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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Bibliographic Details
Published in:American journal of clinical pathology Vol. 134; no. 6; p. 939
Main Authors: De Smet, Dieter, Martens, Geert A, Berghe, Bram Vanden, Meysman, Marc, Heylen, Olivier, Gorus, Frans K, De Waele, Marc
Format: Journal Article
Language:English
Published: England 01.12.2010
Subjects:
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
Online Access:Get more information
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Summary: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.
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ISSN:1943-7722
1943-7722
DOI:10.1309/AJCPNC7STHG0FWMP