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Managing Health Effects of Beryllium Exposure (2008) / Chapter Skim
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Appendix B: Air Force Beryllium Program Clinical Decision Logic
Pages 165-168

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From page 165...
... increased over reference range in a single test Borderline: One increased value (SI or LAV) over reference range with at least one control in normal range Uninterpretable: Phytohemagglutinin <50 and tetanus toxid <3 with no increase in Sis over reference range Confirmed abnormal: Two abnormal BeLPT values or one abnormal and one borderline, either in split sample or in two different samples separated in time Decision Logic for BeLPT Testing First Test: Single BeLPT Second Test: Use a split sample with two laboratories 165
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From page 166...
... (1) BeLPT Test 1: Normal: NO FURTHER ACTIONS; retest periodically per protocol Abnormal: RETEST split sample in two laboratories Borderline: RETEST split sample in two laboratories Uninterpretable: RETEST split sample in two laboratories
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From page 167...
... Middleton et al. estimate a PPV of 0.872 for a single abnormal BeLPT result when the prevalence of BeS is 10%, but in settings with a lower prevalence of BeS a single unconfirmed abnormal has less value because of a low PPV for sensitization.
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From page 168...
... The committee therefore recommends that the Air Force use the approach that is generally accepted and use all available tests to determine whether a person has a confirmed abnormal test result. If the Air Force is able to achieve harmonization between two laboratories, the variation in a single person's test results is likely to decrease.
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Key Terms

  • single abnormal
  • confirmed abnormal
  • abnormal belpt
  • abnormal test
  • clinical evaluation

  • test result
  • belpt result
  • retest split
  • belpt test
  • abnormal plus

  • reference range
  • test values
  • sample sent
  • available tests
  • positive predictive

  • increased sensitivity
  • predictive value
  • low ppv
  • abnormal sample
  • harmonization protocol

  • initial test
  • belpt values
  • split tests
  • protocol normal
  • enhanced algorithm

  • single sample
  • initially sent
  • nonnormal tests
  • initial round
  • range confirmed


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