Accuracy of diagnostic testing in XXXX .

@entity1 @entity1009 @entity910 @entity1579 @entity842
UNASSIGNED: Diagnosis of @entity910 ( @entity910 ) lacks a "gold standard" test and is therefore based on combinations of tests including nasal @entity842 (nNO), high-speed video microscopy analysis (HSVMA), genotyping and @entity1579 ( @entity1579 ). There are few published data on the accuracy of this approach.Using prospectively collected data from 654 consecutive @entity1 referred for @entity910 diagnostics we calculated sensitivity and specificity for individual and combination testing strategies. Not all @entity1 underwent all tests.HSVMA had excellent sensitivity and specificity (100% and 93%, respectively). @entity1579 was 100% specific, but 21% of @entity910 @entity1 had normal ultrastructure. nNO (30   nL  @entity1009 ) cut-off) had good sensitivity and specificity (91% and 96%, respectively). Simultaneous testing using HSVMA and @entity1579 was 100% sensitive and 92% specific.In conclusion, combination testing was found to be a highly accurate approach for diagnosing @entity910 . HSVMA alone has excellent accuracy, but requires significant expertise, and repeated sampling or cell culture is often needed. @entity1579 alone is specific but misses 21% of cases. nNO ( <=30   nL  @entity1009 )) contributes well to the diagnostic process. In isolation nNO screening at this cut-off would miss    10% of cases, but in combination with HSVMA could reduce unnecessary further testing. Standardisation of testing between centres is a future priority.
