278 Chapter 13 Table 3 shows the diagnostic accuracy of the contrast enema when only taking into account the patients treated for NEC. It shows a sensitivity of 100%, specificity of 97%, a positive predictive value of 91% and a negative predictive value of 100% whilst the AUC was 0.98 (95%-CI: 0.96 – 1.00). False positive enemas, no stricture found during surgery In three patients, two treated for NEC and one for Hirschsprung disease, a stricture was seen on contrast enema whilst no strictures was observed during stoma reversal or redo-surgery making the false positive rate 13% (N=3/24) in the overall cohort and 9% (N=2/22) in patients previously treated for NEC. In all of these patients with a false positive enema, the enema suggested of a stricture at the splenic flexure, yet no strictures were identified during surgery and no obstructive symptoms developed during follow-up for which reason no redo-surgery was necessary. A more extensive description of these patients can be found in Appendix 2. Table 2 – Predictive capabilities enema full cohort Strictures at surgery No strictures at surgery Total row Enema positive 21 3 24 Enema negative 0 127 127 Total row 21*1 (14%) 130 151*1 Sensitivity 21 / 21 = 100% PPV 21 / 24 = 88% Specificity 127 / 130 = 98% NPV 127 / 127 = 100% *1: Three cases of strictures were excluded, reasons for exclusion are described in the results Table 3 - Predictive capabilities enema NEC patients Strictures at surgery No strictures at surgery Total row Enema positive 20*1 2 22 Enema negative 0 58 58 Total row 20*2 (25%) 60 80*2 Sensitivity 20 / 20 = 100% PPV 20 / 22 = 91% Specificity 58 / 60 = 97% NPV 58 / 58 = 100% *1: In two patients reoperation within three months was necessary for treatment of the stricture *2: Two patients with a stricture (no enema & inconclusive enema) were excluded from the analysis
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