Interpreting borderline BeLPT results.
BACKGROUND
The beryllium lymphocyte proliferation test (BeLPT) identifies persons sensitized to beryllium (BeS) and thus at risk for chronic beryllium disease (CBD). BeLPT test results are abnormal (AB), borderline (BL), or normal (NL). This manuscript addresses the predictive value and interpretation of BL BeLPT results.


METHODS
The various three-result combinations that meet or exceed a nominal referral criteria of 1 AB + 1 BL are assessed with probability modeling and compared.


RESULTS
At 2% prevalence, the three-result combinations that meet or exceed this referral criteria and associated probabilities of BeS are: (a) 1 AB + 1 BL + 1 NL (72%); (b) 3 BL (91%); (c) 2 AB + 1 NL (95%); (d) 1 AB + 2 BL (99%); (e) 2 AB + 1 BL (100%); and (f) 3 AB (100%).


CONCLUSIONS
These results suggest that BL results are meaningful and that three BL results predict BeS across a broad range of population prevalences. An analysis of longitudinal BeLPT results and clinical findings from an actual surveillance program is warranted to confirm the model's predictions.
Agency for Toxic Substances and Disease Registry, Division of Health Studies, National Institutes of Health, Atlanta, GA 30341, USA. dmiddleton@cdc.gov
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Middleton
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Mayer
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Lewin
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Mroz
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Maier
D000465:Algorithms; D001607:Berylliosis / Q000175:diagnosis* / Q000453:epidemiology / Q000209:etiology; D001608:Beryllium / Q000633:toxicity*; D003657:Decision Making; D006801:Humans; D008137:Longitudinal Studies; D008214:Lymphocytes / Q000528:radiation effects*; D016273:Occupational Exposure / Q000009:adverse effects*; D011237:Predictive Value of Tests; D015995:Prevalence; D012307:Risk Factors; D012680:Sensitivity and Specificity; D013997:Time Factors; D014481:United States / Q000453:epidemiology
D001608:Beryllium