Understanding diagnostic tests 2: likelihood ratios, pre‐ and post‐test probabilities and their use in clinical practice

Akobeng, Anthony K

doi:10.1111/j.1651-2227.2006.00179.x

Cited by 370 publications

(253 citation statements)

References 13 publications

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“…The more rare a disease is, the more accurate the screening instrument has to be, since the Bayes theorem states that the chance that a disease is truly present depends on the prevalence of the disease and the properties of the test (Akobeng, 2006). Because of the low prevalence rate of ASD, designing screening instruments to be used in the general population with an acceptable sensitivity is rather difficult.…”

Section: Discussionmentioning

confidence: 99%

“…Positive likelihood ratio (LR+; how much the probability of having ASD increases after a positive screen) was 17.42. This means that a child with ASD is about 17 times more likely to have a positive screen on the CESDD than a child 16 without ASD (rates above 10 are considered as good; Akobeng, 2006). The negative likelihood ratio (LR-; how much the propability of having ASD decreases after a negative screen) was .33.…”

Section: [Insert Figure 2 Here]mentioning

confidence: 99%

“…The negative likelihood ratio (LR-; how much the propability of having ASD decreases after a negative screen) was .33. This means that the probability of having a negative test for children with ASD is about one-third of that of those without the disorder (LR-below .10 virtually rule out the chance that a person has ASD; Akobeng, 2006).…”

Section: [Insert Figure 2 Here]mentioning

confidence: 99%

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Screening for Autism Spectrum Disorders in Flemish Day-Care Centres with the Checklist for Early Signs of Developmental Disorders

Dereu

Warreyn

Raymaekers

et al. 2010

J Autism Dev Disord

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Section: Discussionmentioning

confidence: 99%

Section: [Insert Figure 2 Here]mentioning

confidence: 99%

Section: [Insert Figure 2 Here]mentioning

confidence: 99%

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Screening for Autism Spectrum Disorders in Flemish Day-Care Centres with the Checklist for Early Signs of Developmental Disorders

Dereu

Warreyn

Raymaekers

et al. 2010

J Autism Dev Disord

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“…Specificities were evaluated for Swiss blood donors and patients with non-parasitic liver lesions or parasitic infections. Likelihood ratios and post-test probabilities (reviewed in [30]) were calculated for different clinical and epidemiological settings:…”

Section: Evaluation Of Test Performancesmentioning

confidence: 99%

Serological diagnosis of echinococcosis: the diagnostic potential of native antigens

et al. 2011

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PURPOSE: Human alveolar (AE) and cystic echinococcosis (CE) caused by the metacestode stages of Echinococcus multilocularis and E. granulosus, respectively, lack pathognomonic clinical signs. Diagnosis therefore relies on the results of imaging and serological studies. The primary goal of this study was to evaluate the efficacy of several easy-to-produce crude or partially purified E. granulosus and E. multilocularis metacestode-derived antigens as tools for the serological diagnosis and differential diagnosis of patients suspicious for AE or CE. METHODS: The sera of 51 treatment-naïve AE and 32 CE patients, 98 Swiss blood donors and 38 patients who were initially suspicious for echinococcosis but suffering from various other liver diseases (e.g., liver neoplasia, etc.) were analysed. RESULTS: According to the results of enzyme-linked immunosorbent assays (ELISA), metacestode-derived antigens of E. granulosus had sensitivities varying from 81 to 97% and >99.9% for the diagnosis of CE and AE, respectively. Antigens derived from E. multilocularis metacestodes had sensitivities ranging from 84 to 91% and >99.9% for the diagnosis of CE and AE, respectively. Specificities ranged from 92 to >99.9%. Post-test probabilities for the differential diagnosis of AE from liver neoplasias, CE from cystic liver lesions, and screening for AE in Switzerland were around 95, 86 and 2.2%, respectively. Cross-reactions with antibodies in sera of patients with other parasitic affections (fasciolosis, schistosomosis, amebosis, cysticercosis, and filarioses) did occur at variable frequencies, but could be eliminated through the use of confirmatory testing. CONCLUSIONS: Different metacestode-derived antigens of E. granulosus and E. multilocularis are valuable, widely accessible, and cost-efficient tools for the serological diagnosis of echinococcosis. However, confirmatory testing is necessary, due to the lack of species specificity and the occurrence of cross-reactions to other helminthic diseases. Abstract Purpose Human alveolar (AE) and cystic echinococcosis (CE) caused by the metacestode stages of Echinococcus multilocularis and E. granulosus, respectively, lack pathognomonic clinical signs. Diagnosis therefore relies on the results of imaging and serological studies. The primary goal of this study was to evaluate the efficacy of several easy-to-produce crude or partially purified E. granulosus and E. multilocularis metacestode-derived antigens as tools for the serological diagnosis and differential diagnosis of patients suspicious for AE or CE. Methods The sera of 51 treatment-naïve AE and 32 CE patients, 98 Swiss blood donors and 38 patients who were initially suspicious for echinococcosis but suffering from various other liver diseases (e.g., liver neoplasia, etc.) were analysed. Results According to the results of enzyme-linked immunosorbent assays (ELISA), metacestode-derived antigens of E. granulosus had sensitivities varying from 81 to 97% and [99.9% for the diagnosis of CE and AE, respectively. Antigens derived from...

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“…Although this analysis is rarely used, it has more important benefits than sensitivity and specificity measurements alone and is the best way of measuring and expressing diagnostic accuracy. LR analysis can also be used for mental health screening instruments (Akobeng, 2006;Attia, 2003;McGee, 2002;Schmitz, Kruse & Tress, 2002;Sonis, 1999).…”

Section: The Data Analysismentioning

confidence: 99%

Screening for the hyperkinetic disorder by using strength and difficulties questionnaire teacher-report (SDQ-TR) in Indonesia school-aged children

Siregar¹,

Wimbarti²

2018

GJPR

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The aim of the research was to examine the validity of strength and difficulties questionnaire teacher-report (SDQ-TR) to screen hyperkinetic disorder in Indonesia school-aged children. The SDQ-TR was administrated to the teacher of representative samples of 222 elementary school children (7-14 years old). The SDQ-TR hyperactivity-inattention subscale scores were compared with the clinical diagnostic classification from clinical psychologists. The validity of the screening result was analysed using receiver operating characteristic (ROC), likelihood ratio (LR) and Chi-Square. Based on the analysis of ROC and LR by using cutoff point ≥ 7, obtained prevalence of hyperkinetic disorder was equal to 34.23% with sensitivity 72.4% and specificity 73.3%. Positive and Negative LR were 2.71 and 0.38. The Chi-Square analysis showed that there was a positive correlation between clinical psychologists' diagnosis and the SDQ-TR screening result. The study showed that SDQ-TR was a valid instrument for screen hyperkinetic disorder in Indonesia school-aged children.

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Understanding diagnostic tests 2: likelihood ratios, pre‐ and post‐test probabilities and their use in clinical practice

Cited by 370 publications

References 13 publications

Screening for Autism Spectrum Disorders in Flemish Day-Care Centres with the Checklist for Early Signs of Developmental Disorders

Screening for Autism Spectrum Disorders in Flemish Day-Care Centres with the Checklist for Early Signs of Developmental Disorders

Serological diagnosis of echinococcosis: the diagnostic potential of native antigens

Screening for the hyperkinetic disorder by using strength and difficulties questionnaire teacher-report (SDQ-TR) in Indonesia school-aged children

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