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Table 1 Comparison of the participants' judgments with likelihood ratios (LRs)

From: Challenging script concordance test reference standard by evidence: do judgments by emergency medicine consultants agree with likelihood ratios?

Disease/finding Judgments Mean (SD) LR: raw [Transformed] Pvaluea Difference
1. Meningitis     
??1A. Presence of headache 4.08 (2.23) 1.10 [0.41] P?<?0.001 Overestimation [+]b
??1B. Absence of nausea/vomiting 0.16 (0.87) 0.64 [? 1.93] P?<?0.001 Contradictory
??1C. Presence of neck stiffness 7.03 (2.17) 1.10 [0.41] P?<?0.001 Overestimation [+]
??1D. Presence of Brudzinski's sign 6.00 (2.72) 0.97 [? 0.13] P?<?0.001 Contradictory
??1E. Presence of Kernig's sign 6.51 (1.69) 0.97 [? 0.13] P?<?0.001 Contradictory
2. Myocardial infarction     
??2A. Presence of chest pain with radiation to both arms 4.59 (2.63) 4.10 [6.12] P?=?0.043 Underestimation [+]
??2B. Absence of nausea/vomiting ? 0.21 (0.80) 0.87 [? 0.60] P?=?0.091 -
??2C. Presence of sharp chest pain or stabbing ? 0.47 (4.00) 0.30 [? 5.22] P?=?0.002 Underestimation [?]
??2D. Presence of any ST segment elevation 7.62 (2.52) 3.20 [5.05] P?=?0.002 Overestimation [+]
??2E. Presence of any Q wave 4.21 (3.40) 3.90 [5.91] P?=?0.074 -
3. Pneumonia (in a child)     
??3A. Presence of retraction 5.31 (2.88) 1.00 [0.00] P?<?0.001 Overestimation [+]
??3B. Absence of tachypnea ?3.06 (4.70) 0.97 [?0.13] P?=?0.030 Overestimation [?]
??3C. Presence of crackles 4.96 (2.46) 1.60 [2.04] P?=?0.001 Overestimation [+]
??3D. Presence of grunting 4.00 (2.74) 2.70 [4.31] P?=?0.665 -
??3E. Absence of fever ?1.10 (3.02) 0.07 [?1.19] P?=?0.920 -
4. Thoracic aortic dissection     
??4A. Presence of history of hypertension 4.33 (2.27) 1.60 [2.04] P?=?0.002 Overestimation [+]
??4B. Presence of focal neurologic deficit 4.56 (2.60) 14.75 [10c] P?<?0.001 Underestimation [+]
??4C. Absence of pulse deficit 0.45 (4.46) 0.70 [?1.50] P?=?0.104 -
??4D. Absence of enlarged aorta/wide mediastinum in chest X-ray (CXR) 2.01 (4.81) 0.30 [?5.22] P?<?0.001 Contradictory
??4E. Absence of sudden chest pain ?2.49 (4.19) 0.30 [?5.22] P?=?0.025 Underestimation [?]
5. Appendicitis     
??5A. Absence of anorexia ?2.81 (2.58) 0.64 [?1.93] P?=?0.229 -
??5B. Presence of guarding 4.90 (2.28) 1.70 [2.30] P?=?0.001 Overestimation [+]
??5C. Absence of rebound tenderness ?1.27 (3.91) 0.002 [?10d] P?<?0.001 Underestimation [?]
??5D. Presence of psoas sign 3.80 (2.80) 2.40 [3.80] P?=?0.999 -
??5E. White blood cell count of 12,000 3.82 (3.14) 1.30 [1.13] P?=?0.005 Overestimation [+]
6. Congestive heart failure     
??6A. Presence of third heart sound 6.18 (2.15) 11.00 [10e] P?<?0.001 Underestimation [+]
??6B. Absence of cardiomegaly in CXR ?3.89 (2.92) 0.33 [?4.81] P?=?0.258 -
??6C. Presence of interstitial edema in CXR 5.77 (2.17) 12.00 [10f] P?<?0.001 Underestimation [+]
??6D. Presence of atrial fibrillation in EKG 2.73 (2.89) 3.80 [5.79] P?=?0.001 Underestimation [+]
??6E. Presence of lateral EKG changes 1.81 (2.15) 2.20 [3.42] P?=?0.012 Underestimation [+]
  1. aEach P value is derived from a one-sample t test comparing the mean expert judgments (measured by visual analog scales) with the corresponding transformed likelihood ratio [10xlog(LR)].
  2. b`Overestimation [+] implies that the value of this finding was overestimated positively (i.e. towards ruling in).
  3. cSince the highest possible value for the expert judgments was 10, the transformed LR of 11.69 was considered 10 in the corresponding one-sample t test.
  4. dSimilarly, the transformed LR of ?25.32 was considered ?10 in the corresponding one-sample t test.
  5. eLikewise, the transformed LR of 10.41 was considered 10 in the corresponding one-sample t test.
  6. fAlso, the transformed LR of 10.79 was considered 10 in the corresponding one-sample t test.