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Table 3 Diagnostic sensitivity and specificity, positive and negative predictive values and positive likelihood ratio of clinical findings in cows with traumatic reticuloperitonitis (TRP) and cows with type 1 (U1), type 2 (U2), type 3 (U3), type 4 (U4) or type 5 (U5) abomasal ulcer (in percent)

From: Diagnostic reliability of clinical signs in cows with traumatic reticuloperitonitis and abomasal ulcers

Variable Reliability indices TRP U1 U2 U3 U4 U5
Rectal temperature ≤ 38.5 °C Diagn. sensitivity 25 29 31 27 34 15
Diagn. specificity 88 88 88 88 88 88
Pos. pred. Value 86 50 68 43 59 9
Neg. pred. Value 30 69 62 79 74 94
LR+ 2 2 3 2 3 1
Rectal temperature ≤ 38.0 °C Diagn. sensitivity 7 9 15 7 18 15
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 94 80 92 67 89 50
Neg. pred. Value 28 68 59 76 72 94
LR+ 6 8 14 6 17 14
Rectal temperature >  39.0 °C Diagn. sensitivity 43 33 30 50 47 50
Diagn. specificity 68 68 68 68 68 68
Pos. pred. Value 79 35 43 34 41 9
Neg. pred. Value 30 67 55 81 73 95
LR+ 1 1 1 2 1 2
Rectal temperature >  39.5 °C Diagn. sensitivity 14 10 4 18 23 NA
Diagn. specificity 94 94 94 94 94 94
Pos. pred. Value 87 45 35 50 65 NA
Neg. pred. Value 28 67 55 78 72 93
LR+ 2 1 1 3 4 NA
Rectal temperature > 40.0 °C Diagn. sensitivity 5 3 1 10 3 NA
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 96 75 67 86 75 NA
Neg. pred. Value 28 67 56 77 68 93
LR+ 9 6 3 18 6 NA
Heart rate >  80 bpm Diagn. sensitivity 26 49 90 55 68 36
Diagn. specificity 85 85 85 85 85 85
Pos. pred. Value 82 62 82 54 68 15
Neg. pred. Value 29 76 91 85 85 94
LR+ 2 3 6 4 4 2
Heart rate > 100 bpm Diagn. sensitivity 4 24 62 17 41 86
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 92 92 98 83 95 86
Neg. pred. Value 27 72 77 78 78 99
LR+ 4 22 56 15 38 78
Heart rate >  120 bpm Diagn. sensitivity 1 7 26 2 15 7
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 88 88 97 50 93 50
Neg. pred. Value 27 68 63 75 71 93
LR+ 3 14 46 3 27 13
Respiratory rate >  35 breaths/min Diagn. sensitivity 23 29 36 37 38 36
Diagn. specificity 85 85 85 85 85 85
Pos. pred. Value 81 50 66 45 55 16
Neg. pred. Value 29 70 63 80 75 95
LR+ 2 2 2 2 3 2
Respiratory rate >  45 breaths/min Diagn. sensitivity 4 14 14 15 20 NA
Diagn. specificity 98 98 98 98 98 98
Pos. pred. Value 84 76 83 69 81 NA
Neg. pred. Value 27 69 59 78 72 93
LR+ 2 6 6 7 9 NA
Respiratory rate > 55 breaths/min Diagn. sensitivity 2 10 8 7 16 NA
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 92 90 92 80 93 NA
Neg. pred. Value 27 68 58 76 72 93
LR+ 4 17 15 12 30 NA
Abnormal demeanour Diagn. sensitivity 87 94 97 95 NA 93
Diagn. specificity 99 99 99 99 99 99
Pos. pred. Value 100 98 99 97 98 87
Neg. pred. Value 73 97 98 98 100 99
LR+ 79 85 88 86 91 85
Colic Diagn. sensitivity 3 21 10 2 10 14
Diagn. specificity 100 100 100 100 100 100
Pos. pred. Value 100 100 100 100 100 100
Neg. pred. Value 27 71 58 76 70 94
LR+ 31 211 101 21 101 141
Arched back Diagn. sensitivity 18 12 3 13 28 36
Diagn. specificity 100 100 100 100 100 100
Pos. pred. Value 100 100 100 100 100 100
Neg. pred. Value 31 69 57 78 74 95
LR+ 181 121 3 131 281 361
Abdominal guarding Diagn. sensitivity 54 59 43 61 81 100
Diagn. specificity 80 80 80 80 80 80
Pos. pred. Value 88 60 63 50 65 28
Neg. pred. Value 39 80 64 86 90 100
LR+ 3 3 2 3 4 5
Bruxism Diagn. sensitivity 20 15 12 18 25 21
Diagn. specificity 100 100 100 100 100 100
Pos. pred. Value 100 100 100 100 100 100
Neg. pred. Value 31 69 59 79 74 94
LR+ 201 151 121 181 251 211
Congested scleral vessels Diagn. sensitivity 79 89 35 73 77 79
Diagn. specificity 71 71 71 71 71 71
Pos. pred. Value 90 66 55 51 61 21
Neg. pred. Value 49 91 53 87 84 97
LR+ 3 3 1 3 3 3
Pale mucous membranes Diagn. sensitivity 7 10 69 3 27 14
Diagn. specificity 97 97 97 97 97 97
Pos. pred. Value 88 64 95 29 82 29
Neg. pred. Value 28 68 80 75 74 94
LR+ 3 4 25 1 10 5
Rumen motility reduced or rumen atony Diagn. sensitivity 73 90 92 93 99 93
Diagn. specificity 87 87 87 87 87 87
Pos. pred. Value 94 69 85 69 78 35
Neg. pred. Value 54 96 93 98 99 99
LR+ 6 7 7 7 8 7
Rumen atony Diagn. sensitivity 6 56 45 49 27 36
Diagn. specificity 100 100 100 100 100 100
Pos. pred. Value 100 100 100 100 100 100
Neg. pred. Value 28 82 70 86 74 95
LR+ 6 561 451 491 271 361
At least one foreign body test positive Diagn. sensitivity 60 21 28 45 58 38
Diagn. specificity 55 55 55 55 55 55
Pos. pred. Value 79 19 31 24 35 6
Neg. pred. Value 34 62 53 76 76 93
LR+ 1 1 1 1 1 1
PSA and/or BSA on the right side positive Diagn. sensitivity 17 53 33 47 51 64
Diagn. specificity 90 90 90 90 90 90
Pos. pred. Value 82 72 71 60 70 32
Neg. pred. Value 28 79 63 84 79 97
LR+ 2 5 3 5 5 6
Faeces dark or black Diagn. sensitivity NA 18 80 11 16 21
Diagn. specificity 100 100 100 100 100 100
Pos. pred. Value NA 100 100 100 100 100
Neg. pred. Value 27 74 87 79 74 94
LR+ NA 181 801 111 161 321
  1. 1 The calculation of the LR+ required the reduction of the diagnostic specificity from 100 to 99%
  2. PSA Percussion and simultaneous auscultation, BSA Ballottement and simultaneous auscultation, NA not applicable
  3. Values between 80 and 89% are in italic
  4. Values between 90 and 100% are in bold
  5. Values of LR+ ≥ 10 are in bold-italic