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In a diagnostic test study the validity of three serodiagnostic test was compared in patients with liver
Carlos Manterola1, Alvaro Cuadra, Sergio Muñoz
1Department of Surgery, Hospital Regional de Temuco, Faculty of Medicine, Universidad de La Frontera, Casilla 54-D, Temuco, Chile. cmantero@ufro.cl
Background And Objective:
To determine the efficacy of immunoprecipitation (DD5), enzyme immunoanalysis (ELISA-IgG), and immunoelectrotransference or Western blot (WB) in patients with liver echinococcosis (LE) used separately, in parallel and in series.
Methods:
Diagnostic test study. DD5, ELISA-IgG, and WB were applied in 75 patients with LE and 75 with cholelithiasis. Surgery was considered a reference standard. The sample size was calculated assuming a 99% confidence interval (99% CI), expected sensitivity (S) of 90% and a worst result of 80%; expected specificity (SP) of 95% and a worst result of 85%. S, SP, and predictive values (PPV and NPV) were calculated.
Results:
The best S was verified with ELISA-IgG and WB (82.7%) and the best SP with DD5 (94.7%). DD5 presented a better PPV (92.9%) and WB a better NPV (83.5%). When applying the tests in parallel, the best S was obtained from the combination of DD5 and WB (82.7%); and the best SP, PPV and NPV with ELISA-IgG and WB (88.0%, 87.3%, and 83.5%, respectively).
Conclusions:
DD5 appears as the most specific test and as having greater PPV; ELISA-IgG and WB are more sensitive. The combined use of these tests does not improve diagnosis validity.
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