Table 3.

Spasticity Referral Tool Performance

Primary Care Provider	Subjects Evaluated by Rater and Reference Standard	Spasticity Prevalence (Positive Pre-Test Probability)a	Sensitivity (95% CI)	Positive Likelihood Ratio (95% CI)b	Spasticity Prevalence in Subjects Referred (Positive Post-Test Probability)c	Specificity (95% CI)	Negative Likelihood Ratio (95% CI)d	Spasticity Prevalence in Subjects Not Referred (Negative Post-Test Probability)e
Primary care physician (PCP)	n=43	30%	92% (64–100%)	4.0 (2.0–7.7)	63%	78% (58-90%)	0.10 (0.02–0.67)	4%
Nurse practitioner (NP)	n=45	33%	80% (52–96%)	1.7 (1.1–2.7)	46%	53% (34–72%)	0.38 (0.13–1.1)	16%

Notes: ^aSpasticity prevalence in the study population was 35% (17/49 subjects evaluated by the reference standard). Overlap between the reference standard and subjects evaluated by the PCP and NP was 43 and 45, respectively; therefore, prevalence within those subsets are presented for probability estimates. ^bCalculated as sensitivity/(1-specificity). ^cProbability of spasticity being present after rater referral to a spasticity specialist. ^dCalculated as (1-sensitivity)/specificity. ^eProbability of spasticity being present after rater deciding not to refer to a spasticity specialist.