Diagnostic Accuracy of Transthoracic Echocardiography for Infective Endocarditis Findings Using Transesophageal Echocardiography as the Reference Standard: A Meta-Analysis

2017 ◽  
Vol 30 (7) ◽  
pp. 639-646.e8 ◽  
Author(s):  
Anthony D. Bai ◽  
Marilyn Steinberg ◽  
Adrienne Showler ◽  
Lisa Burry ◽  
R. Sacha Bhatia ◽  
...  
Keyword(s):  
Infective Endocarditis ◽  
Diagnostic Accuracy ◽  
Transesophageal Echocardiography ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Reference Standard

scholarly journals Diagnostic Accuracy of Transthoracic Echocardiography and Transesophageal Echocardiography for Ruptured Chordae Tendineae: A Meta-Analysis

2020 ◽  
Author(s):  
Lisi Liao ◽  
Fa-jin DONG ◽  
Jie-ying ZENG ◽  
Bo-bo SHI ◽  
Xiao-fang ZHONG ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Transesophageal Echocardiography ◽  
Transthoracic Echocardiography ◽  
Gold Standard ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Chordae Tendineae ◽  
Prior Probabilities ◽  
Highly Sensitive ◽  
Better Than

Abstract Background Echocardiography is significant for the diagnosis of ruptured chordae tendineae (RCT) for which transesophageal echocardiography (TEE) is always better than transthoracic echocardiography (TTE), but the diagnostic accuracy of TTE still remains confusing. Methods A meta-analysis of included papers was performed to evaluate the diagnostic accuracy of TTE and TEE, with surgical findings of RCT as the gold standard of patients with suspected RCT. Results The literature search yielded 862 papers, 6 met the inclusion criteria, included 505 patients, for detecting RCT, the sensitivity and specificity of TTE were 48% (95% CI: 35–62%) and 98% (95% CI: 89–100%), and those of TEE were 99% (95% CI: 64–100%) and 94% (95% CI: 87–98%), respectively. The summary + LR, -LR of TTE were 22.40 (95%CI: 4.89–102.62), 0.53(95%CI:0. 41–0.68), respectively. The summary + LR, -LR of TEE were 17.62(95%CI: 7.16–43.39), 0.02(95%CI:0. 00-0.57), respectively. For TTE, the area under SROC was 84% (95%CI:92%-96%),and that of TEE is 98%. The pooled + LR and -LR were calculated by setting the prior probabilities of 20% in both TTE and TEE. Conclusions TTE is not highly sensitive for the detection of RCT but is highly specific, so there is a potential of missing diagnosis, and subsequent TEE is almost required in highly suspected patients.

Diagnostic accuracy of transthoracic echocardiography to identify native valve infective endocarditis: a systematic review and meta-analysis

2018 ◽  
Vol 13 (6) ◽  
pp. 937-946 ◽  
Author(s):  
Mattia Bonzi ◽  
Giulia Cernuschi ◽  
Monica Solbiati ◽  
Giuliano Giusti ◽  
Nicola Montano ◽  
...  
Keyword(s):  
Systematic Review ◽  
Infective Endocarditis ◽  
Diagnostic Accuracy ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Native Valve

scholarly journals Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Liqin Jing ◽  
Yanchun Song
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Diagnostic Accuracy ◽  
English Language ◽  
Cardiac Computed Tomography ◽  
Meta Analysis ◽  
Transoesophageal Echocardiography ◽  
Cochrane Central Register ◽  
Index Test ◽  
Creative Commons

Objective: To investigate the comparative diagnostic accuracy of cardiac computed tomography (CT) and transoesophageal echocardiography (TEE) for detecting infective endocarditis. Methods: Original publications published in English language before July, 2021 were thoroughly search in PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar literature databases. Studies were included if they used CT and/or TEE as an index test, presented data on valvular complications related to infective endocarditis, and used surgical findings as to the reference standard. Results:­­­ Literature screening identified fifteen studies that fulfilled the inclusion criteria. Meta-analysis showed that CT sensitivity for detecting valvular abscesses was higher than that of TEE [0.88 (95% confidence interval [CI]: 0.82 to 0.94; 11 studies involving 842 subjects) versus 0.74 (95% CI: 0.65 to 0.84) P = 0.015; 12 studies involving 917 subjects]. TEE showed statistically significantly greater sensitivity than CT for detecting valvular vegetation [0.91 (95% CI: 0.84 to 0.97, 11 studies involving 971 subjects) versus 0.80 (95% CI: 0.69 to 0.82), 12 studies involving 915 subjects, P =0.019. In case of leaflet detection, TEE showed statistically significantly higher sensitivity than CT (0.76 vs 0.46, P =0.010). Conclusion: CT performs statistically significantly better than TEE for detecting abscesses while TEE provides statistically significant superior results for detecting vegetation. There is a need for well-designed prospective studies to further corroborate these findings. doi: https://doi.org/10.12669/pjms.38.3.5139 How to cite this:Jing L, Song Y. Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis . Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5139 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Diagnostic Accuracy of Stool Xpert MTB/RIF for Detection of Pulmonary Tuberculosis in Children: a Systematic Review and Meta-analysis

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Emily MacLean ◽  
Giorgia Sulis ◽  
Claudia M. Denkinger ◽  
James C. Johnston ◽  
Madhukar Pai ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Tuberculosis ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Target Population ◽  
Nucleic Acid Amplification ◽  
Reference Standard ◽  
Noninvasive Method ◽  
High Data

ABSTRACT Invasive collection methods are often required to obtain samples for the microbiological evaluation of children with presumptive pulmonary tuberculosis (PTB). Nucleic acid amplification testing of easier-to-collect stool samples could be a noninvasive method of diagnosing PTB. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of testing stool with the Xpert MTB/RIF assay (“stool Xpert”) for childhood PTB. Four databases were searched for publications from January 2008 to June 2018. Studies assessing the diagnostic accuracy among children of stool Xpert compared to a microbiological reference standard of conventional specimens tested by mycobacterial culture or Xpert were eligible. Bivariate random-effects meta-analyses were performed to calculate pooled sensitivity and specificity of stool Xpert against the reference standard. From 1,589 citations, 9 studies (n = 1,681) were included. Median participant ages ranged from 1.3 to 10.6 years. Protocols for stool processing and testing varied substantially, with differences in reagents and methods of homogenization and filtering. Against the microbiological reference standard, the pooled sensitivity and specificity of stool Xpert were 67% (95% confidence interval [CI], 52 to 79%) and 99% (95% CI, 98 to 99%), respectively. Sensitivity was higher among children with HIV (79% [95% CI, 68 to 87%] versus 60% [95% CI, 44 to 74%] among HIV-uninfected children). Heterogeneity was high. Data were insufficient for subgroup analyses among children under the age of 5 years, the most relevant target population. Stool Xpert could be a noninvasive method of ruling in PTB in children, particularly those with HIV. However, studies focused on children under 5 years of age are needed, and generalizability of the evidence is limited by the lack of standardized stool preparation and testing protocols.

scholarly journals Diagnostic accuracy of transthoracic echocardiography for pulmonary hypertension: a systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (12) ◽  
pp. e033084 ◽  
Author(s):  
Jin-Rong Ni ◽  
Pei-Jing Yan ◽  
Shi-Dong Liu ◽  
Yuan Hu ◽  
Ke-Hu Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Hypertension ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Transthoracic Echocardiography ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Time Interval

ObjectiveTo evaluate the diagnostic accuracy of transthoracic echocardiography (TTE) in patients with pulmonary hypertension (PH).DesignSystematic review and meta-analysis.Data sources and eligibility criteriaEmbase, Cochrane Library for clinical trials, PubMed and Web of Science were used to search studies from inception to 19 June, 2019. Studies using both TTE and right heart catheterisation (RHC) to diagnose PH were included.Main resultsA total of 27 studies involving 4386 subjects were considered as eligible for analysis. TTE had a pooled sensitivity of 85%, a pooled specificity of 74%, a pooled positive likelihood ratio of 3.2, a pooled negative likelihood ratio of 0.20, a pooled diagnostic OR of 16 and finally an area under the summary receiver operating characteristic curve of 0.88. The subgroup with the shortest time interval between TTE and RHC had the best diagnostic effect, with sensitivity, specificity and area under the curve (AUC) of 88%, 90% and 0.94, respectively. TTE had lower sensitivity (81%), specificity (61%) and AUC (0.73) in the subgroup of patients with definite lung diseases. Subgroup analysis also showed that different thresholds of TTE resulted in a different diagnostic performance in the diagnosis of PH.ConclusionTTE has a clinical value in diagnosing PH, although it cannot yet replace RHC considered as the gold standard. The accuracy of TTE may be improved by shortening the time interval between TTE and RHC and by developing an appropriate threshold. TTE may not be suitable to assess pulmonary arterial pressure in patients with pulmonary diseases.PROSPERO registration numberPROSPERO CRD42019123289.

scholarly journals A Systematic Review and Meta-analysis of the Diagnostic Accuracy of Nucleic Acid Amplification Tests for Tuberculous Meningitis

2019 ◽  
Vol 57 (6) ◽  
Author(s):  
Ali Pormohammad ◽  
Mohammad Javad Nasiri ◽  
Timothy D. McHugh ◽  
Seyed Mohammad Riahi ◽  
Nathan C. Bahr
Keyword(s):  
Systematic Review ◽  
Nucleic Acid ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Tuberculous Meningitis ◽  
Meta Analysis ◽  
Nucleic Acid Amplification ◽  
Data Sets ◽  
Reference Standard ◽  
Sensitivity Specificity

ABSTRACTThe diagnosis of tuberculous meningitis (TBM) is difficult and poses a significant challenge to physicians worldwide. Recently, nucleic acid amplification (NAA) tests have shown promise for the diagnosis of TBM, although their performance has been variable. We undertook a systematic review and meta-analysis to evaluate the diagnostic accuracy of NAA tests with cerebrospinal fluid (CSF) samples against that of culture as the reference standard or a combined reference standard (CRS) for TBM. We searched the Embase, PubMed, Web of Science, and Cochrane Library databases for the relevant records. The QUADAS-2 tool was used to assess the quality of the studies. Diagnostic accuracy measures (i.e., sensitivity and specificity) were pooled with a random-effects model. All statistical analyses were performed with STATA (version 14 IC; Stata Corporation, College Station, TX, USA), Meta-DiSc (version 1.4 for Windows; Cochrane Colloquium, Barcelona, Spain), and RevMan (version 5.3; The Nordic Cochrane Centre, the Cochrane Collaboration, Copenhagen, Denmark) software. Sixty-three studies comprising 1,381 cases of confirmed TBM and 5,712 non-TBM controls were included in the final analysis. These 63 studies were divided into two groups comprising 71 data sets (43 in-house tests and 28 commercial tests) that used culture as the reference standard and 24 data sets (21 in-house tests and 3 commercial tests) that used a CRS. Studies which used a culture reference standard had better pooled summary estimates than studies which used CRS. The overall pooled estimates of sensitivity, specificity, positive likelihood ratio (PLR), and negative likelihood ratio (NLR) of the NAA tests against culture were 82% (95% confidence interval [CI], 75 to 87%), 99% (95% CI, 98 to 99%), 58.6 (95% CI, 35.3 to 97.3), and 0.19 (95% CI, 0.14 to 0.25), respectively. The pooled sensitivity, specificity, PLR, and NLR of NAA tests against CRS were 68% (95% CI, 41 to 87%), 98% (95% CI, 95 to 99%), 36.5 (95% CI, 15.6 to 85.3), and 0.32 (95% CI, 0.15 to 0.70), respectively. The analysis has demonstrated that the diagnostic accuracy of NAA tests is currently insufficient for them to replace culture as a lone diagnostic test. NAA tests may be used in combination with culture due to the advantage of time to result and in scenarios where culture tests are not feasible. Further work to improve NAA tests would benefit from the availability of standardized reference standards and improvements to the methodology.

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