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John Eckfeldt, MD, PhD; Grace Mary Ederer, MPH; Rebecca Oetjen Keenan, MT (ASCP)
University of Minnesota Hospitals Minneapolis

JAMA. 1978;240(18):1955.

	Since this article does not have an abstract, we have provided the first 150 words of the full text PDF and any section headings.

In Reply.—

Hamoudi and Fleer present some interesting data. Their data for CIE on CSF in cases of suspected meningitis are similar to our own. The sensitivity of the test for the various organisms is surprisingly close to what we reported considering our limited number of cases. We did find rare false-positives, which they apparently have not (yet) observed. However, they do have many cases that were CIE-positive but culture-negative, which they attribute to partial treatment before obtaining cultures. One cannot be certain that a few of those cases are not false-positives.

When one attempts to evaluate any new test that is designed to diagnose a disease for which there is no sure way of distinguishing patients with and without disease, the trap of circular reasoning must be recognized. There is no good experimental approach to this problem. But, to assume that all patients who show positive results with the . . . [Full Text PDF of this Article]

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