dc.contributor.author |
Steele, ML |
en |
dc.contributor.author |
Janda, M |
en |
dc.contributor.author |
Vagenas, D |
en |
dc.contributor.author |
Ward, LC |
en |
dc.contributor.author |
Cornish, BH |
en |
dc.contributor.author |
Box, R |
en |
dc.contributor.author |
Gordon, S |
en |
dc.contributor.author |
Matthews, M |
en |
dc.contributor.author |
Poppitt, Sally |
en |
dc.contributor.author |
Plank, Lindsay |
en |
dc.contributor.author |
Yip, Wilson |
en |
dc.contributor.author |
Rowan, A |
en |
dc.contributor.author |
Reul-Hirche, H |
en |
dc.contributor.author |
Obermair, A |
en |
dc.contributor.author |
Hayes, SC |
en |
dc.date.accessioned |
2019-10-29T01:35:16Z |
en |
dc.date.issued |
2019 |
en |
dc.identifier.issn |
1557-8585 |
en |
dc.identifier.uri |
http://hdl.handle.net/2292/48700 |
en |
dc.description.abstract |
Background: This study aimed at testing whether arm-to-leg ratios of extracellular water (ECW) and ECW normalized to intracellular water (ICW), measured by bioimpedance spectroscopy (BIS), can accurately detect bilateral, lower-limb lymphedema, and whether accounting for sex, age, and body mass index (BMI) improves the diagnostic performance of cut-offs. Methods and Results: We conducted a dual-approach, case–control study consisting of cases of bilateral, lower-limb lymphedema and healthy controls who self-reported absence of lymphedema. The diagnostic performance using normative data-derived cut-offs (i.e., mean + 0.5 standard deviation [SD] to mean + 3 SD; n = 136, 66% controls) and receiver operating characteristic (ROC) curve-derived cut-offs (n = 746, 94% controls) was assessed. The impact of sex, age, and BMI was investigated by comparing stratified and nonstratified normative data-derived cut-offs, and ROC curves generated from adjusted and unadjusted logistic regression models. Arm-to-leg ratios of ECW between mean + 0.5 SD and mean + 1 SD showed fair to good sensitivity (0.73–0.84) and poor to good specificity (0.64 to 0.84). Arm-to-leg ratios of ECW/ICW failed to detect lymphedema (sensitivity <0.5). Stratification by sex, or by sex and age, yielded similar results to nonstratified cut-offs. Cut-offs derived from adjusted ROC curves showed both good sensitivity (0.83–0.89) and specificity (0.8–0.84). Conclusion: These findings represent new BIS criteria for diagnosing lower-limb lymphedema that do not rely on comparison to baseline measures or the presence of a nonaffected, contralateral limb. |
en |
dc.publisher |
Mary Ann Liebert |
en |
dc.relation.ispartofseries |
Lymphatic Research and Biology |
en |
dc.rights |
Items in ResearchSpace are protected by copyright, with all rights reserved, unless otherwise indicated. Previously published items are made available in accordance with the copyright policy of the publisher. |
en |
dc.rights.uri |
https://researchspace.auckland.ac.nz/docs/uoa-docs/rights.htm |
en |
dc.title |
A bioimpedance spectroscopy-based method for diagnosis of lower-limb lymphedema |
en |
dc.type |
Journal Article |
en |
dc.identifier.doi |
10.1089/lrb.2018.0078 |
en |
dc.rights.holder |
Copyright: The author |
en |
dc.rights.accessrights |
http://purl.org/eprint/accessRights/RestrictedAccess |
en |
pubs.subtype |
Article |
en |
pubs.elements-id |
775459 |
en |
pubs.org-id |
Medical and Health Sciences |
en |
pubs.org-id |
School of Medicine |
en |
pubs.org-id |
Surgery Department |
en |
pubs.org-id |
Science |
en |
pubs.org-id |
Biological Sciences |
en |
pubs.record-created-at-source-date |
2019-06-27 |
en |
pubs.dimensions-id |
31486709 |
en |