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

Braun, Ueli; Nuss, Karl; Warislohner, Sonja; Reif, Christina; Oschlies, Carina; Gerspach, Christian

doi:10.1186/s12917-020-02515-z

BMC Veterinary Research

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 The calculation of the LR₊ required the reduction of the diagnostic specificity from 100 to 99%
PSA Percussion and simultaneous auscultation, BSA Ballottement and simultaneous auscultation, NA not applicable
Values between 80 and 89% are in italic
Values between 90 and 100% are in bold
Values of LR₊ ≥ 10 are in bold-italic

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