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FIGURE 8 Comparisons of ROC curves among five different assays for anti-PF4/heparin antibodies. (Top) UFH-treated patients (n = 192). (Bottom) LMWH-treated patients (n = 256). The sensitivity-specificity tradeoffs at different diagnostic cut-offs for clinical HIT are shown. For the SRA, the points represent step-wise 10% changes in percent serotonin release. For the EIA-IgG and EIA-GTI, the points represent step-wise 0.20 units of optical density, except for the point labeled 0.45, which represents the usual diagnostic cut-off for the three EIAs shown (EIA-IgG, EIA-IgA, and EIA-IgM). For both UFH- and LMWH-treated patients, the ROC curves show that the operating characteristics rank as follows for the diagnosis of clinical HIT: SRA > EIA-IgG > EIA-GTI > EIA-IgA ~ EIA-IgM. Abbreviations: EIA, enzyme immunoassay; LMWH, low molecular weight heparin; ROC, receiver operating characteristic; UFH, unfractionated heparin. Source: From Warkentin et al., 2005a.

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