Sadowski et al evaluated the ability of serum chemistry tests to identify patients with acute pancreatitis secondary to gallstones. The authors are from the University of Calgary and Foothills Hospital in Calgary, Alberta, Canada.
Parameters:
(1) serum alkaline phosphatase
(2) serum AST (SGOT)
(3) serum total bilirubin
Parameter
Finding
Points
serum alkaline phosphatase
< 115 IU/L
0
>= 115 IU/L
1
serum AST
< 80 IU/L
0
>= 80 IU/L
1
serum total bilirubin
< 15 µmol/L
0
>= 15 µmol/L
1
total score =
= SUM(points for all 3 parameters)
Interpretation:
• minimum score: 0
• maximum score: 3
Total Score
Observed Sensitivity
Observed Specificity
1
95%
46%
2 or 3
82%
79%
3
55%
90%
Based on the Youden index, a score >= 2 showed optimum performance.
The presence of an elevated AST alone had a diagnostic efficiency of 80%.
Limitations:
• The analysis was performed on a Kodak Ektachem. 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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