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Good Negative Likelihood Ratio

Biliary Atresia: Likelihood Ratios

Introduction: None written.

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Tags: Hepatic Pediatrics Tag this Diagnosis.

Prevalence

Population / Calculator	Prevalence	Comments / Study / Link
Infants < 12 wk presenting with conj hyperbili	20.5%	Br J Radiol 2000 Nov;73(875):1154-8. PMID 11144791
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The likelihood ratios of findings for Biliary Atresia are listed below. See the left navigation bar to change the display.

Pre-Test Probability (Prevalence): %.	Post-Test Probability (Predictive Value): %.	Switch to display mode.
Note that calculating probabilities from more than one** finding is inherently inaccurate because findings are not independent. (For example, using two positive findings that share a common pathogenesis is likely to overestimate the true probability.)

Good Positive and Negative Likelihood Ratios
Finding	Result	+LR	-LR
[ + ] Abdominal US	+ 0 -	11.8	0.1
gallbladder absent or irregular GB wall infants < 12 wk with conj hyperbili Study: Br J Radiol 2000 Nov;73(875):1154-8. PMID 11144791
[ + ] MRCP	+ 0 -	3.9	0.1
another study showed sensitivity of 100% and specificity of 96% (PMID 11912518) Study: Radiology 2002 Mar;222(3):687-91. PMID 11912518

Good Negative Likelihood Ratio
Finding	Result	+LR	-LR
[ + ] HIDA scan	+ 0 -	1.2	0.5
per UTD: "Pretreatment for five days with phenobarbital (5 mg/kg per day) increases the accuracy of this test by enhancing isotope excretion. The sensitivity and specificity of scintigraphy in detecting obstruction ranges from 83 to 100 percent and 33 to 100 percent respectively." Study: UpToDate 'Approach to neonatal cholestasis' http://www.uptodate.com/online/content/topic.do?topicKey=pedi_hep/2162