Vonm wrote:I have it and I’m apoe 3/4 with CAD , CHF. 60 years old. My Dad had it and Alzheimer’s and CAD,my Mom had it and CHF, I see it all the time in people with heart trouble.
You have provided a great example of what is called the "sensitivity" of Frank's sign as a clinical indicator of heart disease. Sensitivity
refers to the ability to correctly identify all people with a certain condition, with no false negatives; i.e. the test indicated the person didn't have the condition when it was in fact present. One article I saw gave a "sensitivity" rate of 88% for Frank's sign without citation. That would mean that if 100 people with diagnosed heart disease
were looked at, on average 88 would have an observable diagonal crease on both ear lobes. (A crease on one ear lobe is not as sensitive an indicator, and a "wrinkle", "dip" or partial crease on one ear is a weak indicator, apparently.)
So a negative result on an indicator with high sensitivity means it's unlikely the person without Frank's sign has heart disease. (Although it could miss 12% of those people.) Here's an explanation from wikipedia:
A negative result in a test with high sensitivity is useful for ruling out disease. A high sensitivity test is reliable when its result is negative, since it rarely misdiagnoses those who have the disease. A test with 100% sensitivity will recognize all patients with the disease by testing positive. A negative test result would definitively rule out presence of the disease in a patient.
But does that mean that 88% of people with Frank's sign DO heart disease? No, because the "test" has low "specificity". Another study, of 1022 people in a multi-ethnic cohort of Type 2 diabetes patients (who are at risk of CAD), the authors found that the sensitivity and specificity of ELC for detecting CAD were 60% and 48%, which would indicate that in one large group of people with diabetes, 48 percent of those with ear lobe creases do not have coronary artery disease, https://www.ncbi.nlm.nih.gov/pubmed/11108067
To use an example that most people have learned to be very careful about: women who are 8 months pregnant usually have large bellies; I would guess about 88% of them "look" pregnant. But that does not mean that 88% of women with large bellies are pregnant, as my 5 year old son discovered when he loudly announced that a 50 year old secretary in my office was having a baby. In that case, he found a "false positive" due to "low specificity" of the indicator for identifying people who are 8 months pregnant. (Much to my horror, and the secretary's good humor. Thank goodness she liked small children!)
But here's the example I like best: In a study of 4635 people (56.3% women) in Switzerland, an ear lobe crease (ELC) was highly sensitive
ONLY for a history of coronary vascular disease and hypertension.
CONCLUSION: In this community-based sample ELC was significantly and independently associated with hypertension and history of CVD.
As the title of the article implies: Sometimes a ear lobe crease is just an ear lobe crease: Did Dumbo suffer a heart attack? independent association between earlobe crease and cardiovascular disease.