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Fiabilidad de los predictores clínicos y de la biopsia de arteria ...

Fiabilidad de los predictores clínicos y de la biopsia de arteria ...

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<strong>Fiabilidad</strong> <strong>de</strong> <strong>los</strong> <strong>predictores</strong> <strong>clínicos</strong> y <strong>de</strong> <strong>la</strong> <strong>biopsia</strong> <strong>de</strong> <strong>arteria</strong> temporal en el diagnóstico <strong>de</strong> <strong>la</strong> arteritis <strong>de</strong> célu<strong>la</strong>s gigantes<br />

Joan Brunsó Casel<strong>la</strong>s<br />

101<br />

[95% Confi<strong>de</strong>nce Interval]<br />

---------------------------------------------------------------------------<br />

Prevalence Pr(A) 21% 17% 25.5%<br />

---------------------------------------------------------------------------<br />

Sensitivity Pr(+|A) 74.6% 62.9% 84.2%<br />

Specificity Pr(-|N) 70.8% 65% 76.2%<br />

ROC area (Sens. + Spec.)/2 .727 .67 .785<br />

---------------------------------------------------------------------------<br />

Likelihood ratio (+) Pr(+|A)/Pr(+|N) 2.56 2.03 3.22<br />

Likelihood ratio (-) Pr(-|A)/Pr(-|N) .358 .238 .537<br />

Odds ratio LR(+)/LR(-) 7.16 3.96 12.9<br />

Positive predictive value Pr(A|+) 40.2% 31.7% 49%<br />

Negative predictive value Pr(N|-) 91.4% 86.8% 94.8%<br />

Capacidad discriminativa global, aunque no presenta ni alta sensibilidad ni alta<br />

especificidad. El 40.15% <strong>de</strong> <strong>los</strong> pacientes que presentaron cefalea tuvieron un<br />

resultado positivo <strong>de</strong> <strong>la</strong> BAT (fig.56).<br />

9-PCR<br />

300<br />

250<br />

200<br />

150<br />

100<br />

50<br />

0<br />

Punto <strong>de</strong> corte <strong>de</strong>l hospital 1,1 mg/ L.<br />

Figura 57: Distribución <strong>de</strong> <strong>los</strong> pacientes según <strong>los</strong> niveles <strong>de</strong> PCR: mayor o menor a 1.1 mg/L.<br />

p= 0.000<br />

70<br />

188<br />

1<br />

83<br />

PCR> 1.1 PCR≤ 1.1<br />

BAT positiva<br />

BAT negativa

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