Slap G B, Connor J L, Wigton R S, Schwartz J S
JAMA. 1986;255(20):2768-73.
A model to identify 9- to 25-year-old patients with malignant or granulomatous lymphadenopathy demonstrated a sensitivity/specificity of 0.95/0.96 in the original sample. This study tests the performance of the model in three new samples (n = 34, 87, 46) of young patients with peripheral lymphadenopathy. Patient charts were reviewed for the biopsy diagnosis and for the three variables in the model (lymph node size, recent ear-nose-throat symptoms, and chest roentgenogram). Prevalence rates of malignancy or granuloma in the three samples were 0.71, 0.37, and 0.37. The model's sensitivity/specificity in the three samples were 0.96/1.00, 0.88/0.80, and 0.82/0.83. Receiver operating characteristic curve areas for the model ranged from 0.87 to 0.98, indicating excellent discrimination. Likelihood ratios were calculated for all scores to allow adjustment of the model's predictions for population differences in the prevalence of malignancy or granuloma. We conclude that the model performs well and can help physicians to select those young patients with peripheral lymphadenopathy who should undergo biopsy.
一种用于识别9至25岁恶性或肉芽肿性淋巴结病患者的模型，在原始样本中显示出的灵敏度/特异度为0.95/0.96。本研究在三组新的外周淋巴结病年轻患者样本（n = 34、87、46）中测试了该模型的性能。查阅患者病历以获取活检诊断结果以及模型中的三个变量（淋巴结大小、近期耳鼻喉症状和胸部X光片）。三组样本中恶性肿瘤或肉芽肿的患病率分别为0.71、0.37和0.37。该模型在三组样本中的灵敏度/特异度分别为0.96/1.00、0.88/0.80和0.82/0.83。该模型的受试者工作特征曲线面积在0.87至0.98之间，表明具有出色的区分能力。计算了所有评分的似然比，以便根据恶性肿瘤或肉芽肿患病率的人群差异对模型的预测进行调整。我们得出结论，该模型性能良好，可帮助医生选择那些应接受活检的外周淋巴结病年轻患者。
