التفاصيل البيبلوغرافية
| العنوان: |
Using Antineutrophil Cytoplasmic Antibody Testing to Diagnose Vasculitis: Can Test-Ordering Guidelines Improve Diagnostic Accuracy? |
| المؤلفون: |
Mandl, Lisa A., Solomon, Daniel H., Smith, Ellison L., Lew, Robert A., Katz, Jeffrey N., Shmerling, Robert H. |
| المصدر: |
Archives of Internal Medicine; 7/8/2002, Vol. 162 Issue 13, p1509, 6p |
| مصطلحات موضوعية: |
VASCULITIS, NEUTROPHILS, CYTOPLASM, DIAGNOSIS |
| مستخلص: |
Background: Antineutrophil cytoplasmic antibodies (ANCAs) are strongly associated with Wegener granulomatosis, Churg-Strauss angiitis, microscopic polyangiitis, and pauci-immune glomerulonephritis, referred to collectively as ANCA-associated vasculitis (AAVs). It is unclear how accurate ANCA measurement is for diagnosing AAV in diverse populations or whether proposed ANCA test-ordering guidelines improve test performance. Methods: We assembled a retrospective case series of hospitalized and ambulatory patients from 2 academic medical centers to assess the diagnostic accuracy of AN CA measurement by enzyme-linked immunosorbent assay in identifying cases of AAV. In addition, we assessed the effect of applying proposed ANCA test-ordering guidelines on test performance. Results: For ANCA testing, sensitivity was 81%; specificity, 98%; positive predictive value, 54%; and negative predictive value, 99%. There were no significant changes in operating characteristics after applying the guideline criteria. Using guidelines would have decreased ANCA test ordering by 23% and would have decreased the false-positive rate by 27%. No cases of AAV would have been missed if only patients fulfilling the guidelines were ANCA tested. Conclusion: A positive result on an enzyme-linked immunosorbent assay ANCA test, as it is currently ordered, is not a definitive diagnostic indicator of AAV. Compliance with guidelines for ANCA testing would decrease the number of false-positive results and has the potential to reduce total test expenditures. [ABSTRACT FROM AUTHOR] |
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| قاعدة البيانات: |
Complementary Index |
