Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients
Abstract Background The aim of this study was to evaluate the utility of the tourniquet test (TT) for dengue diagnosing. To our knowledge, no previous study with such a large sample, of this duration, with as many laboratory methods referenced, or relating the results of the TT to the 2009 WHO class...
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doaj-eadfb1e1ac2341679ce7461a49e50bd42020-11-25T03:54:58ZengBMCBMC Infectious Diseases1471-23342016-11-011611710.1186/s12879-016-1947-7Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patientsNathália Barbosa Furlan0Caroline Tukasan1Cássia Fernanda Estofolete2Maurício Lacerda Nogueira3Natal Santos da Silva4Faculdade de Medicina, União das Faculdades dos Grandes LagosFaculdade de Medicina, União das Faculdades dos Grandes LagosFaculdade de Medicina, União das Faculdades dos Grandes LagosLaboratório de Pesquisas em Virologia, Faculdade de Medicina de São José do Rio PretoFaculdade de Medicina, União das Faculdades dos Grandes LagosAbstract Background The aim of this study was to evaluate the utility of the tourniquet test (TT) for dengue diagnosing. To our knowledge, no previous study with such a large sample, of this duration, with as many laboratory methods referenced, or relating the results of the TT to the 2009 WHO classification of severity has been conducted thus far. Methods In this study, we analyzed the records of 119,589 suspected dengue cases in a Brazilian city, with 30,670 confirmed cases. The Cohen’s Kappa test was applied to evaluate the degree of agreement between the tests, and the sensitivity and specificity was calculated for the TT. Results Twenty-eight thousand six hundred thirty-five TT were performed. No association between the outcome of the TT and greater severity of infection, according to the 2009 guideline, was observed (P = 0.28); furthermore, relevant agreement with the final diagnosis (κ = 0.01; 95 % CI = 0.00 to 0.02) or individually with the IgM enzyme-linked immunoassay was not observed (κ = 0.05; 95 % CI = 0.04 to 0.06), and was even lower with PCR (κ = 0.27; 95 % CI = 0.06 to 0.49). Most importance of the TT was shown in relation to specificity (88.9 %; 95 % CI = 0.88 to 0.89) and negative predictive value (70.3 %; CI 95 % = 0.70 to 0.71). Conclusions TT was more effective in detecting cases that were truly negative than positive. These results suggest that the TT should not be used as diagnosis of dengue.http://link.springer.com/article/10.1186/s12879-016-1947-7DengueTourniquet testDiagnostic test for dengue |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Nathália Barbosa Furlan Caroline Tukasan Cássia Fernanda Estofolete Maurício Lacerda Nogueira Natal Santos da Silva |
spellingShingle |
Nathália Barbosa Furlan Caroline Tukasan Cássia Fernanda Estofolete Maurício Lacerda Nogueira Natal Santos da Silva Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients BMC Infectious Diseases Dengue Tourniquet test Diagnostic test for dengue |
author_facet |
Nathália Barbosa Furlan Caroline Tukasan Cássia Fernanda Estofolete Maurício Lacerda Nogueira Natal Santos da Silva |
author_sort |
Nathália Barbosa Furlan |
title |
Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
title_short |
Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
title_full |
Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
title_fullStr |
Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
title_full_unstemmed |
Low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
title_sort |
low sensitivity of the tourniquet test for differential diagnosis of dengue: an analysis of 28,000 trials in patients |
publisher |
BMC |
series |
BMC Infectious Diseases |
issn |
1471-2334 |
publishDate |
2016-11-01 |
description |
Abstract Background The aim of this study was to evaluate the utility of the tourniquet test (TT) for dengue diagnosing. To our knowledge, no previous study with such a large sample, of this duration, with as many laboratory methods referenced, or relating the results of the TT to the 2009 WHO classification of severity has been conducted thus far. Methods In this study, we analyzed the records of 119,589 suspected dengue cases in a Brazilian city, with 30,670 confirmed cases. The Cohen’s Kappa test was applied to evaluate the degree of agreement between the tests, and the sensitivity and specificity was calculated for the TT. Results Twenty-eight thousand six hundred thirty-five TT were performed. No association between the outcome of the TT and greater severity of infection, according to the 2009 guideline, was observed (P = 0.28); furthermore, relevant agreement with the final diagnosis (κ = 0.01; 95 % CI = 0.00 to 0.02) or individually with the IgM enzyme-linked immunoassay was not observed (κ = 0.05; 95 % CI = 0.04 to 0.06), and was even lower with PCR (κ = 0.27; 95 % CI = 0.06 to 0.49). Most importance of the TT was shown in relation to specificity (88.9 %; 95 % CI = 0.88 to 0.89) and negative predictive value (70.3 %; CI 95 % = 0.70 to 0.71). Conclusions TT was more effective in detecting cases that were truly negative than positive. These results suggest that the TT should not be used as diagnosis of dengue. |
topic |
Dengue Tourniquet test Diagnostic test for dengue |
url |
http://link.springer.com/article/10.1186/s12879-016-1947-7 |
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