Table 4.
The individual and combined diagnostic performance of GM ELISA, WB, and serum PCR
| Assay | Performance value (% [95% CI])a |
LR+b | LR− | DORc | |||
|---|---|---|---|---|---|---|---|
| Sensitivity | Specificity | PPV | NPV | ||||
| GM | 80.9 (67.5–89.6) | 96.8 (83.8–99.4) | 97.4 (86.8–99.6) | 76.9 (61.7–87.4) | 25.3 | 0.20 | 126.5 |
| WB PCR | 85.1 (72.3–92.6) | 64.5 (47.0–78.9) | 78.4 (65.4–87.5) | 74.1 (65.4–87.5) | 2.4 | 0.23 | 10.4 |
| Serum PCR | 78.7 (65.1–88.0) | 83.9 (67.4–92.9) | 88.1 (75.0–94.8) | 72.2 (56.0–84.2) | 4.9 | 0.25 | 19.6 |
| Combination testingd | |||||||
| GM/GM | 48.9 (35.3–62.8) | 100 (89.0–100) | 100 (85.7–100) | 56.4 (43.3–68.7) | >489 | 0.51 | >958.9 |
| GM/WB | 68.1 (53.8–79.6) | 100 (89.0–100) | 100 (89.3–100) | 67.4 (53.0–79.1) | >681 | 0.32 | >2,128.1 |
| GM/serum | 59.6 (45.3–72.4) | 100 (89.0–100) | 100 (87.9–100) | 62.0 (48.2–74.1) | >596 | 0.40 | >1,490 |
| WB/WB | 46.8 (33.3–60.8) | 93.5 (79.3–98.2) | 91.7 (74.2–97.7) | 53.7 (40.6–66.3) | 7.2 | 0.57 | 12.6 |
| WB/serum | 57.4 (43.3–70.5) | 96.8 (83.8–99.4) | 96.4 (82.3–99.4) | 60.0 (46.2–72.4) | 17.9 | 0.44 | 40.7 |
| Serum/serum | 53.2 (39.2–66.7) | 100 (89.0–100) | 100 (86.7–100) | 58.5 (45.1–70.7) | >532 | 0.47 | 1,131.9 |
a
PPV, positive predictive value; NPV, negative predictive value.
b
LR, likelihood ratio.
c
DOR, diagnostic odds ratio.
d
As an example, the combination GM/GM means that a first positive test had to be confirmed by a second positive test within 11 days.