Chest
Clinical Investigations: Pleural EffusionsDiagnostic Value of Tests That Discriminate Between Exudative and Transudative Pleural Effusions
Section snippets
Materials and Methods
The study was a meta-analysis of the published English-language literature designed to examine the diagnostic accuracy of the eight biochemical tests reported to be of value in separating exudative from transudative pleural effusions. We used statistical techniques to generate receiver operating characteristic (ROC) curves and odds ratios with their 95% confidence intervals (CIs) to compare, respectively, the discriminative properties of individual tests and tests combined in parallel (test
Results
Eleven studies were identified by the literature search.16, 17, 18, 19, 20, 21, 22, 23, 24, 25, 26 Four studies with a total of 408 patients17, 20, 21, 24 were excluded because only patients with treated heart failure were examined17 or original data were no longer available from contacted investigators and test results could not be extracted from the published report.20, 21, 24 The remaining seven studies16, 18, 19, 22, 23, 25, 26 fulfilled the entrance criteria and were included in the
Discussion
Determining the transudative or exudative nature of PF is the initial step in evaluating pleural effusions of uncertain etiology. This meta-analysis formally and critically examined the primary investigations that report the discriminative properties of various PF tests used for establishing the presence of an exudate. Our analysis resulted in two major categories of findings that pertained to (1) the diagnostic accuracies of the tests and (2) the quality of study design of the primary
References (29)
- et al.
Testing the waters: differentiating transudates from exudates
Chest
(1995) - et al.
Comparative analysis of the biochemical parameters used to distinguish between pleural transudates and exudates
Chest
(1995) - et al.
Treatment of congestive heart failure: its effect on pleural fluid chemistry
Chest
(1989) - et al.
Measurement of pleural fluid cholesterol and lactate dehydrogenase: a simple and accurate set of indicators for separating exudates from transudates
Chest
(1995) - et al.
Cholesterol in pleural effusions: a diagnostic aid
Chest
(1987) - et al.
Pleural fluid to serum bilirubin concentration ratio for the separation of transudates and exudates
Chest
(1990) - et al.
Evaluation of different criteria for the separation of pleural transudates from exudates
Chest
(1993) - et al.
The serum-effusion albumin gradient in the evaluation of pleural effusions
Chest
(1990) - et al.
Cholesterol: a useful parameter for distinguishing between pleural exudates and transudates
Chest
(1991) The relationship between the specific gravity and the protein content in human serous effusions
Am J Med Sci
(1941)
Pleural effusion, a statistical study of 436 patients
N Engl J Med
Pleural effusion: the diagnostic separation of transudates and exudates
Ann Intern Med
Pleural disease
Designing clinical research
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Supported by the Mercy Health Services Research Fund.
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A complete list of participants is located in the appendix.