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Table 4 Test and performance characteristics of claims–based definitions for febrile neutropenia

From: Technical evaluation of methods for identifying chemotherapy-induced febrile neutropenia in healthcare claims databases

    Gold standard:
    FN: No FN:   FN: No FN:   FN: No FN:   FN: No FN:   FN: No FN:
  Claims–Based Definitions: FN: 47 7 FN: 55 16 FN: 28 0 FN: 55 23 FN: 71 130
   No FN: 35 268 No FN: 27 259 No FN: 54 275 No FN: 27 252 No FN: 11 145
Test/Performance Characteristic*    Neutropenia, Primary Position   Neutropenia, Any Position   Neutropenia + Fever,Any Position   Neutropenia or Fever, Any Position   Neutropenia, Fever, or Infection, Any Position
 Patient Classification, %                 
  True–Positive    13% (10–17)   15% (11–19)   8% (5–11)   15% (11–19)   20% (16–24)
  False–Positive    2% (0–3)   4% (2–7)   0% (–––)   6% (4–9)   36% (31–42)
  True–Negative    75% (70–79)   73% (68–77)   77% (73–81)   71% (66–75)   41% (36–45)
  False–Negative    10% (7–13)   8% (5–10)   15% (11–18)   8% (5–10)   3% (1–5)
 Sensitivity, %    57% (46–68)   67% (56–77)   34% (24–45)   67% (56–77)   87% (79–94)
 Specificity, %    97% (96–99)   94% (91–97)   100% (–––)   92% (88–95)   53% (47–59)
 Positive Predictive Value (PPV), %    87% (78–95)   77% (68–87)   100% (–––)   71% (61–80)   35% (29–42)
 Negative Predictive Value (NPV), %    88% (85–92)   91% (87–94)   84% (80–87)   90% (87–94)   93% (89–97)
 Accuracy, %    88% (85–91)   88% (85–91)   85% (82–89)   86% (82–90)   61% (55–66)
 Likelihood ratio positive (LR+)    22.5 (12.3–68.5)   11.5 (7.6–20.4)   –––   8.0 (5.6–13.4)   1.8 (1.6–2.1)
 Likelihood ratio negative (LR–)    0.4 (0.3–0.6)   0.3 (0.2–0.5)   0.7 (0.6–0.8)   0.4 (0.3–0.5)   0.3 (0.1–0.4)
  1. FN: febrile neutropenia.
  2. *Value (95% CI).