Table 2:

Diagnostic utility of DRE in diagnosing RED

Finding	SN (%)	SP (%)	(+) LR	(−) LR
DRE (any abnormality)24–30	75.0 (63.4–88.5)	84.4 (55.9–87.6)	4.8 (2.1–5.2)	0.3 (0.2–0.4)
Paradoxical puborectalis contraction or impaired relaxation during defecation24, 25, 27–30	81.8 (55.4–89.2)	58.9 (52.1–75.3)	2.0 (1.7–2.6)	0.3 (0.2–0.6)
Paradoxical puborectalis contraction24, 25, 27, 30	69.6 (55.0–87.2)	56.1 (52.6–56.8)	1.9 (1.7–2.9)	0.4 (0.2–0.6)
Impaired anal relaxation29, 30	52.1 (30.8–73.4)	68.1 (53.6–82.6)	2.4 (2.0–2.8)	0.5 (0.3–0.7)
Increased resting anal tone28, 30	49.1 (46.0–52.3)	67.0 (60.8–73.1)	1.8 (1.4–2.2)	0.8 (0.7–0.9)
Increased anal squeeze28, 30	38.1 (29.2–47.1)	93.7 (91.1–96.4)	12.7 (8.8–16.6)	0.7 (0.6–0.7)
Abnormal perineal descent (increased/decreased)26, 30	70.8 (63.7–78.0)	62.6 (57.5–67.7)	1.9 (1.9–2.0)	0.4 (0.4–0.5)
Decreased/absent perineal descent26, 30	80.1 (77.5–82.6)	68.5 (60.5–76.4)	3.3 (2.5–4.1)	0.3 (0.3–0.3)
Increased perineal descent26	18.2	89.7	1.8	0.9
Inability to contract abdominal muscles during defecation29	71.0	52.3	1.5	0.6
Puborectalis tenderness30	54.1	71.3	1.9	0.6
No dyssynergia overall* 28, 29	83.2 (78.2–88.2)	71.7 (65.2–78.1)	3.5 (2.9–4.1)	0.2 (0.2–0.3)

Data presented as median (Q1,Q3). If no IQR present, this is due to only one reference with the pertinent information.

Reference numbers in brackets are found in the Supplemental reference list.

^*No dyssynergia overall is defined by absence of at least 2 of 4 findings during simulated defecation: 1) inability to contract abdominal muscle 2) inability to relax anal sphincter 3) paradoxical anal contraction 4) absence of perineal descent

Grey = SN/SP ≥85% with IQR <20%; (+)LR ≥2 with IQR <1.0, (−) LR <0.5 with IQR <0.5

Black = SN/SP ≥95% with IQR <20%, (+) LR ≥5 with IQR <1.0, (−) LR <0.2 with IQR <0.5