1.

A study of diagnostic accuracy of arterial blood gas for diagnosis of pulmonary embolus

(PE) included 212 patients with suspected PE, 49 of whom were subsequently determined

to have PE. Of 49 patients with PE, 41 had abnormal alveolar-arterial oxygen gradient. Of

163 patients without PE, 118 had abnormal alveolar-arterial oxygen gradient. What is the

sensitivity, specificity, LR positive and LR negative of abnormal alveolar-arterial oxygen

gradient for the diagnosis PE.

A. Sensitivity = 41/49 =0.84

B. Specificity =45/163=0.28

C. Likelihood ratio positive =sensitivity/(1-specficity)=0.84/(1-0.28)=1.17

D. Likelihood ratio negative =(1-sensitivity)/specificity=(1-0.84)/0.28=0.57

2. A study of treatment for migraine headache tested a new drug sumatriptan against placebo.

In the treatment group, 256 out of 1036 patients had mild or no pain at 2 hours. In the

control group, 1067 out of 1854 patients had mild or no pain at 2 hours. Based on the above

scenario calculate EER, CER, ARR, RRR, and NNT.

A. Event rate in the experimental group (EER) = 256/1036 = 0.25

B. Event rate in the control group (CER) = 1067/1854 = 0.58

C. Absolute risk reduction (ARR) = CER−EER = 0.58 – 0.25 = 0.33

D. Relative risk reduction (RRR) = ARR/CER = 0.33/0.25 = 1.33

E. Numbers needed to treat (NNT) = 1/ARR = 1/0.33 = 3