184 chapter 2 Table 40. Hypothetical second-best-case scenario (6% missed malignancies in unoperated nodules) estimated pooled test performance of Afirma® GEC in indeterminate thyroid nodules reference ni TP FP FN TN sensitivity (95% CI), % specificity (95% CI), % LR+ (95% CI) LR- (95% CI) Alexander 2012 210 46 77 5 82 90 (79-97) 52 (44-60) 1.86 (1.55-2.24) 0.19 (0.08-0.44) Alexander 2014 326 49 90 11 159 82 (70-90) 64 (58-70) 2.26 (1.84-2.77) 0.29 (0.17-0.49) Harrell 2014 58 17 19 3 17 85 (62-97) 47 (30-65) 1.61 (1.12-2.31) 0.32 (0.11-0.95) Lastra 2014 132 23 39 4 66 85 (66-96) 63 (53-72) 2.29 (1.71-3.08) 0.24 (0.09-0.59) McIver 2014 72 6 38 2 14 75 (35-97) 27 (16-41) 1.03 (0.67-1.58) 0.93 (0.26-3.34) Sullivan 2014 14 2 5 0 6 100 (16-100) 55 (23-83) 1.82 (0.82-4.03) 0.31 (0.02-4.07) Brauner 2015 72 6 39 1 25 86 (42-100) 39 (27-52) 1.41 (0.98-2.02) 0.37 (0.06-2.30) Celik 2015 40 10 13 1 10 91 (59-100) 43 (23-66) 1.61 (1.07-2.41) 0.21 (0.03-1.43) Marti 2015 165 29 75 3 58 91 (75-98) 44 (35-52) 1.61 (1.33-1.94) 0.21 (0.07-0.64) Noureldine 2015 222 74 123 2 16 97 (91-100) 12 (7-18) 1.10 (1.03-1.18) 0.23 (0.05-0.97) Witt 2016 32 6 9 1 13 86 (42-100) 59 (36-79) 2.10 (1.17-3.77) 0.24 (0.04-1.53) Wu 2016 214 52 55 7 83 88 (77-95) 60 (51-68) 2.21 (1.77-2.77) 0.20 (0.10-0.40) Yang 2016 189 34 60 5 75 87 (73-96) 56 (47-64) 1.96 (1.57-2.45) 0.23 (0.10-0.53) POOLED RESULTS 1,746 353 643 44 625 89.3 (84.7-92.6) 46.7 (37.1-56.4) 1.67 (1.42-1.97) 0.23 (0.17-0.31) FN: false negative. FP: false positive. LR+: positive likelihood ratio. LR-: negative likelihood ratio. ni : number of included indeterminate nodules. TN: true negative. TP: true positive.
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