[Construction of an ultrasound clinical scale for the diagnosis of choledocolithiasis].
OBJECTIVE
to describe the construction of a clinical ultrasonographic scale for diagnosing choledocholithiasis.


METHODS
A retrospective study of diagnostic tests, done through files of patients older than 18 years old with diagnosis related to having jaundice, who received care at three hospital facilities in Culiacan, Sinaloa, Mexico from 1998 to 1999, was carried out. Clinical, lab and cabinet data were collected. Gold standards were considered endoscopic retrograde cholangio-pancreatography as well as exploratory laparotomy. A diagnostic scale for choledocholithiasis was constructed through logistic regression and multivariate analysis using principal components. Sensitivity, specificity, prediction values, negative and positive likelihood ratio (LR) and ROC curves were estimated. The threshold model was applied for medical decision making.


RESULTS
For detecting choledocholithiasis the scale's sensitivity was 98%, specificity was 95%, positive and negative predictive values were 95% and 97%, respectively. The estimated positive LR was 19.6 and negative 0.02.


CONCLUSIONS
In adult patients up to 70 years with acute jaundice evolution, the scale can diagnose securely choledocholithiasis. The pretest prevalence and/ or probability do not affect importantly its accuracy for medical decision making.
Irineo-Cabrales
Ana Bertha
AB
Postgrado de la Facultad de Medicina, Programa de Maestría y Doctorado en Ciencias Médicas, Universidad Autónoma de Sinaloa. drairineo@hotmail.com
Zambada-Sentíes
Carlos
C
Garduño-Espinosa
Juan
J
Mejía-Arreguin
Hugo
H
Vadillo-Ortega
Felipe
F
Osuna-Ramírez
Ignacio
I
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D042883:Choledocholithiasis / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014463:Ultrasonography