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Titolo:
DIAGNOSTIC-VALUE OF TESTS THAT DISCRIMINATE BETWEEN EXUDATIVE AND TRANSUDATIVE PLEURAL EFFUSIONS
Autore:
HEFFNER JE; BROWN LK; BARBIERI CA; BURGESS L; CRUZ E; POSE A; ROTH BJ; SUAY VG; VALDES L;
Indirizzi:
ST JOSEPHS & MED CTR,DEPT MED,350 W THOMAS RD PHOENIX AZ 85013 UNIV ARIZONA,HLTH SCI CTR TUCSON AZ 00000
Titolo Testata:
Chest
fascicolo: 4, volume: 111, anno: 1997,
pagine: 970 - 980
SICI:
0012-3692(1997)111:4<970:DOTTDB>2.0.ZU;2-R
Fonte:
ISI
Lingua:
ENG
Soggetto:
CHOLESTEROL; SEPARATION; FLUID; CRITERIA; CURVE;
Keywords:
DIAGNOSIS; PLEURAL DISEASE; PLEURAL EFFUSION; RECEIVER OPERATING CHARACTERISTIC;
Tipo documento:
Article
Natura:
Periodico
Settore Disciplinare:
Science Citation Index Expanded
Citazioni:
29
Recensione:
Indirizzi per estratti:
Citazione:
J.E. Heffner et al., "DIAGNOSTIC-VALUE OF TESTS THAT DISCRIMINATE BETWEEN EXUDATIVE AND TRANSUDATIVE PLEURAL EFFUSIONS", Chest, 111(4), 1997, pp. 970-980

Abstract

Study objective: To (1) determine appropriate decision thresholds anddiagnostic accuracies for pleural fluid (PF) tests that discriminate between exudative and transudative pleural effusions, and (2) evaluatethe quality of the primary investigations. Design: Formal meta-analysis of studies that report the diagnostic value of pleural fluid tests. Setting: Data collected from international academic medical centers. Patients: Hospitalized patients undergoing thoracentesis for pleural effusions. Interventions: Primary investigators were requested to transmit original data from patients described in their studies. Measurements and results: Eight primary studies described 1,448 patients with one or more of the following tests: protein (P)-PF, P-PF/serum ratio (R), bilirubin (BILI)-R, lactate dehydrogenase (LDH)-PF, LDH-R, cholesterol (C)-PF, C-R, and albumin gradient. We found that all eight tests had similar diagnostic accuracies when evaluated by receiver operating characteristic (ROC) analysis except for BILI-R, which was less diagnostically accurate. Decision thresholds determined by ROC analysis differed from previously reported values for LDH-PF (>0.45 upper limits of normal) and C-PF (>45 mg/dL). Paired and triplet test combinations tended to have higher diagnostic accuracies compared with individual tests, but examination of the odds ratios with 95% confidence intervals did not identify a clearly superior test combination. Limitations of theprimary studies presented a high likelihood of bias affecting their results. Conclusions: Several strategies exist for clinicians in utilizing PF tests to classify effusions as exudates or transudates but accurate interpretations of these test results will require better designed studies.

ASDD Area Sistemi Dipartimentali e Documentali, Università di Bologna, Catalogo delle riviste ed altri periodici
Documento generato il 27/11/20 alle ore 06:05:49