Use of likelihood ratios improves interpretation of laboratory testing for pulmonary sarcoidosis

Laboratory tests for pulmonary sarcoidosis (percentage lymphocytes and CD4/CD8 ratio in bronchoalveolar lavage fluid and serum angiotensin-converting enzyme activity) lack sensitivity and specificity. In a retrospective study of 153 subjects under suspicion of pulmonary sarcoidosis (36 cases and 117...

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Vydáno v:	American journal of clinical pathology Ročník 134; číslo 6; s. 939
Hlavní autoři:	De Smet, Dieter, Martens, Geert A, Berghe, Bram Vanden, Meysman, Marc, Heylen, Olivier, Gorus, Frans K, De Waele, Marc
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	England 01.12.2010
Témata:	Algorithms Bronchoalveolar Lavage Fluid - chemistry Bronchoalveolar Lavage Fluid - cytology CD4-CD8 Ratio - statistics & numerical data Clinical Laboratory Techniques - methods Clinical Laboratory Techniques - standards Clinical Laboratory Techniques - statistics & numerical data Data Interpretation, Statistical Female Humans Likelihood Functions Logistic Models Male Retrospective Studies Sarcoidosis, Pulmonary - blood Sarcoidosis, Pulmonary - diagnosis
ISSN:	1943-7722, 1943-7722
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Shrnutí:	Laboratory tests for pulmonary sarcoidosis (percentage lymphocytes and CD4/CD8 ratio in bronchoalveolar lavage fluid and serum angiotensin-converting enzyme activity) lack sensitivity and specificity. In a retrospective study of 153 subjects under suspicion of pulmonary sarcoidosis (36 cases and 117 patients with other diseases [control patients]), we defined likelihood ratios (LRs) for rationally selected result intervals of these tests, which improve clinical interpretation as compared with dichotomous interpretation based on a single cutoff value. By using logistic regression analysis, we further integrated the 3 individual tests into a unified algorithm that could rule out diagnosis in 57 (48.7%) of the 177 control subjects and confirm diagnosis in 12 (33%) of the 36 pulmonary sarcoidosis cases. We conclude that use of LRs improves interpretation of laboratory tests for pulmonary sarcoidosis. In addition, we present a prediction algorithm based on the combination of laboratory tests that helps clinicians confirm or exclude diagnosis in almost half of the study population.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 ObjectType-Undefined-3
ISSN:	1943-7722 1943-7722
DOI:	10.1309/AJCPNC7STHG0FWMP