| Chapter 1: Primer on Precision and Accuracy | | | | |
| Chapter 2: Abdominal Aortic Aneurysm | Occur in 4% to 8% of older men. The prevalence in older women is less than 2%. | Physical examination for aneurysm > 4.0 cm | 16 (8.6-29) | 0.51 (0.38-0.67) |
| Physical examination for aneurysm > 3.0 cm | 12 (7.4-20) | 0.72 (0.65-0.81) |
| Chapter 3: Abdominal Bruits | Approximately 1% to 5% of the general population has renovascular disease. Approximately 20% of white patients with medical refractory hypertension have renal artery stenosis. | Systolic-diastolic bruit | 39 (10-145) | 0.62 (0.49-0.73) |
| Systolic bruit | 4.3 (2.3-8.0) | 0.52 (0.34-0.78) |
| History of atherosclerotic disease | 2.2 (1.8-2.8) | 0.52 (0.40-0.66) |
| Chapter 4: Problem Alcohol Drinking | 3 of 10 adults engage in risky drinking behaviors. In primary care clinics, the prevalence will be around 11% to 18%. | (see Tables 4-12 and 4-13) | |
| AUDIT or AUDIT-C ≥ 8 | 6.8-12 |
| AUDIT or AUDIT-C ≤ 8 | 0.46-0.62 |
| |
| (see Table 4-14) | |
| CAGE ≥ 1 | 3.4 (2.3-5.1) |
| CAGE = 0 | 0.18 (0.11-0.29) |
| |
| (see Tables 4-15 and 4-16) | |
| TWEAK ≥ 2 or T-ACE ≥ 1 | 3.6-4.0 |
| TWEAK ≤ 1 or T-ACE = 0 | 0.12-0.15 |
| Chapter 5: Appendicitis, Adult | 25% for patients younger than 60, 5% for patients older than 60 | Alvarado score (≥7 is positive, see Table 5-5) | 3.1 (1.9-5.0) | 0.26 (0.19-0.35) |
| Prior Probability | Test/Finding | LR+ | LR- |
| Chapter 6: Ascites | Less than 1% for unselected population, 5% for general medical patients | Symptoms |
| Increased abdominal girth makes ascites more likely | 4.1 (2.3-4.7) | |
| Recent weight gain makes ascites more likely | 3.2 (1.7-6.2) | |
| Ankle swelling makes ascites more likely | 2.8 (1.8-4.3) | |
| No ankle swelling makes ascites less likely | | 0.10 (0.01-0.67) |
| No increase in abdominal gain makes ascites less likely | | 0.17 (0.05-0.62) |
| No recent weight gain makes ascites less likely | | 0.42 (0.20-0.87) |
| Signs |
| Fluid wave | 5.3 (2.9-9.5) | |
| Shifting dullness | 2.1 (1.6-2.9) | |
| Chapter 7: Low Back Pain | Approximately 85% of patients with back pain will not have a definitive diagnosis. Since 20-30% of asymptomatic patients have a herniated disc, this can be used as the prior probability for herniation. | Sit-to-stand test for upper lumbar herniation | 26 (1.7-413) | 0.35 (0.22-0.56) |
| Nocturnal pain for cancer-induced back pain | 1.7 (1.2-1.9) | >0.17 (0.03-0.73) |
| Crossed straight-leg herniation | 1.6-5.8 | 0.59-0.90 |
| Ipsilateral straight-leg raise for disk herniation | 0.99-2.0 | 0.04-0.50 |
| Chapter 8: Breast Cancer | 12% lifetime risk for US women | Clinical breast examination | 11 (5.8-19) | 0.47 (0.40-0.56) |
| Chapter 9: Carotid Bruit | Symptomatic patients: 10%-30% will have surgically amenable carotid stenosis Asymptomatic patients: 1%-10% probability for carotid stenosis in patients 60 years or older. 0.5% for patients 50 years of age to approximately 10% by age 90 years. For patients older than 65, 5% to 7% of women and 7% to 10% of men will have carotid stenosis of 50% or higher. 1% to 2.3% of women and 1% to 4.1% of ... |