Table 10:
Validity of DPC data for identifying hyponatremia and hypernatremia based on various cutoff values and corrections for glucose, triglycerides, or total protein in supplementary analyses.
| Hyponatremia | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Type of population | Presence of correction | Cutoff, mmol/l | Disease frequency (%) | Diagnosis frequency (%) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | LR+ | LR− | DOR |
| Available glucose levels (N = 1 146 779) | Not corrected for glucose | <135 | 23.8 | 1.2 | 4.5 | 99.9 | 92.4 | 77.0 | 39.1 | 0.96 | 40.9 |
| <130 | 7.3 | 1.2 | 12.5 | 99.7 | 78.7 | 93.5 | 46.8 | 0.88 | 53.3 | ||
| <125 | 2.3 | 1.2 | 25.9 | 99.4 | 51.8 | 98.3 | 45.1 | 0.75 | 60.5 | ||
| Corrected for glucose (correction performed in 1 146 779) | <135 | 21.9 | 1.2 | 4.8 | 99.9 | 90.5 | 78.9 | 33.9 | 0.95 | 35.6 | |
| <130 | 6.6 | 1.2 | 13.3 | 99.7 | 75.4 | 94.2 | 43.4 | 0.87 | 49.9 | ||
| <125 | 2.1 | 1.2 | 27.1 | 99.4 | 49.8 | 98.4 | 45.4 | 0.73 | 61.9 | ||
| Available triglyceride levels (N = 450 019) | Not corrected for high triglycerides | <135 | 19.6 | 1.1 | 5.4 | 99.9 | 94.4 | 81.3 | 68.8 | 0.95 | 72.6 |
| <130 | 6.0 | 1.1 | 15.3 | 99.8 | 82.4 | 94.8 | 72.6 | 0.85 | 85.5 | ||
| <125 | 2.1 | 1.1 | 31.1 | 99.5 | 57.1 | 98.6 | 63.4 | 0.69 | 91.5 | ||
| Corrected for high triglycerides (correction performed in 361) | <135 | 19.5 | 1.1 | 5.4 | 99.9 | 94.2 | 81.3 | 67.4 | 0.95 | 71.2 | |
| <130 | 6.0 | 1.1 | 15.3 | 99.8 | 82.2 | 94.8 | 72.2 | 0.85 | 85.1 | ||
| <125 | 2.0 | 1.1 | 31.2 | 99.5 | 57.0 | 98.6 | 63.5 | 0.69 | 91.8 | ||
| Available total protein levels (N = 1 486 592) | Not corrected for total protein | <135 | 23.1 | 1.0 | 4.1 | 99.9 | 92.6 | 77.7 | 42.0 | 0.96 | 43.8 |
| <130 | 6.9 | 1.0 | 11.6 | 99.8 | 78.4 | 93.8 | 49.0 | 0.89 | 55.2 | ||
| <125 | 2.1 | 1.0 | 24.4 | 99.5 | 51.0 | 98.4 | 47.8 | 0.76 | 62.9 | ||
| Corrected for total protein (correction performed in 1 486 592) | <135 | 45.3 | 1.0 | 2.2 | 99.9 | 96.4 | 55.2 | 32.5 | 0.98 | 33.2 | |
| <130 | 14.0 | 1.0 | 6.4 | 99.9 | 87.5 | 86.8 | 43.1 | 0.94 | 45.9 | ||
| <125 | 4.3 | 1.0 | 15.6 | 99.6 | 65.4 | 96.4 | 42.4 | 0.85 | 50.1 | ||
| Hypernatremia | |||||||||||
| Type of population | Presence of correction | Cutoff, mmol/L | Disease frequency (%) | Diagnosis frequency (%) | Sensitivity (%) | Specificity (%) | PPV (%) | NPV (%) | LR+ | LR− | DOR |
| Available glucose levels (N = 1 123 465) | Not corrected for glucose | >145 | 7.1 | 0.2 | 2.6 | >99.9 | 96.9 | 93.1 | 410 | 0.98 | 421 |
| >150 | 2.4 | 0.2 | 6.8 | >99.9 | 87.7 | 97.7 | 289 | 0.93 | 310 | ||
| >155 | 1.2 | 0.2 | 10.7 | 99.9 | 69.7 | 98.9 | 187 | 0.89 | 209 | ||
| Corrected for glucose (correction performed in 1 123 465) | >145 | 10.9 | 0.2 | 1.7 | >99.9 | 97.3 | 89.3 | 300 | 0.98 | 305 | |
| >150 | 3.2 | 0.2 | 5.4 | >99.9 | 90.6 | 97.0 | 295 | 0.95 | 311 | ||
| >155 | 1.6 | 0.2 | 8.8 | >99.9 | 75.7 | 98.5 | 191 | 0.91 | 210 | ||
| Available triglyceride levels (N = 438 098) | Not corrected for high triglycerides | >145 | 5.0 | 0.1 | 2.8 | >99.9 | 96.5 | 95.2 | 523 | 0.97 | 538 |
| >150 | 1.3 | 0.1 | 9.2 | >99.9 | 86.7 | 98.8 | 480 | 0.91 | 529 | ||
| >155 | 0.7 | 0.1 | 14.2 | >99.9 | 70.5 | 99.4 | 337 | 0.86 | 392 | ||
| Corrected for high triglycerides (correction performed in 71) | >145 | 5.0 | 0.1 | 2.8 | >99.9 | 96.5 | 95.2 | 523 | 0.97 | 538 | |
| >150 | 1.3 | 0.1 | 9.2 | >99.9 | 86.7 | 98.8 | 480 | 0.91 | 529 | ||
| >155 | 0.7 | 0.1 | 14.2 | >99.9 | 70.5 | 99.4 | 336 | 0.86 | 392 | ||
| Available total protein levels (N = 1 465 526) | Not corrected for total protein | >145 | 6.9 | 0.2 | 2.2 | >99.9 | 96.7 | 93.2 | 390 | 0.98 | 399 |
| >150 | 2.2 | 0.2 | 6.1 | >99.9 | 86.7 | 97.9 | 285 | 0.94 | 304 | ||
| >155 | 1.1 | 0.2 | 9.7 | 99.9 | 68.6 | 99.0 | 194 | 0.90 | 214 | ||
| Corrected for total protein (correction performed in 1 465 526) | >145 | 3.6 | 0.2 | 4.1 | >99.9 | 93.5 | 96.6 | 390 | 0.96 | 407 | |
| >150 | 1.5 | 0.2 | 8.0 | >99.9 | 78.6 | 98.6 | 235 | 0.92 | 256 | ||
| >155 | 0.8 | 0.2 | 12.2 | 99.9 | 59.2 | 99.3 | 188 | 0.88 | 214 | ||
DPC, Diagnosis Procedure Combination; NPV, negative predictive value; PPV, positive predictive value; LR+: positive likelihood ratio; LR−: negative likelihood ratio; DOR: diagnostic odds ratio