Key result
A novel scoring system based on six clinical parameters accurately distinguished tuberculous from non-tuberculous benign pleural effusion, achieving an AUC of 0.937 in the training set.
Why the study?
Distinguishing tuberculous pleural effusion from non-tuberculosis benign pleural effusion remains challenging in clinical practice.
Does a novel scoring system based on 6 clinical and laboratory parameters improve the diagnostic accuracy in distinguishing tuberculous pleural effusion from non-tuberculosis benign pleural effusion in adults?
Cohort (n=1,019)
Yes
Does a novel scoring system based on 6 clinical and laboratory parameters improve the diagnostic accuracy in distinguishing tuberculous pleural effusion from non-tuberculosis benign pleural effusion in adults?
Effect estimate: AUC 0.937 (95% CI 0.917-0.957)
A novel 6-variable scoring system provides high diagnostic accuracy for distinguishing tuberculous from non-tuberculous benign pleural effusions, offering a convenient tool for clinical settings.
May support nomogram use for tuberculous pleural effusion differentiation; leaves open prospective validation before clinical adoption.
BACKGROUND: Distinguishing tuberculous pleural effusion (TPE) from non-tuberculosis (TB) benign pleural effusion (BPE) remains to be a challenge in clinical practice. The aim of the present study was to develop and validate a novel nomogram for diagnosing TPE. METHODS: In this retrospective analysis, a total of 909 consecutive patients with TPE and non-TB BPE from Ningbo First Hospital were divided into the training set and the internal validation set at a ratio of 7:3, respectively. The clinical and laboratory features were collected and analyzed by logistic regression analysis. A diagnostic model incorporating selected variables was developed and was externally validated in a cohort of 110 patients from another hospital. RESULTS: Six variables including age, effusion lymphocyte, effusion adenosine deaminase (ADA), effusion lactatedehy drogenase (LDH), effusion LDH/effusion ADA, and serum white blood cell (WBC) were identified as valuable parameters used for developing a nomogram. The nomogram showed a good diagnostic performance in the training set. A novel scoring system was then established based on the nomogram to distinguish TPE from non-TB BPE. The scoring system showed good diagnostic performance in the training set [area under the curve (AUC) (95% confidence interval (CI)), 0.937 (0.917-0.957); sensitivity, 89.0%, and specificity, 89.5%], the internal validation set [AUC (95%CI), 0.934 (0.902-0.966); sensitivity, 88.7%, and specificity, 90.3%], and the external validation set [(AUC (95%CI), 0.941 (0.891-0.991); sensitivity, 93.6%, and specificity, 87.5%)], respectively. CONCLUSIONS: The study developed and validated a novel scoring system based on a nomogram originated from six clinical parameters. The novel scoring system showed a good diagnostic performance in distinguishing TPE from non-TB BPE and can be conveniently used in clinical settings.
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Liu et al. (2022) conducted a cohort in Tuberculous pleural effusion (n=1,019). Nomogram-based scoring system was evaluated on Diagnostic performance (Area Under the Curve) for distinguishing tuberculous pleural effusion from non-tuberculosis benign pleural effusion in the training set (AUC 0.937, 95% CI 0.917-0.957). A novel scoring system based on six clinical parameters accurately distinguished tuberculous from non-tuberculous benign pleural effusion, achieving an AUC of 0.937 in the training set.
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