Evaluation of an Automated Screening Assay, Compared to Indirect Immunofluorescence, an Extractable Nuclear Antigen Assay, and a Line Immunoassay in a Large Cohort of Asian Patients with Antinuclear Antibody-Associated Rheumatoid Diseases: A Multicenter Retrospective Study
Table 3
ROC-AUC, sensitivity, and specificity of the CTD screen, tested independently and in combination.
Predefined diseases
Parameter
CTD screen
CTD screen + IIF
CTD screen + EliA ENA
CTD screen + LIA
Total AARD ()
ROC-AUC
0.89 (0.85–0.93)
0.89 (0.85–0.93)
0.89 (0.85–0.93)
0.92 (0.88–0.95)
value
<0.0001
<0.0001
<0.0001
<0.0001
Sensitivity (%)
81.3 (72.8–88.0)
85.7 (77.8–91.6)
83.0 (74.8–89.5)
92.9 (86.4–96.9)
Specificity (%)
92.1 (90.3–93.7)
85.2 (82.9–87.4)
89.6 (87.6–91.4)
83.7 (81.3–86.0)
+LR
10.3
5.8
8.0
5.7
−LR
0.2
0.2
0.2
0.1
Odds ratio
50.7 (29.9–85.9)
34.7 (19.9–60.5)
42.3 (24.8–72.1)
67.0 (32.0–140.2)
SLE ()
ROC-AUC
0.93 (0.88–0.97)
0.92 (0.88–0.97)
0.92 (0.88–0.96)
0.95 (0.91–0.98)
value
<0.0001
<0.0001
<0.0001
<0.0001
Sensitivity (%)
85.1 (74.3–92.6)
80.6 (69.1–89.2)
88.1 (77.8–94.7)
95.5 (87.5–99.1)
Specificity (%)
93.7 (92.0–95.1)
95.7 (94.3–96.9)
88.3 (86.2–90.3)
83.8 (81.4–86.1)
+LR
13.5
18.8
7.6
5.9
−LR
0.2
0.2
0.1
0.1
Odds ratio
85.0 (41.4–174.5)
92.7 (47.1–182.7)
55.8 (26.0–119.8)
110.7 (34.4–356.8)
SSc ()
ROC-AUC
0.73 (0.58–0.88)
0.75 (0.59–0.90)
0.72 (0.57–0.87)
0.76 (0.61–0.91)
value
0.0017
0.0011
0.0018
0.0003
Sensitivity (%)
61.9 (38.4–81.9)
71.4 (47.8–88.7)
61.9 (38.4–81.9)
76.2 (52.8–91.8)
Specificity (%)
92.5 (90.7–94.1)
87.2 (85.0–89.2)
90.6 (88.7–92.4)
85.2 (82.9–87.4)
+LR
8.3
5.6
6.6
5.2
−LR
0.4
0.3
0.4
0.3
Odds ratio
20.1 (8.1–50.0)
17.1 (6.5–44.8)
15.7 (6.4–38.9)
18.5 (6.7–51.2)
SS ()
ROC-AUC
0.93 (0.87–0.99)
0.93 (0.88–0.98)
0.94 (0.88–0.99)
0.97 (0.95–0.99)
value
<0.0001
<0.0001
<0.0001
<0.0001
Sensitivity (%)
89.5 (66.9–98.7)
94.7 (74.0–99.9)
89.5 (66.9–98.7)
100.0 (82.4–100.0)
Specificity (%)
90.7 (88.8–92.5)
83.7 (81.3–86.0)
91.7 (89.8–93.4)
85.1 (82.8–87.3)
+LR
9.7
5.8
10.8
6.7
−LR
0.1
0.1
0.1
0.0
Odds ratio
83.2 (18.9–365.6)
92.8 (12.3–699.7)
94.2 (21.4–414.8)
NC
MCTD ()
ROC-AUC
0.95 (0.92–0.98)
0.95 (0.90–100.0)
0.94 (0.91–0.98)
0.94 (0.89–100.0)
value
<0.0001
<0.0001
<0.0001
<0.0001
Sensitivity (%)
100.0 (47.8–100.0)
100.0 (47.8–100.0)
100.0 (47.8–100.0)
100.0 (47.8–100.0)
Specificity (%)
92.1 (90.3–93.7)
85.2 (82.9–87.4)
90.5 (88.5–92.3)
83.5 (81.1–85.8)
+LR
12.7
6.8
10.6
6.1
−LR
0.0
0.0
0.0
0.0
Odds ratio
NC
NC
NC
NC
ROC-AUC: areas under the receiver operating characteristic curve; IIF: indirect immunofluorescence; ENA: extractable nuclear antigen; LIA: line immunoassay; LR: likelihood ratio; AARD: antinuclear antibody-associated rheumatoid disease; SLE: systemic lupus erythematosus; SSc: systemic sclerosis; SS: Sjögren’s syndrome; MCTD: mixed connective tissue disease; NC: not calculated. Data are shown with the 95% confidence interval in parentheses, and the values presented for the ROC-AUCs were greater than 0.5.
