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.

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.)

History
Finding	Result	Sensitivity	Specificity
[ + ] Ankle Swelling	+ 0 -	93%	66%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Coagulopathy	+ 0 -	26%	96%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Heart Failure	+ 0 -	47%	73%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Hepatic Carcinoma	+ 0 -	13%	85%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] History of Alcoholism	+ 0 -	60%	58%
see Alcoholism Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Increased Girth	+ 0 -	87%	77%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Jaundice	+ 0 -	33%	90%
by "history" Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Jaundice	+ 0 -	27%	100%
by physical exam Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Viral Hepatitis	+ 0 -	27%	92%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Weight Gain	+ 0 -	67%	79%
(recent) Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966

Physical Exam
Finding	Result	Sensitivity	Specificity
[ + ] Bulging Flanks	+ 0 -	78%	44%
Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
[ + ] Everted Navel	+ 0 -	33%	88%
or flat Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Flank Dullness	+ 0 -	94%	56%
Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
[ + ] Fluid Wave	+ 0 -	50%	82%
Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
[ + ] Jaundice	+ 0 -	33%	90%
by "history" Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Jaundice	+ 0 -	27%	100%
by physical exam Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Palpable Liver	+ 0 -	27%	93%
aka "ballotable" liver Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966
[ + ] Peripheral Edema	+ 0 -	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
[ + ] Puddle Sign	+ 0 -	51%	51%
with patient on hands and knees, percuss umbilical region for dullness Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
[ + ] Shifting Dullness	+ 0 -	83%	56%
Study: JAMA. 1982 Feb 26;247(8):1164-6. PMID: 7057606
[ + ] Telangiectasias	+ 0 -	27%	100%
Study: J Gen Intern Med. 1988 Sep-Oct;3(5):423-8. PMID: 3049966