Ascites: Sensitivity and Specificity

Introduction: 80% of ascites is due to Cirrhosis.

The sensitivity and specificity of findings for Ascites are listed below. See the left navigation bar to change the display.

Specific Findings

Finding	Sensitivity	Specificity	Comments, Study
Telangiectasias	27%	100%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Jaundice Duplicate	27%	100%	by physical exam Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Coagulopathy	26%	96%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Palpable Liver	27%	93%	aka "ballotable" liver Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Viral Hepatitis	27%	92%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Jaundice Duplicate	33%	90%	by "history" Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Everted Navel	33%	88%	or flat Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Hepatic Carcinoma	13%	85%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966

Sensitive Findings

Finding	Sensitivity	Specificity	Comments, Study
Flank Dullness	94%	56%	Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
Ankle Swelling	93%	66%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Increased Girth	87%	77%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Peripheral Edema	87%	77%	it is unclear to me how this differs from Ankle Swelling (granted, that's history vs physical exam here) Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966

Negative Findings

13%

85%

Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966

Poorly Diagnostic Findings

Finding	Sensitivity	Specificity	Comments, Study
Fluid Wave	50%	82%	Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
Weight Gain	67%	79%	(recent) Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Heart Failure	47%	73%	Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
History of Alcoholism	60%	58%	see Alcoholism Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
Shifting Dullness	83%	56%	Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
Puddle Sign	51%	51%	with patient on hands and knees, percuss umbilical region for dullness Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
Bulging Flanks	78%	44%	Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606