Multilevel and continuous pleural fluid pH likelihood ratios for evaluating XXXX .

@entity1 @entity177 @entity3483 @entity204
STUDY OBJECTIVE: Expert consensus recommends testing pleural fluid for pH to assist the selection of @entity1 with @entity3483 for pleurodesis. Although published studies report an association between pleural fluid pH and @entity1 outcomes after pleurodesis, clinicians have no definitive information on how to use pH to select @entity1 for pleurodesis. Thus, we quantitatively assessed different methods for deriving likelihood ratios from pleural fluid pH and evaluated the potential role of pH in selecting @entity1 for pleurodesis. DATA SOURCES: MEDLINE, systematic reviews, article reference lists, and contact with primary authors. STUDY SELECTION: Studies that assessed the impact of pleural fluid pH on survival and @entity177 rates among @entity1 with @entity3483 . DATA EXTRACTION: Primary authors provided their data in electronic spreadsheets. DATA SYNTHESIS: Retrieved data sets included survival and @entity177 rates for 417 @entity1 and 433 @entity1 , respectively. Binary, multilevel, and continuous likelihood ratios were calculated to estimate the likelihood of @entity204 within 3 months of pleurodesis or @entity177 rates. Values for the likelihood ratios were compared for each of the three strategies, and relative clinical and statistical significance were assessed. Pleural fluid pH had marginal performance for identifying @entity1 with < 3-month anticipated survival; binary likelihood ratios provided as much information as the multilevel and continuous strategies. Likelihood ratios for identifying @entity1 likely to fail pleurodesis were clinically useful. Continuous likelihood ratios provided statistically more information as compared with the multilevel and binary strategies. CONCLUSIONS: Pleural fluid pH has marginal value for estimating @entity204 within 3 months of pleurodesis, and binary likelihood ratios (cut point </= 7.20) perform as well as the other strategies assessed. Pleural fluid pH provides more useful information for estimating the likelihood of @entity177 for which continuous likelihood ratios provide the most information as compared with binary or multilevel likelihood ratios.
