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Table 4 Performance of various tests used for detection of specific antibodies

From: Antinuclear antibodies and their detection methods in diagnosis of connective tissue diseases: a journey revisited

Method

Advantages

Disadvantages

IF-ANA

Cost effective

Easy to perform

High sensitivity and specificity

Time consuming

Can give false positive results

ENA categorization difficult

Requires trained personnel

ELISA

Automated

Potential for quantification

High sensitivity

Potential for antibody class definition

Potential for false positives

Expensive

Requires purified antigen

DID

Cost effective

High specificity

Detects multiple antibodies at a time

Low sensitivity

Subjective interpretation

Need for large volumes of prototype sera

CIE

Cost effective

High specificity

Detects multiple antibodies at a time

Faster than double diffusion

Modest sensitivity

Subjective interpretation

Need for large volumes of prototype sera

PHA

Semiquantitative

High specificity

Time consuming

Needs purified antigen

Western blot

More sensitive than DID and CIE

High specificity

Expensive

Time consuming

Detects linear epitopes only

Dot/Line blot

Easy to perform, rapid

High sensitivity and specificity

Automation possible

Qualitative

Distinction between certain antibodies difficult

MIA

Detects multiple antibodies at a time

Quantitation possible

Expensive

Flowcytometry

Cost effective

Automated

High sensitivity

Provides single result at a time

Microarray

Detects multiple antibodies at a time

Complete automation possible

High sensitivity and specificity

Cost effective

Not widely available