O'Leary D H, Clouse M E, Persson A V, Edwards S A
AJR Am J Roentgenol. 1982 Jan;138(1):109-11. doi: 10.2214/ajr.138.1.109.
Determination of the specificity, sensitivity, and accuracy of diagnostic tests usually identifies the value of the tests in isolation, but the clinical significance of the findings is less clear. In this study the accuracies of direct continuous wave color-coded Doppler imaging (DDI), periorbital directional Doppler ultrasonography (PDDU), and oculoplethysmography-carotid phonangiography (OPG-CPA) were calculated for each examination alone and in combination with others for 176 patients who had been studied by all three noninvasive methods for suspected extracranial carotid arterial disease. When evaluated alone, DDI yielded the highest accuracy, 94%. In 89% of the population, DDI agreed with at least one of the other two tests. When this occurred, the majority finding was correct 98%. When DDI disagreed with the other two tests (11% of cases), it was correct in only 50%. These findings suggest a clinical approach which would minimize testing while achieving a high accuracy for most patients and identifying those patients whose carotid status could not be discerned with these studies.
确定诊断测试的特异性、敏感性和准确性通常能单独确定这些测试的价值，但研究结果的临床意义却不太明确。在本研究中，对176例疑似颅外颈动脉疾病且接受过所有三种非侵入性检查方法检查的患者，分别计算了直接连续波彩色编码多普勒成像（DDI）、眶周定向多普勒超声检查（PDDU）和眼体积描记法-颈动脉血管造影术（OPG-CPA）单独检查以及与其他检查联合检查时的准确性。单独评估时，DDI的准确性最高，为94%。在89%的人群中，DDI与其他两项检查中的至少一项结果一致。当出现这种情况时，多数结果正确的概率为98%。当DDI与其他两项检查结果不一致时（占病例的11%），其正确的概率仅为50%。这些研究结果提示了一种临床方法，该方法可以在尽量减少检查次数的同时，使大多数患者获得较高的准确性，并识别出那些通过这些检查无法明确颈动脉状况的患者。
