title: Combined serum amylase and lipase determinations for diagnosis of suspected acute pancreatitis.
abstract: Serum amylase and lipase measurements are often used to diagnose acute pancreatitis. This study addresses the question of whether it is advantageous to order serum amylase and lipase tests simultaneously. We evaluated performance of the two tests separately and in combination through a retrospective study of patients for whom both amylase and lipase determinations were ordered. Initial analysis of test performance was conducted with a uniformly applied criterion based on determination of optimal sensitivity-specificity pairs. Individual tests and combinations of tests, including the "AND" and "OR" rules and discriminant functions, were examined. Only the discriminant approach demonstrated better performance than the lipase test alone. This finding was subsequently confirmed by logistic regression analysis. We conclude that ordering both tests simultaneously can be advantageous in diagnosing acute pancreatitis when a bivariate approach is used; however, this must be weighed against the difficulties associated with clinical implementation of such approaches.
authors.affiliation: Department of Pathology, University of Rochester School of Medicine and Dentistry, NY 14642.
authors.forename: J P
authors.initials: JP
authors.lastname: Corsetti
authors.forename: C
authors.initials: C
authors.lastname: Cox
authors.forename: T J
authors.initials: TJ
authors.lastname: Schulz
authors.forename: D A
authors.initials: DA
authors.lastname: Arvan
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000681:Amylases / Q000097:blood*; D005260:Female; D006801:Humans; D008049:Lipase / Q000097:blood*; D008297:Male; D008875:Middle Aged; D010195:Pancreatitis / Q000097:blood / Q000175:diagnosis*; D011786:Quality Control; D012016:Reference Values; D012044:Regression Analysis; D012189:Retrospective Studies; D012680:Sensitivity and Specificity
chemical_list: D008049:Lipase; D000681:Amylases