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Free Content Screening of tuberculous pleural effusion by discriminant analysis

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SETTING: Pneumology Department of a 635-bed acute-care teaching hospital in Valencia, Spain.

OBJECTIVE: To assess the value of discriminant analysis as a method of optimizing the discriminant power of routine radiographic features and a panel of laboratory parameters including biochemical analyses of pleural fluid for differentiation between tuberculous and non-tuberculous pleural effusion.

DESIGN: A series of 47 variables were retrospectively obtained from the medical records of 189 patients with exudative pleural effusion (tuberculous pleurisy, n = 78; non-tuberculous pleurisy, n = 11). A backward elimination method was applied until the best discriminant function was found.

RESULTS: The most powerful predictor of tuberculous pleural effusion was a function that consisted of four variables, as follows: age (years); tuberculin skin test (mm of induration at 48 hours); white blood cell count (cells/mm3); and bloodstained exudate (coded as yes = 1, no = 2). This function showed a sensitivity of 90%, specificity of 87%, positive predictive value of 83%, negative predictive value of 92%, and was able to give an 88% rate of correct classification.

CONCLUSION: The calculated discriminant function based on the patientÕs age, peripheral leukocyte count, tuberculin skin test and blood in the exudate is a simple, rapid and inexpensive method for screening tuberculous etiology in patients with pleural effusion.
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Keywords: discriminant analysis; 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: July 1, 2001

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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 lung health world-wide.

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