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Table 3 Diagnostic performance of laboratory findings for primary aldosteronism

From: Sparing confirmatory testing in primary aldosteronism (SCIPA): a multicenter retrospective diagnostic accuracy study

 

Sensitivity, %

Specificity, %

PPV, %

NPV, %

LR+

LR-

Accuracy, %

Estimate (95% CI)

3 combinations

 A1:

PAC > 10 ng/dL + PRA < 1.0 ng/dL/hr + spont. hypoK

48.81% (37.74 – 59.96%)

70.27% (53.02 – 84.13%)

78.85% (68.44 – 86.50%)

37.68% (31.02 – 44.84%)

1.64 (0.96 - 2.82)

0.73 (0.54 – 0.98)

55.37% (46.06 - 64.41%)

 A2:

PAC > 15 ng/dL + PRA < 1.0 ng/dL/hr + spont. hypoK

44.05% (33.22 - 55.30%)

83.78% (67.99 – 93.81%)

86.05% (74.04 – 93.02%)

39.74% (34.23 – 45.53%)

2.72 (1.26 – 5.87)

0.67 (0.53 - 0.85)

56.20% (46.89 -65.20%)

 A3:

PAC > 20 ng/dL + PRA < 1.0 ng/dL/hr + spont. hypoK

34.52% (24.48 – 45.69%)

89.19% (74.58 - 96.97%)

87.88% (73.30 – 95.04%)

37.50% (33.13 – 42.09%)

3.19 (1.21 -8.43)

0.73 (0.61 - 0.89)

51.24% (41.99 - 60.43%)

 A4:

PAC > 25 ng/dL + PRA < 1.0 ng/dL/hr + spont. hypoK

27.38% (18.21 - 38.20%)

100.00% (90.51 - 100.00%)

100.00% (85.18 – 100.00%)

37.76% (34.72 – 40.89%)

-

0.73

(0.64 - 0.83)

49.59% (40.37 – 58.82%)

 A5:

PAC > 10 ng/dL + PRA < 0.6 ng/dL/hr + spont. hypoK

46.43% (35.47 – 57.65%)

72.97% (55.88 - 86.21%)

79.59% (68.65 – 87.41%)

37.50% (31.21 – 44.24%)

1.72 (0.96 – 3.06)

0.73 (0.56 – 0.97)

54.55% (45.24 – 63.62%)

 A6:

PAC > 15 ng/dL + PRA < 0.6 ng/dL/hr + spont. hypoK

41.67% (31.00 – 52.94%)

89.19% (74.58 – 96.97%)

89.74% (77.02 -95.81%)

40.24% (35.25 -45.45%)

3.85 (1.48 – 10.06)

0.65 (0.53 - 0.81)

56.20% (46.89 – 65.20%)

 A7:

PAC > 20 ng/dL + PRA < 0.6 ng/dL/hr + spont. hypoK

34.52% (24.48 – 45.69%)

94.59% (81.81 - 99.34%)

93.55% (78.49 – 98.29%)

38.89% (34.86 – 43.08%)

6.39 (1.61 – 25.38)

0.69 (0.58 - 0.82)

52.89% (43.61 - 62.03%)

 A8:

PAC > 25 ng/dL + PRA < 0.6 ng/dL/hr + spont. hypoK

27.38% (18.21 - 38.20%)

100.00% (90.51 - 100.00%)

100.00% (85.18 – 100.00%)

37.76% (34.72 – 40.89%)

-

0.73 (0.64 - 0.83)

49.59% (40.37 – 58.82%)

2 Combinations

 B1:

PAC > 10 ng/dL + PRA < 1.0 ng/dL/hr

79.76% (69.59 - 87.75%)

35.90% (21.20 – 52.82%)

72.83% (67.42 – 77.63%)

45.16% (31.20 – 59.93%)

1.24 (0.96 - 1.61)

0.56 (0.31 - 1.02)

65.85% (56.76 – 74.16%)

 B2:

PAC > 15 ng/dL + PRA < 1.0 ng/dL/hr

66.67% (55.54 – 76.58%)

61.54% (44.62 – 76.64%)

78.87% (70.94 – 85.10%)

46.15% (36.69 – 55.90%)

1.73 (1.13 - 2.65)

0.54 (0.37 - 0.80)

65.04% (55.92 -73.42%)

 B3:

PAC > 20 ng/dL + PRA < 1.0 ng/dL/hr

48.81%

(37.74 – 59.96%)

79.49%

(63.54 – 90.70%)

83.67%

(72.68 – 90.80%)

41.89%

(35.66 – 48.39%)

2.38

(1.24 - 4.58)

0.64

(0.50 - 0.84)

58.54%

(49.31 - 67.35%)

 B4:

PAC > 25 ng/dL + PRA < 1.0 ng/dL/hr

41.67%

(31.00 – 52.94%)

89.74%

(75.78 – 97.13%)

89.74%

(76.97 – 95.82%)

41.67%

(36.68 – 46.83%)

4.06

(1.55 – 10.63)

0.65

(0.53 - 0.80)

56.91%

(47.68 - 65.80%)

 B5:

PAC > 10 ng/dL + PRA < 0.6 ng/dL/hr

67.86%

(56.78 – 77.64%)

43.59%

(27.81 – 60.38%)

72.15%

(65.46 – 77.98%)

38.64%

(28.17 – 50.27%)

1.20

(0.88 - 1.64)

0.74

(0.46 - 1.18)

60.16%

(50.95- 68.88%)

 B6:

PAC > 15 ng/dL + PRA < 0.6 ng/dL/hr

54.76%

(43.52 – 65.66%)

69.23%

(52.43 – 82.98%)

79.31%

(69.73 – 86.45%)

41.54%

(34.15 – 49.33%)

1.78

(1.07 - 2.96)

0.65

(0.48 – 0.90)

59.35%

(50.12 – 68.11%)

 B7:

PAC > 20 ng/dL + PRA < 0.6 ng/dL/hr

41.67%

(31.00 – 52.94%)

84.62%

(69.47 – 94.14%)

85.37%

(72.82 – 92.70%)

40.24%

(34.97 – 45.75%)

2.71

(1.24 - 5.90)

0.69

(0.55 - 0.86)

55.28%

(46.06 - 64.25%)

 B8:

PAC > 25 ng/dL + PRA < 0.6 ng/dL/hr

32.14%

(22.36 – 43.22%)

97.44%

(86.52 - 99.94%)

96.43%

(79.19 - 99.48%)

40.00%

(36.33 – 43.79%)

12.54

(1.77 – 88.95)

0.70

(0.60 - 0.81)

52.85%

(43.64 - 61.91%)

  1. Legend: PAC plasma aldosterone concentration, PRA plasma renin activity, Spont. hypoK – spontaneous hypokalemia, PPV positive predictive value, NPV negative predictive value, LR+ – positive likelihood ratio, LR negative likelihood ratio