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[The diagnostic evaluation of rapid sputum technics for Pneumococcus in community-acquired pneumonia. The usefulness of Bayes theorem for clinical application].

This study aimed to quantify the diagnostic value of immunological techniques and methods for rapid analysis of sputum for pneumococcus, using sensitivity and specificity values reported in the literature to calculate positive and negative predictive values (PPV and NPV) according to Bayes formulas. Diagnostic gains of the test are calculated and compared to pretext probability. We located articles reporting sensitivity and specificity of counterimmunoelectrophoresis (CIE), coagglutination (CoA) and latex agglutination (LA) tests. We also calculated the probability ratios for the three tests. LA achieved the best overall diagnostic utility rating. CoA had the highest PPV, whereas LA offered the highest NPV. CIE was the least useful. These three tests are more useful at intermediate levels of prevalence of pneumococcus, which coincide with estimate in our population. We conclude that LA and CoA are of greater diagnostic utility for community acquired pneumonia, as they are useful for determining prevalence as well as for deciding initial antibiotic treatment.

Agglutination Tests↗
PubMed2002

A method of probability diagnostic assignment that applies bayes theorem for use in serologic diagnostics, using an example of Neospora caninum infection in cattle.

OBJECTIVE: To develop a method of probability diagnostic assignment (PDA) that uses continuous serologic measures and infection prevalence to estimate the probability of an animal being infected, using Neospora caninum as an example. ANIMALS: 196 N caninum-infected beef and dairy cattle and 553 cattle not infected with N caninum; 50 dairy cows that aborted and 50 herdmates that did not abort. PROCEDURE: Probability density functions corresponding to distributions of N caninum kinetic ELISA results from infected and uninfected cattle were estimated by maximum likelihood methods. Maximum likelihood methods also were used to estimate N caninum infection prevalence in a herd that had an excessive number of abortions. Density functions and the prevalence estimate were incorporated into Bayes formula to calculate the conditional probability that a cow with a particular ELISA value was infected with N caninum. RESULTS: Probability functions identified for infected and uninfected cattle were Weibull and inverse gamma functions, respectively. Herd prevalence was estimated, and probabilities of N caninum infection were determined for cows with various ELISA values. CONCLUSIONS AND CLINICAL RELEVANCE: Use of PDA offers an advantage to clinicians and diagnosticians over traditional seronegative or seropositive classifications used as a proxy for infection status by providing an assessment of the actual probability of infection. The PDA permits use of all diagnostic information inherent in an assay, thereby eliminating a need for estimates of sensitivity and specificity. The PDA also would have general utility in interpreting results of any diagnostic assay measured on a continuous or discrete scale.

Abortion, Veterinary↗