RT Journal Article
SR Electronic
T1 Concordance or Discordance Between ESR and hs-CRP: Are Both Tests Necessary for Patient Diagnosis?
JF American Society for Clinical Laboratory Science
JO Clin Lab Sci
FD American Society of Chemistry and Laboratory Science
SP 20
OP 26
DO 10.29074/ascls.2021003168
VO 36
IS 1
A1 McKenzie, Shannan F.
A1 Beydoun, Hind
A1 Ganjoo, Rohini
A1 Dobrydneva, Yuliya
YR 2023
UL http://hwmaint.clsjournal.ascls.org/content/36/1/20.abstract
AB INTRODUCTION: Erythrocyte sedimentation rate (ESR) and high-sensitivity C-reactive protein (hs-CRP) are screening tests for inflammation and are often ordered simultaneously. Our study investigated concordance between ESR and hs-CRP to optimize patient diagnosis.METHODS: A retrospective review was conducted on ESR and hs-CRP tests performed simultaneously in the same clinical encounter during a 10-month period at Alaska Regional Hospital. Kappa statistics and correlation coefficients were calculated to evaluate the level of concordance between ESR and hs-CRP tests. Logistic regression models and receiver operator characteristic (ROC) curves were constructed to evaluate the ability of each screening test to predict the other screening test.RESULTS: ESR and hs-CRP were elevated in 54% and 76% of the patient population (N = 860) respectively. Among patients with abnormal ESR, 93% also had abnormal hs-CRP, whereas among patients with abnormal hs-CRP, 66% also had abnormal ESR. ESR and hs-CRP tests agreed in 70% of cases. Kappa statistics indicated a fair to moderate level of agreement between dichotomous ESR and hs-CRP tests, with significant differences among patients with and without noninfectious organ diseases, but no other demographic or clinical characteristics. The correlation coefficient between continuous ESR and hs-CRP was nearly 0.40, with no statistically significant correlation among patients with connective tissue/musculoskeletal/autoimmune diseases or diabetes. Finally, hs-CRP and ESR were predictive of each other based on logistic regression and ROC analyses.CONCLUSION: hs-CRP identified the majority of inflammatory conditions and should be included in the first line of testing when the clinical indication clearly suggests an inflammatory process.