The Sensitivity and Specificity of Potassium Hydroxide Smear and Fungal Culture Relative to Clinical Assessment in the Evaluation of Tinea Pedis: A Pooled Analysis

Table 5

Sensitivity, specificity, and predictive value for KOH smear and culture with clinical cure at six weeks as gold standard overall and for component studies (a–f).

(a) Overall (𝑁=460).

		Clinical Cure
		Yes	No
Culture	Neg	78	61
	Pos	109	212
	Total	187	273
SENSITIVITY (%)		41.7 (34.6-49.1)^∗∗
SPECIFICITY (%)		77.7 (72.2–82.5)
PV Neg (%)^∗		56.1 (47.4–64.5)
PV Pos (%)		66.0 (60.6–71.2)
	Neg	137	157
KOH Smear	Pos	50	116
	Total	187	273
SENSITIVITY (%)		73.3 (66.3–79.5)
SPECIFICITY (%)		42.5 (36.6–48.6)
PV Neg (%)		46.6 (40.8–52.5)
PV Pos (%)		69.9 (62.3–76.7)

^∗PV = Predictive value, Neg=Negative, Pos=Positive
^∗∗Pointestimate with exact 95% binomial confidence limits.

(b) Study STUDY #1 (𝑁=100).

		Clinical Cure
		Yes	No
Culture	Neg	18	9
	Pos	28	45
	Total	46	54
SENSITIVITY (%)		39.1 (25.1–54.6)
SPECIFICITY (%)		83.3 (70.7–92.1)
PV Neg (%)		66.7 (46.0–83.5)
PV Pos (%)		61.6 (49.5–72.8)
KOH Smear	Neg	42	40
	Pos	4	14
	Total	46	54
SENSITIVITY (%)		91.3 (79.2–97.6)
SPECIFICITY (%)		25.9 (15.0–39.7)
PV Neg (%)		51.2 (39.9–62.4)
PV Pos (%)		77.8 (52.4–93.6)

(c) Study STUDY #2 (𝑁=81).

		Clinical Cure
		Yes	No
Culture	Neg	19	12
	Pos	22	32
	Total	41	44
SENSITIVITY (%)			46.3 (30.7–62.6)
SPECIFICITY (%)			72.7 (57.2–85.0)
PV Neg (%)			61.3 (42.2–78.2)
PV Pos (%)			59.3 (45.0–72.4)
	Neg	29	35
KOH Smear	Pos	12	9
	Total	41	44
SENSITIVITY (%)		70.7 (54.5–83.9)
SPECIFICITY (%)		20.5 (9.8–35.3)
PV Neg (%)		45.3 (32.8–58.3)
PV Pos (%)		42.9 (21.8–66.0)

(d) Study STUDY #3 (𝑁=81).

		Clinical Cure
		Yes	No
Culture	Neg	8	11
	Pos	10	52
	Total	18	63
SENSITIVITY (%)		44.4 (21.5–69.2)
SPECIFICITY (%)		82.5 (70.9–90.9)
PV Neg (%)		42.1 (20.3–66.5)
PV Pos (%)		83.9 (72.3–92.0)
KOH Smear	Neg	15	35
	Pos	3	28
	Total	18	63
SENSITIVITY (%)		83.3 (58.6–96.4)
SPECIFICITY (%)		44.4 (31.9–57.5)
PV Neg (%)		30.0 (17.9–44.6)
PV Pos (%)		90.3 (74.2–98.0)

(e) Study STUDY #4 (𝑁=82).

		Clinical Cure
		Yes	No
Culture	Neg	15	13
	Pos	22	32
	Total	37	45
SENSITIVITY (%)		40.5 (24.8–57.9)
SPECIFICITY (%)		71.1 (55.7–83.6)
PV Neg (%)		53.6 (33.9–72.5)
PV Pos (%)		59.3 (45.0–72.4)
KOH Smear	Neg	25	26
	Pos	12	19
	Total	37	45
SENSITIVITY (%)		67.6 (50.2–82.0)
SPECIFICITY (%)		42.2 (27.7–57.9)
PV Neg (%)		49.0 (34.8–63.4)
PV Pos (%)		61.3 (42.2–78.2)

(f) Study STUDY #5 (𝑁=113).

		Clinical Cure
		Yes	No
Culture	Neg	18	16
	Pos	28	51
	Total	46	67
SENSITIVITY (%)		39.1 (25.1–54.6)
SPECIFICITY (%)		76.1 (64.1–85.7)
PV Neg (%)		52.9 (35.1–70.2)
PV Pos (%)		64.6 (53.0–75.0)
KOH Smear	Neg	27	21
	Pos	19	46
	Total	46	67
SENSITIVITY (%)		58.7 (43.2–73.0)
SPECIFICITY (%)		68.7 (56.2–79.4)
PV Neg (%)		56.3 (41.2–70.5)
PV Pos (%)		70.8 (58.2–81.4)