How many of us have Frank's Sign?

Newcomer introductions, personal anecdotes, caregiver issues, lab results, and n=1 experimentation.
PBW
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Re: How many of us have Frank's Sign?

Postby PBW » Sun Aug 26, 2018 12:25 am

I do not have a crease in either ear lobe. I am a 4/4.

Anna
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Re: How many of us have Frank's Sign?

Postby Anna » Mon Aug 27, 2018 10:16 pm

I am 4/4 and do not have anything resembling Frank's sign.
~Anna
4/4 but so much more

Vonm
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Re: How many of us have Frank's Sign?

Postby Vonm » Mon Aug 27, 2018 10:40 pm

I have it and I’m apoe 3/4 with CAD , CHF. 60 years old. My Dad had it and Alzheimer’s and CAD,my Mom had it and CHF, I see it all the time in people with heart trouble.

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Sara
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Re: How many of us have Frank's Sign?

Postby Sara » Tue Aug 28, 2018 3:49 pm

Hi Vonm and welcome to the apoe4.info site! Thank you for joining us and for your contribution to the Frank's Sign posting. Please feel free to explore and visit our Primer. We would love to hear more about you and your story when ever you feel comfortable sharing more.
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Cat111
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Re: How many of us have Frank's Sign?

Postby Cat111 » Wed Aug 29, 2018 1:38 pm

Starting on my right ear...58yr old 4/4
Cat111
ApoE 4/4 MTHFR C677T/A1298C COMT Apoc1 TOMM40 HLA DQ and not giving up!

Lindy
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Re: How many of us have Frank's Sign?

Postby Lindy » Sun Sep 02, 2018 6:40 pm

Yep, I'm a 4/4 and I have it on my left ear. Just a very faint suggestion my right ear might have one eventually.
APOE-ε4/ε4 on the voyage of discovery.

Starfish77
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Re: How many of us have Frank's Sign?

Postby Starfish77 » Sun Sep 02, 2018 9:27 pm

I'm an 81 year old 4/4 with Frank's sign on both ears. I would have said I didn't have it until I looked in the mirror. I just never noticed it.

My right earlobe is way thicker than my left. A few earrings have too short a post for my thicker right earlobe. My thicker earlobe seems to look more like other people's earlobes than my thin one. Does this difference in earlobes signify anything interesting or am I just a somewhat irregular.

NF52
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Re: How many of us have Frank's Sign?

Postby NF52 » Mon Sep 03, 2018 9:15 am

Vonm wrote:I have it and I’m apoe 3/4 with CAD , CHF. 60 years old. My Dad had it and Alzheimer’s and CAD,my Mom had it and CHF, I see it all the time in people with heart trouble.
Hi Vonm,

You have provided a great example of what is called the "sensitivity" of Frank's sign as a clinical indicator of heart disease. Sensitivity refers to the ability to correctly identify all people with a certain condition, with no false negatives; i.e. the test indicated the person didn't have the condition when it was in fact present. One article I saw gave a "sensitivity" rate of 88% for Frank's sign without citation. That would mean that if 100 people with diagnosed heart disease were looked at, on average 88 would have an observable diagonal crease on both ear lobes. (A crease on one ear lobe is not as sensitive an indicator, and a "wrinkle", "dip" or partial crease on one ear is a weak indicator, apparently.)

So a negative result on an indicator with high sensitivity means it's unlikely the person without Frank's sign has heart disease. (Although it could miss 12% of those people.) Here's an explanation from wikipedia:
A negative result in a test with high sensitivity is useful for ruling out disease. A high sensitivity test is reliable when its result is negative, since it rarely misdiagnoses those who have the disease. A test with 100% sensitivity will recognize all patients with the disease by testing positive. A negative test result would definitively rule out presence of the disease in a patient.
https://en.wikipedia.org/wiki/Sensitivity_and_specificity

But does that mean that 88% of people with Frank's sign DO heart disease? No, because the "test" has low "specificity". Another study, of 1022 people in a multi-ethnic cohort of Type 2 diabetes patients (who are at risk of CAD), the authors found that the sensitivity and specificity of ELC for detecting CAD were 60% and 48%, which would indicate that in one large group of people with diabetes, 48 percent of those with ear lobe creases do not have coronary artery disease, https://www.ncbi.nlm.nih.gov/pubmed/11108067

To use an example that most people have learned to be very careful about: women who are 8 months pregnant usually have large bellies; I would guess about 88% of them "look" pregnant. But that does not mean that 88% of women with large bellies are pregnant, as my 5 year old son discovered when he loudly announced that a 50 year old secretary in my office was having a baby. In that case, he found a "false positive" due to "low specificity" of the indicator for identifying people who are 8 months pregnant. (Much to my horror, and the secretary's good humor. Thank goodness she liked small children!)

But here's the example I like best: In a study of 4635 people (56.3% women) in Switzerland, an ear lobe crease (ELC) was highly sensitive ONLY for a history of coronary vascular disease and hypertension.
CONCLUSION: In this community-based sample ELC was significantly and independently associated with hypertension and history of CVD.
As the title of the article implies: Sometimes a ear lobe crease is just an ear lobe crease:
Did Dumbo suffer a heart attack? independent association between earlobe crease and cardiovascular disease.
4/4 and still an optimist!


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