Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru

2.50
Hdl Handle:
http://hdl.handle.net/10757/623065
Title:
Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru
Authors:
Solari, Lely; Soto, Alonso; Van der Stuyft, Patrick
Citation:
Development of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru 2018, 69:103 International Journal of Infectious Diseases
Publisher:
Elsevier B.V.
Journal:
International Journal of Infectious Diseases
Issue Date:
Apr-2018
URI:
http://hdl.handle.net/10757/623065
DOI:
10.1016/j.ijid.2018.01.026
Additional Links:
http://linkinghub.elsevier.com/retrieve/pii/S1201971218300274
Abstract:
Objectives: To develop a clinical prediction rule (CPR) for the diagnosis of pleural tuberculosis (PT) in patients with pleural exudates in Peru. Methods: Clinical and laboratory information was collected from patients with exudative pleural effusion attending two reference hospitals in Lima, Peru. Predictive findings associated with PT in a multiple logistic regression model were used to develop the CPR. A definite diagnosis of PT was based on a composite reference standard including bacteriological and/or histological analysis of pleural fluid and pleural biopsy specimens. Results: A total of 238 patients were included in the analysis, of whom 176 had PT. Age, sex, previous contact with a TB patient, presence of lymphadenopathy, and pleural adenosine deaminase (ADA) levels were found to be independently associated with PT. These predictive findings were used to construct a CPR, for which the area under the receiver operating characteristics curve (AUC) was 0.92. The single best cut-off point was a score of ≥60 points, which had a sensitivity of 88%, specificity of 92%, a positive likelihood ratio of 10.9, and a negative likelihood ratio of 0.13. Conclusions: The CPR is accurate for the diagnosis of PT and could be useful for treatment initiation while avoiding pleural biopsy. A prospective evaluation is needed before its implementation in different settings.
Type:
info:eu-repo/semantics/article
Rights:
info:eu-repo/semantics/openAccess
Language:
eng
Keywords:
Aadenosine deaminase; Clinical prediction rules; Pleural effusion; Tuberculosis
ISSN:
12019712

Full metadata record

DC FieldValue Language
dc.contributor.authorSolari, Lelyes
dc.contributor.authorSoto, Alonsoes
dc.contributor.authorVan der Stuyft, Patrickes
dc.date.accessioned2018-04-04T16:09:20Z-
dc.date.available2018-04-04T16:09:20Z-
dc.date.issued2018-04-
dc.identifier.citationDevelopment of a clinical prediction rule for the diagnosis of pleural tuberculosis in Peru 2018, 69:103 International Journal of Infectious Diseaseses
dc.identifier.issn12019712-
dc.identifier.doi10.1016/j.ijid.2018.01.026-
dc.identifier.urihttp://hdl.handle.net/10757/623065-
dc.description.abstractObjectives: To develop a clinical prediction rule (CPR) for the diagnosis of pleural tuberculosis (PT) in patients with pleural exudates in Peru. Methods: Clinical and laboratory information was collected from patients with exudative pleural effusion attending two reference hospitals in Lima, Peru. Predictive findings associated with PT in a multiple logistic regression model were used to develop the CPR. A definite diagnosis of PT was based on a composite reference standard including bacteriological and/or histological analysis of pleural fluid and pleural biopsy specimens. Results: A total of 238 patients were included in the analysis, of whom 176 had PT. Age, sex, previous contact with a TB patient, presence of lymphadenopathy, and pleural adenosine deaminase (ADA) levels were found to be independently associated with PT. These predictive findings were used to construct a CPR, for which the area under the receiver operating characteristics curve (AUC) was 0.92. The single best cut-off point was a score of ≥60 points, which had a sensitivity of 88%, specificity of 92%, a positive likelihood ratio of 10.9, and a negative likelihood ratio of 0.13. Conclusions: The CPR is accurate for the diagnosis of PT and could be useful for treatment initiation while avoiding pleural biopsy. A prospective evaluation is needed before its implementation in different settings.es
dc.formatapplication/pdfes
dc.language.isoenges
dc.publisherElsevier B.V.es
dc.relation.urlhttp://linkinghub.elsevier.com/retrieve/pii/S1201971218300274es
dc.rightsinfo:eu-repo/semantics/openAccesses
dc.sourceUniversidad Peruana de Ciencias Aplicadas (UPC)es_PE
dc.sourceRepositorio Academico - UPCes_PE
dc.subjectAadenosine deaminasees
dc.subjectClinical prediction ruleses
dc.subjectPleural effusiones
dc.subjectTuberculosises
dc.titleDevelopment of a clinical prediction rule for the diagnosis of pleural tuberculosis in Perues
dc.typeinfo:eu-repo/semantics/articlees
dc.identifier.journalInternational Journal of Infectious Diseaseses
dc.description.peerreviewRevisión por pareses_PE
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