Clinical Chemistry
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
QUICK SEARCH:   [advanced]


     

Clinical Chemistry 43: 1555-1560, 1997;
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Web of Science (4)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Black, E. R.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Black, E. R.
Related Collections
Right arrow Laboratory Management
Right arrow Arnold O. Beckman Conference
Right arrow Evidence Based Laboratory Medicine and Test Utilization
(Clinical Chemistry. 1997;43:1555-1560.)
© 1997 American Association for Clinical Chemistry, Inc.

Articles

Diagnostic strategies and test algorithms in liver disease

Edgar R. Black

General Medicine/Geriatrics Unit, Department of Medicine, University of Rochester School of Medicine and Dentistry, Rochester, NY 14642.
Address for correspondence: Box MED, University of Rochester Medical Center, 601 Elmwood Ave., Rochester, NY 14642. Fax 716-273-1069; e-mail Edgar_Black{at}medicine.rochester.edu

As clinicians evaluate patients, they first develop problem lists based on the history, physical examination, and basic laboratory studies. Synthesis and analysis result in a differential diagnosis with associated disease probabilities. Experienced clinicians then selectively use diagnostic tests to rule in or rule out these possibilities. For example, in a patient presenting with jaundice, anorexia, fever, and abdominal pain, the relative increases of the serum aminotransferase activity and the serum alkaline phosphatase will help to guide the subsequent evaluation. If the aminotransferase activity is markedly increased, then the subsequent evaluation will be targeted toward identifying an etiology for hepatocellular injury. In contrast, if the alkaline phosphatase is markedly increased, then the evaluation would be targeted toward identifying an etiology for obstructive jaundice. This paper reviews clinical decision making, discusses characteristics of diagnostic tests, and presents examples of how basic clinical information can guide the use of the laboratory in evaluating patients with suspected liver disease.


Key Words: indexing terms: sensitivity • specificity • predictive value




The following articles in journals at HighWire Press have cited this article:


Home page
 Arch Intern MedHome page
J. M. Rothschild, R. Khorasani, S. G. Silverman, R. W. Hanson, J. M. Fiskio, and D. W. Bates
Abdominal Cross-sectional Imaging for Inpatients With Abnormal Liver Function Test Results: Yield and Usefulness
Arch Intern Med, February 26, 2001; 161(4): 583 - 588.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Copyright © 1997 by the American Association for Clinical Chemistry.