BACKGROUND: Serum creatinine has been used as the diagnostic test for acute kidney injury (AKI) for decades despite having imperfect sensitivity and specificity. Novel tubular injury biomarkers may revolutionize the diagnosis of AKI; however, even if a novel tubular injury biomarker is 100% sensitive and 100% specific, it may appear inaccurate when using serum creatinine as the gold standard. CONCLUSIONS: In general, the apparent diagnostic performance of a biomarker depends not only on its ability to detect injury but also on disease prevalence and the sensitivity and specificity of the imperfect gold standard. Apparent errors in diagnosis using a new biomarker may be a reflection of errors in the imperfect gold standard itself rather than poor performance of the biomarker.
BACKGROUND: Serum creatinine has been used as the diagnostic test for acute kidney injury (AKI) for decades despite having imperfect sensitivity and specificity. Novel tubular injury biomarkers may revolutionize the diagnosis of AKI; however, even if a novel tubular injury biomarker is 100% sensitive and 100% specific, it may appear inaccurate when using serum creatinine as the gold standard. CONCLUSIONS: In general, the apparent diagnostic performance of a biomarker depends not only on its ability to detect injury but also on disease prevalence and the sensitivity and specificity of the imperfect gold standard. Apparent errors in diagnosis using a new biomarker may be a reflection of errors in the imperfect gold standard itself rather than poor performance of the biomarker.
Authors: E M Antman; M J Tanasijevic; B Thompson; M Schactman; C H McCabe; C P Cannon; G A Fischer; A Y Fung; C Thompson; D Wybenga; E Braunwald Journal: N Engl J Med Date: 1996-10-31 Impact factor: 91.245
Authors: C W Hamm; J Ravkilde; W Gerhardt; P Jørgensen; E Peheim; L Ljungdahl; B Goldmann; H A Katus Journal: N Engl J Med Date: 1992-07-16 Impact factor: 91.245
Authors: Anna Zuk; Paul M Palevsky; Linda Fried; Frank E Harrell; Samina Khan; Dianne B McKay; Luke Devey; Lakhmir Chawla; Mark de Caestecker; James S Kaufman; B Taylor Thompson; Anupam Agarwal; Tom Greene; Mark Douglas Okusa; Joseph V Bonventre; Laura M Dember; Kathleen D Liu; Benjamin D Humphreys; Daniel Gossett; Yining Xie; Jenna M Norton; Paul L Kimmel; Robert A Star Journal: Clin J Am Soc Nephrol Date: 2018-03-09 Impact factor: 8.237
Authors: Thomas Althaus; Janjira Thaipadungpanit; Rachel C Greer; Myo Maung Maung Swe; Sabine Dittrich; Pimnara Peerawaranun; Pieter W Smit; Tri Wangrangsimakul; Stuart Blacksell; Jonas M Winchell; Maureen H Diaz; Nicholas P J Day; Frank Smithuis; Paul Turner; Yoel Lubell Journal: Int J Infect Dis Date: 2020-05-11 Impact factor: 3.623