Goodman et al used serum chemistry tests to help identify patients with acute pancreatitis secondary to gallstones. This can help separate patients who require cholecystectomy from those who require further investigation. The authors are from the Leicester Royal Infirmary in England.
Parameters:
(1) serum alkaline phosphatase
(2) serum ALT (alanine transaminase, SGPT)
(3) serum total bilirubin
Parameter
Finding
Points
serum alkaline phosphatase
< 225 IU/L
0
>= 225 IU/L
1
serum ALT
< 75 IU/L
0
>= 75 IU/L
1
serum total bilirubin
< 40 µmol/L
0
>= 40 µmol/L
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
• A score >= 1 was associated with gallstones, while a score of 0 was associated with a nonbiliary cause.
Performance:
• In the original study the sensitivity was 73% and specificity 94%.
• The positive predictive value was 97% and negative predictive value was 57%.
Limitations:
• The analysis was performed on a Technicon SMAC-1. The reference ranges for the 3 tests was not given. This means that transporting the method may require some adjustments to the cutoff points.
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