Research Article

The Usefulness of Clinical-Practice-Based Laboratory Data in Facilitating the Diagnosis of Dengue Illness

Table 3

Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of laboratory data in the diagnoses of overall dengue, DF, and DHF1.

Variable2Overall dengue cases, (%)DF cases, (%)DHF cases, (%)Nondengue cases, 3 (%)

Prolonged APTT61/68 (89.7)433/36 (91.7)4,728/32 (87.5)426/41 (63.4)
Leukopenia49/100 (49.0)31/57 (54.4)18/43 (41.9)25/100 (25.0)
Platelet < cells/L100/100 (100)4,757/57 (100)4,743/43 (100)4,771/100 (71.0)
ALT > 40 U/L49/65 (75.4)24/37 (64.9)25/28 (89.3)4,719/55 (34.5)
AST > 40 U/L68/79 (86.0)434/44 (77.3)34/35 (97)4,727/64 (42.3)
Prolonged APTT + leukopenia32/68 (47.1)18/36 (50.0)14/32 (43.8)14/41 (34.1)
Prolonged APTT + platelet < cells/L60/67 (89.6)432/35 (91.4)428/32 (87.5)4,721/41 (51.2)
Prolonged APTT + ALT > 40 U/L35/50 (70.0)18/28 (64.3)17/22 (77.3)79/30 (30.0)
Prolonged APTT + AST > 40 U/L50/60 (83.3)4,626/32 (81.3)424/28 (85.7)4,712/31 (38.7)
Prolonged APTT + leukopenia + platelet < cells/L32/68 (47.0)18/36 (50.0)14/32 (43.8)12/41 (29.3)
Prolonged APTT + leukopenia + ALT > 40 U/L18/50 (36.0)58/28 (28.6)510/22 (45.5)55/30 (16.7)
Prolonged APTT + leukopenia + AST > 40 U/L27/60 (45.0)5,615/32 (46.9)512/28 (42.9)55/31 (16.1)
Prolonged APTT + leukopenia + platelet < cells/L + ALT > 40 U/L18/50 (36.0)58/28 (28.6)510/22 (45.6)55/30 (16.7)
Prolonged APTT + leukopenia + platelet < cells/L + AST > 40 U/L27/60 (45.0)5,615/32 (46.9)512/28 (42.9)55/31 (16.1)
Prolonged APTT + leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L15/52 (28.8)55/31 (16.1)510/21 (47.6)54/29 (13.8)
Leukopenia + platelet < cells/L49/100 (49.0)31/57 (54.4)18/43 (41.9)23/100 (23.0)
Leukopenia + ALT > 40 U/L22/65 (33.8)511/37 (29.7)511/28 (39.3)57/55 (12.7)
Leukopenia + AST > 40 U/L32/79 (40.5)518/44 (40.9)514/35 (40.0)59/64 (14.1)
Leukopenia + platelet < cells/L + ALT > 40 U/L22/65 (33.8)511/37 (29.7)511/28 (39.3)57/55 (12.7)
Leukopenia + platelet < cells/L + AST > 40 U/L32/78 (41.0)518/44 (40.9)514/34 (41.2)59/64 (14.1)
Leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L21/60 (35.0)510/33 (30.3)511/27 (40.7)56/47 (12.8)
Platelet < cells/L + ALT > 40 U/L49/65 (75.4)24/37 (64.9)25/28 (89.3)4,717/55 (30.9)
Platelet < cells/L + AST > 40 U/L67/78 (85.9)433/43 (76.7)34/35 (97.1)4,725/64 (39.1)
Platelet < cells/L + ALT > 40 U/L + AST > 40 U/L46/59 (77.9)21/32 (65.6)25/27 (92.6)4,713/47 (27.7)
ALT > 40 U/L + AST > 40 U/L48/60 (80.0)23/33 (69.7)25/27 (92.6)4,714/47 (29.8)
Prolonged APTT + normal PT59/66 (89.4)433/36 (91.7)4,726/30 (86.7)4,719/38 (50.0)
Prolonged APTT + normal PT + leukopenia30/66 (45.6)18/36 (50)12/30 (40.0)12/38 (31.6)
Prolonged APTT + normal PT + platelet < cells/L59/66 (89.4)4,633/36 (91.7)4,726/30 (86.7)4,714/38 (36.8)
Prolonged  APTT  +  normal  PT  +  ALT  >  40 U/L35/49 (71.4)5,618/28 (64.3)517/21 (80.9)4,5,85/27 (18.5)
Prolonged  APTT  +  normal  PT  +  ALT  >  40 U/L49/58 (84.5)4,6,826/32 (81.3)423/26 (88.5)4,7,87/28 (25.0)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L30/66 (45.5)18/36 (50)12/30 (40)10/38 (26.3)
Prolonged APTT + normal PT + leukopenia + ALT > 40 U/L18/49 (36.7)5,68/28 (28.6)510/21 (47.6)53/27 (11.1)
Prolonged APTT + normal PT + leukopenia + AST > 40 U/L26/58 (44.8)5,615/32 (46.9)511/26 (42.3)54/28 (14.3)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + ALT > 40 U/L18/49 (36.7)5,68/28 (28.6)510/21 (47.6)53/27 (11.1)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + AST > 40 U/L26/57 (45.6)5,615/32 (46.9)511/25 (44.0)54/28 (14.3)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L18/46 (39.1)5,68/26 (30.8)510/20 (50.0)53/26 (11.5)
Platelet  <     cells/L97/100 (97)4,7,854/57 (94.7)4,743/43 (100)4,730/100 (30.0)
Prolonged APTT + platelet < cells/L60/68 (88.2)4,632/36 (88.9)4,728/32 (87.5)4,714/41 (34.1)
Prolonged APTT + leukopenia + platelet < cells/L31/68 (45.6)517/36 (47.2)514/32 (43.8)58/41 (19.5)
Prolonged APTT + leukopenia + platelet < cells/L + ALT > 40 U/L17/50 (34.0)57/28 (25)510/22 (45.5)55/30 (16.7)
Prolonged APTT + leukopenia + platelet < cells/L + AST > 40 U/L26/60 (43.3)5,614/32 (43.8)512/28 (42.9)55/31 (16.1)
Prolonged APTT + leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L17/47 (36.2)5,67/26 (26.9)510/21 (47.6) 54/29 (13.8)
Leukopenia + platelet < 100×109 cells/L47/100 (47)529/57 (50.9)518/43 (41.9) 514/100 (14.0)
Leukopenia + platelet < cells/L + ALT > 40 U/L21/65 (32.3)510/37 (27)511/28 (39.3)57/55 (12.7)
Leukopenia + platelet < cells/L + AST > 40 U/L31/78 (39.7)517/44 (38.6)514/34 (41.2)59/64 (14.1)
Leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L20/60 (33.4)59/33 (27.3)511/27 (40.7)56/47 (12.8)
Platelet  <    cells/L  +  ALT  >  40 U/L48/65 (73.8)23/37 (62.2)25/28 (89.3)4,7,813/53 (24.5)
Platelet < cells/L + AST > 40 U/L 67/79 (84.8)433/44 (75)734/35 (97.1)4,719/64 (29.7)
Platelet  <   cells/L  +  ALT  >  40 U/L  +  AST  >  40 U/L46/60 (76.7)621/33 (63.6)25/27 (92.6)4,7,811/47 (23.4)
Prolonged  APTT  +   normal  PT  +  platelet  <     cells/L58/66 (87.9)4,6,832/36 (88.9)4,6,7,826/30 (86.7)4,7,88/38 (21.1)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L29/66 (43.9)5,617/36 (47.2)512/30 (40.0)56/38 (15.8)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + ALT > 40 U/L17/49 (34.7)5,67/28 (25)510/21 (47.6)53/27 (11.1)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + AST > 40 U/L25/57 (43.9)5,614/32 (43.6)511/25 (44.0)54/28 (14.3)
Prolonged APTT + normal PT + leukopenia + platelet < cells/L + ALT > 40 U/L + AST > 40 U/L17/46 (36.9)5,67/26 (26.9)510/20 (50.0)53/26 (11.5)

Abbreviations: APTT: activated partial thromboplastin time; PT: prothrombin time; AST: aspartate aminotransferase; ALT: alanine aminotransferase; : no. of patients/no. of patients with data available.
1Sensitivity = (number of true-positives) × 100/(number of true-positives + number of false-negatives), specificity = (number of true-negatives) × 100/(number of true-negatives + number of false-positives), accuracy = (number of true-positives + number of true-negatives) × 100/(total instances), PPV = (number of true-positives) × 100/(number of true-positives + number of false-positives), and NPV = (number of true-negatives) × 100/(number of true-negatives + number of false-negatives) [18].
2Leukopenia was defined as peripheral white cell count < cells/L, prolonged APTT as an increased APTT value > 20% of the control value, and prolonged PT as an increased PT value > 3 seconds than that of control. Variables in bold font are those that had an accuracy > 80% in the diagnosis of the DF and/or DHF and were therefore subjected to the receiver-operating-characteristic (ROC) curve analysis in which the under the curve (AUC) was measured to obtain the predictive accuracy (see Table 4 for details).
3See footnote in Table 1 for details.
4Variable with a sensitivity > 80%.
5Variable with a specificity > 80%.
6Variable with a positive predictive value > 80%.
7Variable with a negative predictive value > 80%.
8Variable with an accuracy > 80%.