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Predicting Abdominal Aortic Aneurysm-Reply

David J. Ballard, MD; John W. Hallett Jr, MD
Arch Intern Med. 1991;151(3):618. doi:10.1001/archinte.1991.00400030143034.
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In Reply.—  We appreciate the commentary provided by Nardone regarding our article1 concerning abdominal aortic aneurysm (AAA) screening. Dr Nardone states that "it is impossible to derive positive predictive values" from the data that were provided by us. In fact, given that we sampled all patients with clinical suspicion who were referred for abdominal ultrasonography, we do have all individuals with positive test results (ie, clinical suspicion was positive). Thus, this does allow us to directly calculate positive predictive value. As we state in the article, we cannot directly estimate specificity and sensitivity from our data. We agree that the study proposed by Dr Nardone would certainly add to our ability to evaluate abdominal palpation as a screening tool for abdominal aortic aneurysm. The proposed study would need to be conducted in a prospective manner with all patients who underwent abdominal palpation also undergoing abdominal ultrasonography. It would be


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