Rubenstein L V, Ward N C, Greenfield S
J Gen Intern Med. 1986 Jan-Feb;1(1):38-43. doi: 10.1007/BF02596324.
The serum alkaline phosphatase (ALP) is often included among the tests used for case-finding among ambulatory patients. To determine the positive predictive value of the ALP, test results for all adults screened by a health maintenance organization between March and December 1969 were obtained by computer. The authors reviewed the charts of all 661 patients with abnormal tests whose primary source of medical care was at this facility. Complete two-year follow-up data were available for 91% of these patients. There were 56 patients (9%) with a diagnosis that could have explained an abnormal ALP. Of those cases in which ALP would have been clinically useful all but one could have been diagnosed by a simple, noninvasive workup, and in that one case, no management change would have occurred. The authors conclude that in the absence of a small number of specific indications, extensive testing need not be performed to evaluate an isolated abnormal ALP obtained from a screening examination.
血清碱性磷酸酶（ALP）常用于门诊患者的病例筛查。为确定ALP的阳性预测值，通过计算机获取了1969年3月至12月期间由一家健康维护组织筛查的所有成年人的检测结果。作者查阅了所有661例检测结果异常患者的病历，这些患者主要在此医疗机构接受治疗。其中91%的患者有完整的两年随访数据。有56例患者（9%）的诊断可以解释ALP异常。在那些ALP对临床有帮助的病例中，除1例外，所有病例均可通过简单的非侵入性检查确诊，而在该病例中，治疗方案并无改变。作者得出结论，在没有少数特定指征的情况下，无需进行广泛检测来评估筛查检查中获得的孤立性ALP异常。
