TABLE 6.
Test Characteristics and Predictive Values of Each RBUS “Positive” Threshold for Each of the VCUG Thresholds
| Sensitivity (95% CI) | Specificity (95% CI) | Positive Predictive Value (95% CI) | Negative Predictive Value (95% CI) | |
|---|---|---|---|---|
| VCUG-E threshold (any abnormal finding on VCUG) | ||||
| RBUS-D (most relaxed criteria) | 28.0(25.2–30.9)* / 26.7(23.2–30.4)** | 77.3(74.9–79.6)* / 75.1 (71.5–78.5)** | 49.2(45.0–53.4)* / 51.0(45.3–56.7)** | 57.9(55.5–60.2)* / 51.4(48.1–54.7)** |
| RBUS-C | 25.5(22.8–28.3)* / 24.2(20.8–27.8)** | 78.6(76.2–80.8)* / 76.4 (72.9–79.7)** | 48.3(43.9–52.7)* / 49.8(43.9–55.8)** | 57.4(55.0–59.7)* / 51.0(47.7–54.3)** |
| RBUS-B | 19.1(16.7–21.6)* / 18.8(15.7–22.1)** | 84.2(82.1–86.2)* / 83.0 (79.8–85.9)** | 48.6(43.5–53.7)* / 51.6(44.7–58.5)** | 57.1(54.8–59.3)* / 51.3(48.1–54.5)** |
| RBUS-A (most stringent criteria) | 4.9(3.7–6.5)* / 5.2(3.6–7.4)** | 96.7(95.5–97.6)* / 96.1 (94.2–97.5)** | 53.8(43.1–64.4)* / 56.4(42.3–69.7)** | 56.5(54.4–58.6)* / 51.1(48.2–54.1)** |
| VCUG-D threshold (urethral findings or major bladder finding or any VUR) | ||||
| RBUS-D (most relaxed criteria) | 28.1(25.3–31.0)* / 26.6(23.1–30.4)** | 77.3(74.9–79.6)* / 75.0(71.4–78.4)** | 48.5(44.3–52.7)* / 50.6(44.9–56.3)** | 58.6(56.2–61.0)* / 51.5(48.2–54.8)** |
| RBUS-C | 25.5(22.8–28.4)* / 24.1(20.7–27.7)** | 78.6(76.2–80.8)* / 76.3(72.8–79.7)** | 47.5(43.2–51.9)* / 49.5(43.6–55.4)** | 58.2(55.8–60.5)* / 51.1(47.8–54.4)** |
| RBUS-B | 19.0(16.6–21.6)* / 18.6(15.6–22)** | 84.1(82.0–86.1)* / 82.9(79.7–85.8)** | 47.6(42.5–52.7)* / 51.2(44.3–58)** | 57.8(55.5–60.0)* / 51.4(48.2–54.6)** |
| RBUS-A (most stringent criteria) | 4.9(3.7–6.5)* / 5.3(3.6–7.4)** | 96.7(95.5–97.6)* / 96.1(94.2–97.5)** | 52.7(42.0–63.3)* / 56.4(42.3–69.7)** | 57.2(55.1–59.3)* / 51.3(48.4–54.2)** |
| VCUG-C threshold (urethral findings or major bladder finding or VUR >I) | ||||
| RBUS-D (most relaxed criteria) | 29.0(26.0–32.1)* / 27.3 (23.6–31.3)** | 77.5(75.2–79.7)* / 75.5(72.0–78.7)** | 44.8(40.6–49.0)* / 47.7(42.1–53.5)** | 63.4(61.1–65.7)* / 55.9(52.6–59.2)** |
| RBUS-C | 26.5(23.6–29.5)* / 24.7(21.1–28.6)** | 78.9(76.6–81.0) / 76.9(73.4–80.0) | 44.1(39.8–48.5) / 46.7(40.8–52.6) | 63.0(60.7–65.3) / 55.5(52.2–58.7) |
| RBUS-B | 19.6(17.0–22.4)* / 19.0(15.8–22.6)** | 84.3(82.2–86.1) / 83.1(80.0–85.8) | 44.0(39.0–49.0) / 47.9(41.1–54.8) | 62.5(60.2–64.7) / 55.6(52.4–58.7) |
| RBUS-A (most stringent criteria) | 5.2(3.8–6.8)* / 5.4(3.6–7.6)** | 96.7(95.6–97.6) / 96.1(94.3–97.4) | 49.5(38.8–60.1) / 52.7(38.8–66.3) | 61.8(59.7–63.9) / 55.3(52.4–58.2) |
| VCUG-B threshold (urethral findings or major bladder finding or VUR >II) | ||||
| RBUS-D (most relaxed criteria) | 35.8(31.7–40.0)* / 32.8 (27.9–37.9)** | 78.3(76.3–80.2)* / 77.1(74.1–79.9)** | 33.5(29.6–37.5)* / 37.1(31.7–42.7)** | 80.0(78.0–81.9)* / 73.6(70.5–76.4)** |
| RBUS-C | 33.1(29.1–37.3)* / 29.9(25.2–35.0)** | 79.8(77.9–81.7)* / 78.6(75.7–81.3)** | 33.4(29.4–37.6)* / 36.6(31.0–42.4)** | 79.7(77.7–81.5)* / 73.1(70.1–76.0)** |
| RBUS-B | 25.2(21.5–29.1)* / 23.1(18.8–27.8)** | 85.2(83.5–86.9)* / 84.3(81.7–86.7)** | 34.2(29.5–39.1)* / 37.7(31.2–44.5)** | 78.9(77.0–80.7)* / 72.7(69.8–75.4)** |
| RBUS-A (most stringent criteria) | 7.8(5.6–10.4)* / 7.4(4.9–10.7)** | 97.1(96.2–97.8)* / 96.6(95.1–97.7)** | 45.1(34.6–55.8)* / 47.3(33.7–61.2)** | 77.5(75.7–79.3)* / 71.7(69.0–74.3)** |
| VCUG-A threshold (urethral findings or major bladder finding or VUR >III) | ||||
| RBUS-D (most relaxed criteria) | 54.7(46.0–63.3)* / 54.9(42.7–66.8)** | 76.9(75.1–78.7)* / 76.1(73.5–78.5)** | 13.3(10.6–16.4)* / 12.6(9.1–16.8)** | 96.3(95.3–97.2)* / 96.4(95.0–97.5)** |
| RBUS-C | 53.3(44.6–61.9)* / 53.5(41.3–65.5)** | 78.7(76.9–80.5)* / 78.0(75.5–80.4)** | 13.9(11.1–17.2)* / 13.2(9.5–17.7)** | 96.3(95.3–97.1)* / 96.4(95.0–97.5)** |
| RBUS-B | 44.5(36.0–53.3)* / 46.5(34.5–58.7)** | 84.5(82.9–86.1)* / 83.9(81.7–86.0)** | 15.7(12.2–19.7)* / 15.3(10.8–20.9)** | 95.9(94.9–96.8)* / 96.2(94.8–97.3)** |
| RBUS-A (most stringent criteria) | 18.2(12.2–25.7)* / 18.3(10.1–29.3)** | 96.9(96.1–97.6)* / 96.3(95.0–97.3)** | 27.5(18.6–37.8)* / 23.6(13.2–37.0)** | 94.8(93.8–95.7)* / 94.9(93.5–96.1)** |
See Table 2 for explanation of RBUS threshold criteria. *Values among children age <120 mo with history of UTI as indication for imaging (N = 2259). **Values among children age 2–24 mo with initial febrile UTI as the indication for GU imaging (N = 1203). CI, 95% confidence interval.