Probability of patients in different clinical contexts having neuroblastoma based on positive and negative urine catecholamine and metabolite tests
Population | Pretest (background) probability of neuroblastoma | Test result | Post-test probability of neuroblastoma |
---|---|---|---|
Vague suspicion of neuroblastoma, non-specifically unwell child | 2% | Positive | 63% |
Negative | 0% | ||
Secondary care, distinct suspicion of neuroblastoma32 | 10% | Positive | 99% |
Negative | 1% | ||
Paraspinal or renal mass, strongly suspected neuroblastoma | 60% | Positive | 99.9% |
Negative | 18% | ||
Unilateral Horner's syndrome14 | 8% | Positive | 99% |
Negative | 1% | ||
Well infants ∼6 months old, screening investigation7 | 0.05% | Positive | 20% |
Negative | 0.01% | ||
Opsoclonus-myoclonus syndrome33 34 | 55% | Positive | 99.9% |
Negative | 15% |
Assumes average likelihood ratios (LR) for abnormal urine catecholamines of LR+ 85, LR− 0.15 (sensitivity ∼85% and specificity ∼99%).