The first commercial automated immunoassays specific for soluble fms-like tyrosine kinase 1 (sFlt-1) and placental growth factor (PlGF) (Elecsys sFlt-1 and Elecsys PlGF, respectively) have recently been introduced... The most appropriate reference range curves for plasma levels of sFlt-1 and PlGF, and the sFlt-1/PlGF ratio are presented as quadratic curves after logarithmic transformation. The sFlt-1/PlGF ratio showed the best diagnostic power for both early-onset and late-onset preeclampsia. In addition, a cutoff value of 45 for the sFlt-1/PlGF ratio resulted in the best sensitivity and specificity for the diagnosis of all preeclampsia (97 and 95%, respectively), and for the diagnosis of early-onset preeclampsia (100 and 95%, respectively).
So this is a discussion about a new testing technique. They want these tests to have high sensitivity and specificity -- which means they want them to pick up *all* the preeclamptics, and *only* the preeclamptics, so they don't miss anyone and they don't have any false positives. (Even in theory it is impossible to do this perfectly, so they will generally err on the side of a few false positives in order not to miss anyone.)
It involves all sorts of funky math -- but boils down to a measurement of the rate of change of these proteins. If all of a sudden your sFlt goes through the roof, that's a red flag.
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