Evaluation of the Cepheid Xpert C. difficile diagnostic assay: an update meta-analysis

Abstract Background Accurate and rapid diagnosis of Clostridium difficile infection (CDI) is critical for effective patient management and implementation of infection control measures to prevent transmission. Objectives We updated our previous meta-analysis to provide a more reliable evidence base for the clinical diagnosis of Xpert C. difficile (Xpert C. difficile) assay. Methods We searched PubMed, EMBASE, Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM) databases to identify studies according to predetermined criteria. STATA 13.0 software was used to analyze the tests for sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curves (AUC). QUADAS-2 was used to assess the quality of included studies with RevMan 5.2. Heterogeneity in accuracy measures was tested with Spearman correlation coefficient and chi-square. Meta-regressions and subgroup analyses were performed to figure out the potential sources of heterogeneity. Model diagnostics were used to evaluate the veracity of the data. Results A total of 26 studies were included in the meta-analysis. The pooled sensitivity (95% confidence intervals [CI]) for diagnosis was 0.97(0.95–0.98), and specificity was 0.96(0.95–0.97). The AUC was 0.99 (0.98–1.00). Model diagnostics confirmed the robustness of our meta-analysis’s results. Significant heterogeneity was still observed when we pooled most of the accuracy measures of selected studies. Meta-regression and subgroup analyses showed that the sample size and type, ethnicity, and disease prevalence might be the conspicuous sources of heterogeneity. Conclusions The up-to-date meta-analysis showed the Xpert CD assay had good accuracy for detecting CDI. However, the diagnosis of CDI must combine clinical presentation with diagnostic testing to better answer the question of whether the patient actually has CDI in the future, and inclusion of preanalytical parameters and clinical outcomes in study design would provide a more objective evidence base.

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The value of glycosylated hemoglobin in the diagnosis of diabetic retinopathy: a systematic review and Meta-analysis

BMC Endocrine Disorders ◽

10.1186/s12902-021-00737-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bo Zhang ◽

Bingjie Zhang ◽

Zhulin Zhou ◽

Yutong Guo ◽

Dan Wang

Keyword(s):

Diabetic Retinopathy ◽

Likelihood Ratio ◽

Roc Curve ◽

Meta Analysis ◽

Glycosylated Hemoglobin ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Biomedical Literature ◽

Cochrane Library ◽

Clinical Value

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI: 0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

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Is dezocine effective and safe in preventing opioids-induced cough during general anaesthesia induction? A protocol for systematic review and meta-analysis

BMJ Open ◽

10.1136/bmjopen-2019-035691 ◽

2020 ◽

Vol 10 (6) ◽

pp. e035691

Author(s):

Li-xian He ◽

Ken Shao ◽

Jie Ma ◽

Yuan-yuan Zhao ◽

Yun-tai Yao

Keyword(s):

Systematic Review ◽

Adverse Effects ◽

Treatment Effects ◽

Meta Analysis ◽

Biomedical Literature ◽

Sensitivity Analyses ◽

Systemic Review ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Anaesthesia Induction

IntroductionCough is often observed when administrating a bolus of opioids. Opioid-induced cough (OIC) is mostly transient, benign and self-limiting, but could be associated with adverse effects. Numerous pharmacological and non-pharmacological interventions have been used to manage OIC with controversial efficacy and safety. Recent studies suggested that, pretreatment of intravenous dezocine (DZC) could completely suppress OIC during anaesthesia induction. To address this knowledge lack, we will perform a systemic review and meta-analysis to evaluate the efficacy of DZC on OIC and possible complications. We provide here a protocol that will outline the methods and analyses planned for the systematic review.MethodsPubMed, Embase, Cochrane Library, Web of Science as well as Chinese BioMedical Literature & Retrieval System (SinoMed), China National Knowledge Infrastructure, Wanfang Data and VIP Data will be searched from 1978 to 31 December 2019 to identify all randomised controlled trials comparing DZC with placebo on the incidence and severity of OIC. Primary outcomes of interest include the incidence and severity of OIC. Secondary outcomes of interest include possible complications or adverse effects of DZC. Two authors will independently extract relevant variables and outcome data. For continuous variables, treatment effects will be calculated as weighted mean difference and 95% CI. For dichotomous data, treatment effects will be calculated as OR and 95% CI. Each outcome will be tested for heterogeneity, and randomised-effects or fixed-effects model will be used in the presence or absence of significant heterogeneity. Sensitivity analyses will be done by examining the influence of statistical model and individual trial(s) on estimated treatment effects. Publication bias will be explored through visual inspection of funnel plots of the outcomes. Statistical significance will be defined as p<0.05.Ethics and disseminationThis study is a protocol of meta-analysis of previously published literatures, ethical approval was not necessary according to the Ethical Committee of Fuwai Hospital. The study will be submitted to a peer-reviewed journal and disseminated via research presentations.PROSPERO registration numberCRD42019141255.

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MicroRNAs as diagnostic biomarkers in primary central nervous system lymphoma: a systematic review and meta-analysis

10.21203/rs.3.rs-316868/v1 ◽

2021 ◽

Author(s):

Xiaohong Zheng ◽

Parker Li ◽

Qianqian Dong ◽

Yihong Duan ◽

Shoubo Yang ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Central Nervous System Lymphoma ◽

Cochrane Library ◽

Diagnostic Biomarkers ◽

Subgroup Analyses ◽

Sensitivity Specificity

Abstract Background Diagnosing primary central nervous system lymphoma (PCNSL) remains a challenge. MicroRNAs (miRNAs) are promising noninvasive markers for the identification of PCNSL. The present study aims to assess the diagnostic value of miRNAs for PCNSL patients as biomarkers. Methods We systematically searched PubMed, Embase and the Cochrane library from inception to June 31, 2020. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), together with the summary receiver operator characteristic (SROC) curve, and area under the SROC curve (AUC) value were used to estimate overall diagnostic performance. We used Q statistic and I2 to test heterogeneity, and used subgroup analyses to investigate the source of heterogeneity. The statistical analyses were independently performed by two investigators using Stata 14.0 and Revman 5.3. Results In total, eleven studies from six records were included in the current meta-analysis with 281 PCNSL patients and 367 controls. Our statistical analysis demonstrated that the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.91 (95% CI 0.84–0.95), 0.88 (95% CI 0.84–0.91), 7.48 (95% CI 5.71–9.78), 0.11 (95% CI 0.06–0.19), 70 (95% CI 35–142), and 0.90 (95% CI 0.87–0.92), respectively. The studies had substantial heterogeneity (I2 = 54%, 95% CI 0-100). Two subgroup analyses were conducted based on the type of specimen and miRNAs profiled. Conclusions This meta-analysis indicated miRNAs were suitable as noninvasive diagnostic biomarkers for PCNSL with high accuracy. In addition, both cerebrospinal fluid -based and blood-based miRNAs assays for PCNSL detection were considered reliable for clinical application. MicroRNA-21 assays also seemed to be more accurate in the diagnosis of PCNSL. Good quality studies with large samples should be conducted to verify our results.

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MicroRNAs as Diagnostic Biomarkers in Primary Central Nervous System Lymphoma: A Systematic Review and Meta-Analysis

Frontiers in Oncology ◽

10.3389/fonc.2021.743542 ◽

2021 ◽

Vol 11 ◽

Author(s):

Xiaohong Zheng ◽

Parker Li ◽

Qianqian Dong ◽

Yihong Duan ◽

Shoubo Yang ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Central Nervous System Lymphoma ◽

Cochrane Library ◽

Diagnostic Biomarkers ◽

Subgroup Analyses ◽

Sensitivity Specificity

BackgroundDiagnosing primary central nervous system lymphoma (PCNSL) remains a challenge. MicroRNAs (miRNAs) are promising noninvasive markers for the identification of PCNSL. The present study aims to assess the diagnostic value of miRNAs for PCNSL patients as biomarkers.MethodsWe systematically searched PubMed, Embase, and the Cochrane library from inception to January 31, 2021. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), together with the summary receiver operator characteristic (SROC) curve, and the area under the SROC curve (AUC) value were used to estimate the overall diagnostic performance. We used Q statistic and I2 to test heterogeneity and used subgroup analyses to investigate the source of heterogeneity. The statistical analyses were independently performed by two investigators using Stata 14.0 and Revman 5.3.ResultsIn total, 11 studies from 6 records were included in the current meta-analysis with 281 PCNSL patients and 367 controls. Our statistical analysis demonstrated that the pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0.91 (95% CI 0.84–0.95), 0.88 (95% CI 0.84–0.91), 7.48 (95% CI 5.71–9.78), 0.11 (95% CI 0.06–0.19), 70 (95% CI 35–142), and 0.90 (95% CI 0.87–0.92), respectively. The studies had substantial heterogeneity (I2 = 54%, 95% CI 0–100). Two subgroup analyses were conducted based on the type of specimen and miRNAs profiled.ConclusionsThis meta-analysis indicated that miRNAs were suitable as noninvasive diagnostic biomarkers for PCNSL with high accuracy. In addition, both cerebrospinal fluid-based and blood-based miRNAs assays for PCNSL detection were considered reliable for clinical application. MicroRNA-21 assays also seemed to be more accurate in the diagnosis of PCNSL. Good quality studies with large samples should be conducted to verify our results.

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Current antipsychotic agent use and risk of venous thromboembolism and pulmonary embolism: a systematic review and meta-analysis of observational studies

Therapeutic Advances in Psychopharmacology ◽

10.1177/2045125320982720 ◽

2021 ◽

Vol 11 ◽

pp. 204512532098272

Author(s):

Yinzhao Liu ◽

Jun Xu ◽

Kacey Fang ◽

Yue Xu ◽

Ju Gao ◽

...

Keyword(s):

Pulmonary Embolism ◽

Venous Thromboembolism ◽

Observational Studies ◽

Fixed Effects ◽

Meta Analysis ◽

Cochrane Library ◽

Psychotic Symptoms ◽

Significant Heterogeneity ◽

Increased Risk ◽

Subgroup Analyses

Background: Antipsychotic agents (APS) are widely used drugs to treat psychotic symptoms and can effectively reduce both positive and negative symptoms of schizophrenia. For decades, some studies suggested that there is a relationship between using APS and the risk of venous thromboembolism (VTE) and pulmonary embolism (PE). However, results remain inconclusive. Method: This review has been registered in International Prospective Register of Systematic Reviews (PROSPERO, ID: CDR42020155620). Relevant studies were identified among observational studies published up to 1 October 2019 in the databases MEDLINE, EMBASE, and Cochrane Library. Random or fixed-effects models were used to calculate the pooled odds ratio (OR). Results: In total, 28 observational studies were included. The results showed that compared with non-users, current APS users have significantly increased risks of VTE [OR 1.55 95% confidence interval (CI) 1.36, 1.76] and PE (OR 3.68, 95% CI 1.23, 11.05). Subgroup analyses suggested that new users were associated with a higher risk of VTE (OR 2.06, 95% CI 1.81, 2.35). For individual drugs, increased risk of VTE and PE was observed in taking haloperidol, risperidone, olanzapine, prochlorperazine but not in chlorpromazine, quetiapine or aripiprazole. However, careful interpretation is needed because of high heterogeneity among studies and scarce data. Conclusion: The present comprehensive meta-analysis further indicates a significantly increased risk of VTE and PE in current APS users compared with non-users. Subgroup analyses suggest that new users are more likely to develop VTE. However, due to significant heterogeneity among studies, conclusions should be considered with caution.

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Performance of the MEDS score in predicting mortality among emergency department patients with a suspected infection: a meta-analysis

Emergency Medicine Journal ◽

10.1136/emermed-2019-208901 ◽

2019 ◽

Vol 37 (4) ◽

pp. 232-239

Author(s):

Gensheng Zhang ◽

Kai Zhang ◽

Xie Zheng ◽

Wei Cui ◽

Yucai Hong ◽

...

Keyword(s):

Emergency Department ◽

Likelihood Ratio ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Prognostic Performance ◽

Suspected Infection ◽

Emergency Department Patients

ObjectivesTo carry out a meta-analysis to examine the prognostic performance of the Mortality in Emergency Department Sepsis (MEDS) score in predicting mortality among emergency department patients with a suspected infection.MethodsElectronic databases—PubMed, Embase, Scopus, EBSCO and the Cochrane Library—were searched for eligible articles from their respective inception through February 2019. Sensitivity, specificity, likelihood ratios and receiver operator characteristic area under the curve were calculated. Subgroup analyses were performed to explore the prognostic performance of MEDS in selected populations.ResultsWe identified 24 studies involving 21 246 participants. The pooled sensitivity of MEDS to predict mortality was 79% (95% CI 72% to 84%); specificity was 74% (95% CI 68% to 80%); positive likelihood ratio 3.07 (95% CI 2.47 to 3.82); negative likelihood ratio 0.29 (95% CI 0.22 to 0.37) and area under the curve 0.83 (95% CI 0.80 to 0.86). Significant heterogeneity was seen among included studies. Meta-regression analyses showed that the time at which the MEDS score was measured and the cut-off value used were important sources of heterogeneity.ConclusionThe MEDS score has moderate accuracy in predicting mortality among emergency department patients with a suspected infection. A study comparison MEDS and qSOFA in the same population is needed.

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Regular arrangement of collecting venules (RAC) as an endoscopic marker for exclusion of Helicobacter pylori (H. pylori) infection: A systematic review and meta-analysis

10.22541/au.161607225.59652637/v1 ◽

2021 ◽

Author(s):

Fan Yu ◽

shaoyou qin ◽

Song Wang ◽

Jiangbin Wang

Keyword(s):

Systematic Review ◽

Helicobacter Pylori ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Regular Arrangement ◽

H Pylori

Background: Helicobacter pylori (H. pylori) is the most common cause of gastric cancer. Growing evidence suggests that the regular arrangement of collecting venules (RAC) can be used as an endoscopic marker to diagnose H. pylori infection. However, data on the diagnostic accuracy of RAC for H. pylori infection are conflicting. We performed a systematic review and meta-analysis of relevant studies to determine the diagnostic accuracy and clinical utility of RAC for the diagnosis of H. pylori infection. Methods: We systematically searched PubMed, Embase, Web of Science, and the Cochrane Library between inception and Oct 29, 2020, for studies that assessed the diagnostic accuracy of RAC for H. pylori infection. Results: The literature search yielded 2921 nonduplicated screened titles, of which 58 underwent full-text review. Fifteen studies, representing a total of 6621 patients, met the inclusion criteria. The area under the summary receiver operating characteristic curve was 0.98 (95% CI 0.96 to 0.99). The pooled estimates for RAC were 0.98 (95% CI 0.95 to 0.99) for sensitivity and 0.75 (95% CI 0.54 to 0.88) for specificity. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLR) were 3.8 (95% CI 1.9 to 7.7) and 0.03 (95% CI 0.02 to 0.07), respectively. Conclusions: RAC can be used as an endoscopic marker for exclusion of H. pylori infection. However, it cannot be recommended as a single indicator for the confirmation of H. pylori infection. The conclusion of this study should be treated with caution because significant heterogeneity exists between the evaluated studies.

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The Diagnostic Value of Exosome-Derived Biomarkers in Alzheimer's Disease and Mild Cognitive Impairment: A Meta-Analysis

Frontiers in Aging Neuroscience ◽

10.3389/fnagi.2021.637218 ◽

2021 ◽

Vol 13 ◽

Author(s):

Wenmin Xing ◽

Wenyan Gao ◽

Xiaoling Lv ◽

Xiaogang Xu ◽

Zhongshan Zhang ◽

...

Keyword(s):

Alzheimer’S Disease ◽

Alzheimer's Disease ◽

Cognitive Impairment ◽

Mild Cognitive Impairment ◽

Likelihood Ratio ◽

Meta Analysis ◽

Diagnostic Value ◽

Biomedical Literature ◽

Cochrane Library ◽

Diagnostic Likelihood Ratio

Background: Alzheimer's disease (AD) diagnoses once depended on neuropathologic examination. Now, many widely used, validated biomarkers benefits for monitoring of AD neuropathologic changes. Exosome-derived biomarker studies have reported them to be significantly related to AD's early occurrence and development, although the findings are inconclusive. The aim of this meta-analysis was to identify exosome-derived biomarkers for the diagnosis of AD and mild cognitive impairment (MCI).Methods: PubMed, PubMed Central, Web of Science, Embase, Google Scholar, Cochrane Library, the Chinese National Knowledge Infrastructure (CNKI), and the Chinese Biomedical Literature Database (CBM) were searched for studies assessing the diagnostic value of biomarkers, including data describing the pooled sensitivity (SEN), specificity (SPE), positive diagnostic likelihood ratio (DLR+), negative diagnostic likelihood ratio (DLR–), diagnostic odds ratio (DOR), and area under the curve (AUC). The quality of the included studies was assessed using RevMan 5.3 software. Publication bias was analyzed.Results: In total, 19 eligible studies, including 3,742 patients, were selected for this meta-analysis. The SEN, SPE, DLR+, DLR–, DOR, and AUC (95% confidence intervals) of exosome-derived biomarkers in the diagnosis of AD or MCI were 0.83 (0.76–0.87), 0.82 (0.77–0.86), 4.53 (3.46–5.93), 0.21 (0.15–0.29), 17.27 (11.41–26.14), and 0.89 (0.86–0.92), respectively. Sub-group analyses revealed that studies based on serum or microRNA (miRNA) analysis, and those of Caucasian populations, AD patients, patient sample size >50, neuron-derived exosomes (NDE) from plasma and p-tau had higher sensitivity, specificity, and AUC values.Conclusion: Exosome-derived biomarkers have shown potential diagnostic value in AD and MCI, although further research is required for confirmation.

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Salivary DNA Methylation as an Epigenetic Biomarker for Head and Neck Cancer. Part I: A Diagnostic Accuracy Meta-Analysis

Journal of Personalized Medicine ◽

10.3390/jpm11060568 ◽

2021 ◽

Vol 11 (6) ◽

pp. 568

Author(s):

Óscar Rapado-González ◽

Cristina Martínez-Reglero ◽

Ángel Salgado-Barreira ◽

Laura Muinelo-Romay ◽

Juan Muinelo-Lorenzo ◽

...

Keyword(s):

Dna Methylation ◽

Head And Neck Cancer ◽

Diagnostic Accuracy ◽

Head And Neck ◽

Likelihood Ratio ◽

Neck Cancer ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Epigenetic Mechanism ◽

Cochrane Library

DNA hypermethylation is an important epigenetic mechanism for gene expression inactivation in head and neck cancer (HNC). Saliva has emerged as a novel liquid biopsy representing a potential source of biomarkers. We performed a comprehensive meta-analysis to evaluate the overall diagnostic accuracy of salivary DNA methylation for detecting HNC. PubMed EMBASE, Web of Science, LILACS, and the Cochrane Library were searched. Study quality was assessed by the Quality Assessment for Studies of Diagnostic Accuracy-2, and sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (dOR), and their corresponding 95% confidence intervals (CIs) were calculated using a bivariate random-effect meta-analysis model. Meta-regression and subgroup analyses were performed to assess heterogeneity. Eighty-four study units from 18 articles with 8368 subjects were included. The pooled sensitivity and specificity of salivary DNA methylation were 0.39 and 0.87, respectively, while PLR and NLR were 3.68 and 0.63, respectively. The overall area under the curve (AUC) was 0.81 and the dOR was 8.34. The combination of methylated genes showed higher diagnostic accuracy (AUC, 0.92 and dOR, 36.97) than individual gene analysis (AUC, 0.77 and dOR, 6.02). These findings provide evidence regarding the potential clinical application of salivary DNA methylation for HNC diagnosis.

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Does the Intradiscal Injection of Platelet Rich Plasma Have Any Beneficial Role in the Management of Lumbar Disc Disease?

Global Spine Journal ◽

10.1177/2192568221998367 ◽

2021 ◽

pp. 219256822199836

Author(s):

Sathish Muthu ◽

Madhan Jeyaraman ◽

Girinivasan Chellamuthu ◽

Naveen Jeyaraman ◽

Rashmi Jain ◽

...

Keyword(s):

Beneficial Effect ◽

Platelet Rich Plasma ◽

Lumbar Disc ◽

Meta Analysis ◽

Cochrane Library ◽

Significant Heterogeneity ◽

Disc Disease ◽

Lumbar Disc Disease ◽

Beneficial Role ◽

Sf 36

Study Design: Systematic review and meta-analysis. Objectives: We performed this meta-analysis to evaluate whether intradiscal Platelet Rich Plasma(PRP) injection has any beneficial role in the management of lumbar disc disease. Methods: We conducted independent and duplicate electronic database searches including PubMed, Embase, and Cochrane Library till September 2020 for studies investigating the role of intradiscal PRP in the management of lumbar disc disease. The analysis was performed in the R platform using OpenMeta[Analyst] software. Results: 13 studies including 2 RCTs, 5 prospective, and 6 retrospective studies involving 319 patients were included in the meta-analysis. A single-arm meta-analysis of the included studies showed a beneficial effect of the intervention in terms of pain relief outcomes like VAS score (p < 0.001), pain component of SF-36 (p = 0.003) while such improvement was not seen in functional outcome measures like ODI score (p = 0.071), the physical component of SF-36 (p = 0.130) with significant heterogeneity noted among the included studies. No structural improvement in magnetic resonance imaging was observed (p = 0.106). No additional procedure-related adverse events were noted in the included studies (p = 0.662). Conclusion: There is a paucity of high-quality studies to give conclusive evidence on the benefits of intradiscal PRP for lumbar disc disease. Although intradiscal PRP injection has shown some beneficial effect in controlling pain for lumbar disc disease, we could not find structural or functional improvement from the included studies. Hence, we recommend large double-blind double-arm randomized controlled studies to analyze the benefits of the intervention being analyzed.

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