Table 5. Diagnostic validity and inter-rater reliability of history elements and physical examination tests when individually performed to diagnose or exclude partial or complete ACL tears (n = 43) or complete ACL tears only (n = 22).

	Se (95% CI)		Sp (95% CI)		LR- (95% CI)		LR+ (95% CI)		Inter-rater reliability (95% CI)
	Partial or complete	Complete only	Partial or complete	Complete only	Partial or complete	Complete only	Partial or complete	Complete only
History elements
Pivoting traumatic mechanism	0.79 (0.64–0.90)	0.95 (0.77–1.00)	0.84 (0.79–0.89)	0.81 (0.75–0.85)	0.25 (0.14–0.44)	0.06 (0.01–0.38)	5.0 (3.6–7.0)	4.9 (3.8–6.4)	-
“Popping” sensation	0.58 (0.42–0.73)	-	0.92 (0.88–0.95)	-	0.45 (0.32–0.65)	-	7.6 (4.6–12.7)	-	-
Immediate effusion after trauma	-	0.68 (0.45–0.86)	-	0.94 (0.90–0.96)	-	0.34 (0.18–0.63)	-	11.0 (6.3–19.1)	-
Physical examination tests
Lachman	0.81 (0.67–0.92)	0.82 (0.60–0.95)	0.98 (0.95–0.99)	0.91 (0.87–0.95)	0.19 (0.10–0.36)	0.20 (0.08–0.48)	38.4 (16.0–92.5)	9.6 (6.1–14.9)	0.75 (0.63–0.88)
Pivot shift	0.77 (0.61–0.89)	0.80 (0.56–0.94)	0.98 (0.95–0.99)	0.92 (0.87–0.95)	0.24 (0.13–0.42)	0.22 (0.09–0.53)	37.5 (14.0–100.4)	9.5 (5.8–15.6)	0.84 (0.65–1.00)

ACL: anterior cruciate ligament; Se: sensitivity; Sp: specificity; LR+: positive likelihood ratio; LR-: negative likelihood ratio. “Popping” sensation was not calculated for complete ACL tears and immediate effusion was not calculated for partial and complete tears because it did not show an association with LASSO results presented in Table 4. For Lachman, cases coded as “Uncertain” were considered “Positive” for a suspicion of ACL tear (n = 3). Inter-rater reliability (kappa) was measured only for physical examination tests. The pivot shift could not be evaluated in n = 45 patients (n = 2 partial ACL tears, n = 2 complete ACL tears, 41 non-ACL tears).