Optimizing BeLPT Criteria for Beryllium Sensitization

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BackgroundThe beryllium lymphocyte proliferation test (BeLPT) is used to identify persons sensitized to beryllium.ATSDRATSDR convened an expert panel of physicians and scientists in Aprilto discuss this test and to consider what BeLPT test results actually establish beryllium sensitization. The three criteria proposed by panel members wereone abnormal resultone abnormal and one borderline result, andtwo abnormal resultsMethodsComplete algorithms were developed for each of the three proposed criteria. Using single-test outcome probabilities developed byStange et al. [2004. Am J Ind Med 46:453–462], we calculated and compared the sensitivity, specificity, and positive predictive values (PPVs) for each set of criteria.ResultsThe overall sensitivity and specificity of the three criteria were similar. When the criteria required confirmation of an abnormal result the PPV was higherwhether the requirement was satisfied by a borderline result, or only by another abnormal result. Confirmation also reduced the likelihood of false positives. The differences between the three criteria decreased as the prevalence of sensitization increased.ConclusionsA single unconfirmed abnormal is usually insufficient to establish sensitization for an apparently healthy person. When the prevalence of beryllium sensitization in a group is high, however, even a single abnormal BeLPT can be a strong predictor. Am. J. Ind. Med. 51:166–172, 2008. ©2008 Wiley-Liss, Inc.

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