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Free Content Screening of malignant pleural effusion by discriminant analysis

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OBJECTIVE: To assess the value of discriminant analysis as a method of optimizing the discriminant power of routine parameters in differentiating between malignant and non-malignant pleural effusions.

METHODS: Retrospective review of the medical records of 245 patients with exudative pleural effusion.

RESULTS: The most powerful predictor of the malignant etiology of pleural effusion was a function that consisted of seven variables: age (years); effusion volume (coded as up to one third = 1, up to two thirds = 2, massive = 3); sedimentation rate (mm/h); monocyte count in the peripheral blood (cells/mm3); bloodstained exudate (coded as yes = 1, no = 2); and glucose (mg/dL) and iron (μg/dL) concentration in pleural fluid. This function showed a sensitivity of 77%, specificity of 85%, positive predictive value (PPV) of 76%, negative predictive value (NPV) of 86%, and was able to give an 82% rate of correct classification. In patients aged 50 years or younger, the NPV ranged between 91 and 98%, whereas in those older than 60 years, the PPV was 89%.

CONCLUSION: The calculated discriminant function is a simple, rapid, and inexpensive method for screening patients with pleural effusion for malignant etiology.
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Keywords: diagnosis; discriminant analysis; malignant; pleural effusion; tuberculosis

Document Type: Regular Paper

Affiliations: 1: Service of Pneumology, Hospital Clínico Universitario, Valencia, Spain 2: Service of Pneumology, Hospital Universitario La Fe, Valencia, Spain

Publication date: 2003-09-01

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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