5241 ; 0102-843X
ISSN (online)	1806-9282
ISSN	0104-4230 ; 0004-5241 ; 0102-843X
DOI	10.1590/1806-9282.20210890
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