Steinberg WM et al, 1985, USA | 39 patients with pancreatitis were compared with 127 controls with abdominal pain | Diagnostic study | Sensitivity and specificity of two amylase serum assays for pancreatitis. Using upper limit of normal. Using best cut off | Amylase 1 = sensitivity 94.9% specificity 88.9%. Amylase 2 = sensitivity 94.9% specificity 86.0%. | Various techniques used to confirm diagnosis including CT scans, laparotomy, USS scans |
Amylase 1 = sensitivity 94.8% specificity 98.4% Amylase 2 = sensitivity 92.3% specificity 100% | Patients referred to gastroenterology team with diagnosis based on serum amylase result |
Lin XZ et al, 1989, Taiwan | 62 consecutive patients with image verified pancreatitits, and 414 patients with an acute abdomen | Diagnostic study | Sensitivity and specificity of serum amylase at selected cut off three times above upper limit of normal | Sensitivity of serum amylase: 84% in image proven pancreatitis 92% in patients with or without image verified disease | Problems with gold standard diagnosis of pancreatitis |
Serum amylase used in diagnosis |
Various gold standards used within the study |
Clavien PA et al, 1989, Canada | 352 consecutive attacks of acute pancreatitis in 318 patients | Diagnostic study | Sensitivity and specificity of serum amylase (<160 IU/l) compared with gold standards of CT or laparotomy | Sensitivity of 81% at presentation | Chronic pancreatitis patients were excluded |
Winslet M et al, 1992, UK | 417 patients with acute pancreatitis | Diagnostic study | Sensitivity of serum amylase (>1000 IU) for detecting acute pancreatitis at hospital admission | Mild cases 96.1%. Severe cases 87.4%. Alcohol subgroup 86% | Variable gold standards used |
Sensitivity of serum amylase (>1000 IU) for detecting acute pancreatitis at 48 hours | Mild cases 33.3% Severe cases 48.2%. Alcohol subgroup 76%. | Not all patients had CT |