Can we predict suicide and non-fatal self-harm with the Beck Hopelessness Scale? A meta-analysis

2007 ◽  
Vol 37 (6) ◽  
pp. 769-778 ◽  
Author(s):  
DEAN McMILLAN ◽  
SIMON GILBODY ◽  
EMMA BERESFORD ◽  
LIZ NEILLY
Keyword(s):  
Operating Characteristic ◽  
Meta Analysis ◽  
Roc Curves ◽  
High Risk Group ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Beck Hopelessness Scale ◽  
Self Harm ◽  
Sensitivity Specificity ◽  
Specificity Rate

Background. Hopelessness is considered a pre-eminent risk factor for suicide and non-fatal self-harm. We aimed to quantify the ability of the Beck Hopelessness Scale (BHS) to predict these two outcomes.Method. Medline, Embase, PsycINFO and Cinahl were searched to January 2006. We included cohort studies in which the BHS was applied and patients were followed-up to establish subsequent suicide or non-fatal self-harm. Four studies provided usable data on suicide, and six studies provided data on non-fatal self-harm. Summary sensitivity, specificity, likelihood ratios and diagnostic odds ratios (DORs) were calculated for each study. Random effects meta-analytic pooling across studies at the standard cut-off point ([ges ]9) was undertaken and summary receiver operating characteristic (ROC) curves constructed.Results. For suicide, pooled sensitivity was 0·80 [95% confidence interval (CI) 0·68–0·90], pooled specificity was 0·42 (95% CI 0·41–0·44), and the pooled DOR was 3·39 (95% CI 1·29–8·88). For non-fatal self-harm, pooled sensitivity was 0·78 (95% CI 0·74–0·82), pooled specificity was 0·42 (95% CI 0·38–0·45), and the pooled DOR was 2·27 (95% CI 1·53–3·37).Conclusion. The standard cut-off point on the BHS identifies a high-risk group for potential suicide, but the magnitude of the risk is lower than previously reported estimates. The standard cut-off point is also capable of identifying those who are at risk of future self-harm, but the low specificity rate means it is unlikely to be of use in targeting treatment designed to lower the rate of repetition.

scholarly journals Interleukin-27 as a Diagnostic Biomarker for Patients with Sepsis: A Meta-Analysis

2021 ◽  
Vol 2021 ◽  
pp. 1-7
Author(s):  
Ying Wang ◽  
Jingyi Zhao ◽  
Yinhui Yao ◽  
Dan Zhao ◽  
Shiquan Liu
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Biomarker ◽  
Summary Receiver Operating Characteristic ◽  
Funnel Plot ◽  
Operating Characteristic Curve ◽  
Sensitivity Specificity

Background. The present study was aimed to investigate the value of blood interleukin-27 (IL-27) as a diagnostic biomarker of sepsis. Methods. We searched PubMed, EMBASE, the Cochrane Library, and the reference lists of relevant articles. All studies published up to October 21, 2020, which evaluated the accuracy of IL-27 levels for the diagnosis of sepsis were included. All the selected papers were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2). We used a bivariate random effects model to estimate sensitivity, specificity, diagnostic odds ratios (DOR), and a summary receiver operating characteristic curve (SROC). Deeks’ funnel plot was used to illustrate the potential presence of publication bias. Results. This meta-analysis included seven articles. The pooled sensitivity, specificity, and DOR were 0.85 (95% CI, 0.72-0.93), 0.72 (95% CI, 0.42-0.90), and 15 (95% CI, 3-72), respectively. The area under the summary receiver operating characteristic curve was 0.88 (95% CI, 0.84-0.90). The pooled I 2 statistic was 96.05 for the sensitivity and 96.65 for the specificity in the heterogeneity analysis. Deeks’ funnel plot indicated no publication bias in this meta-analysis ( P = 0.07 ). Conclusions. The present results showed that IL-27 is a reliable diagnostic biomarker of sepsis, but it should be investigated in combination with other clinical tests and results.

scholarly journals Diagnostic Value of Autoantibodies in Lung Cancer: a Systematic Review and Meta-Analysis

2018 ◽  
Vol 51 (6) ◽  
pp. 2631-2646 ◽  
Author(s):  
Jiangyue Qin ◽  
Ni Zeng ◽  
Ting Yang ◽  
Chun Wan ◽  
Lei Chen ◽  
...  
Keyword(s):  
Lung Cancer ◽  
Diagnostic Accuracy ◽  
Test Performance ◽  
Meta Analysis ◽  
Cyclin B1 ◽  
Diagnostic Value ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Mixed Effect ◽  
Sensitivity Specificity

Background/Aims: Recently, many studies have demonstrated that various tumor-associated autoantibodies have been detected in early stages of lung cancer. Therefore, we conducted a meta-analysis to comprehensively evaluate available evidence on the diagnostic value of autoantibodies against tumor-associated antigens in lung cancer. Methods: We systematically searched PubMed, Scopus, Web of Science and other databases through 23 March 2018. Study quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2. We used the bivariate mixed-effect models to calculate pooled values of sensitivity, specificity, positive likelihood ratios, negative likelihood ratios, diagnostic odds ratios and associated 95% confidence intervals. Summary receiver operating characteristic (SROC) curves were used to summarize overall test performance. Deek’s funnel plot was used to detect publication bias. Results: Review of 468 candidate articles identified fifty-three articles with a total of 11,515 patients for qualitative review and meta-analysis. Pooled sensitivity, specificity and area under the SROC curve were as follows for tumor-associated autoantibodies against the following proteins: p53, 0.19, 0.98, 0.82; NY-ESO-1, 0.17, 0.98, 0.90; Survivin, 0.19, 0.99, 0.96; c-myc, 0.14, 0.98, 0.45; Cyclin B1, 0.18, 0.98, 0.91; GBU4-5, 0.07, 0.98, 0.91; CAGE, 0.14, 0.98, 0.90; p16, 0.08, 0.97, 0.91; SOX2, 0.14, 0.99, 0.93; and HuD, 0.17, 0.99, 0.82. Conclusion: Each tumor-associated autoantibody on its own showed excellent diagnostic specificity for lung cancer but inadequate sensitivity. Our results suggest that combinations or panels of tumor-associated autoantibodies may provide better sensitivity for diagnosing lung cancer, and the diagnostic accuracy of tumor-associated autoantibodies should be validated in more studies.

The Interpretation of Test Results

2000 ◽  
Vol 4 (1) ◽  
pp. 19-25 ◽  
Author(s):  
Michael Binder ◽  
Stephan Dreiseitl
Keyword(s):  
Decision Making ◽  
Receiver Operating Characteristic ◽  
Diagnostic Tests ◽  
Operating Characteristic ◽  
Roc Curves ◽  
Test Results ◽  
Likelihood Ratios ◽  
Clinical Routine ◽  
Predictive Values ◽  
Sensitivity Specificity

Background: Dermatologists need to interpret an increasing number of research studies and diagnostic tests. Understanding the techniques for interpreting test results and making decisions based upon those tests represent important tools for decision making for both clinicians and researchers. Objective: This article focuses briefly on the key parameters of diagnostic tests: sensitivity, specificity, prevalence, predictive values, likelihood ratios, and the concept of receiver-operating-characteristic (ROC) curves. A simple example is presented in a step-by-step manner. Conclusion: The principles of interpreting test results are easy to learn and applicable in daily clinical routine. Therefore, dermatologists should be familiar with the concepts outlined in this paper.

scholarly journals Accuracy of Enzyme-Linked Immunosorbent Assays (ELISAs) in Detecting Antibodies againstMycobacterium lepraein Leprosy Patients: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 2018 ◽  
pp. 1-11 ◽  
Author(s):  
Omar Ariel Espinosa ◽  
Silvana Margarida Benevides Ferreira ◽  
Fabiana Gulin Longhi Palacio ◽  
Denise da Costa Boamorte Cortela ◽  
Eliane Ignotti
Keyword(s):  
Diagnostic Accuracy ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Immunosorbent Assays ◽  
Sensitivity Specificity

IgM againstMycobacterium lepraemay be detected by enzyme-linked immunosorbent assays (ELISAs) based on phenolic glycolipid I (PGL-I) or natural disaccharide octyl bovine serum albumin (ND-O-BSA) as antigens, and the IgG response can be detected by an ELISA based on lipid droplet protein 1 (LID-1). The titers of antibodies against these antigens vary with operational classification. The aim of this study was to compare the accuracy of ELISAs involving PGL-I and ND-O-BSA with that involving LID-1. We included studies that analyze multibacillary and paucibacillary leprosy cases and evaluate the diagnostic accuracy of ELISAs based on LID-1 and/or PGL-I or ND-O-BSA as antigens to measure antibody titers againstM. leprae. Studies were found via PubMed, the Virtual Health Library Regional Portal, Literatura Latino-Americana e do Caribe em Ciências da Saúde, Índice Bibliográfico Espanhol de Ciências de Saúde, the Brazilian Society of Dermatology, National Institute for Health and Clinical Excellence, Cochrane Library, Embase (the Elsevier database), and Cumulative Index to Nursing and Allied Health Literature. The Quality Assessment of Diagnostic Accuracy Studies served as a methodological validity tool. Quantitative data were extracted using the Standards for Reporting of Diagnostic Accuracy. Sensitivity, specificity, and a diagnostic odds ratio were calculated, and a hierarchical summary receiver-operating characteristic curve and forest plots were constructed. The protocol register code for this meta-analysis is PROSPERO 2017: CRD42017055983. Nineteen studies were included. ND-O-BSA showed better overall performance in terms of sensitivity, specificity, positive and negative likelihood ratios, and diagnostic odds ratio when compared with PGL-I and LID-1. The multibacillary group showed better performance on these parameters (than the paucibacillary group did), at 94%, 99%, 129, 0.05, and 2293, respectively. LID-1 did not provide any advantage regarding the overall estimate of sensitivity in comparison with PGL-I or ND-O-BSA.

scholarly journals Evaluation of the FilmArray Meningitis/Encephalitis Panel for Diagnosis of Infectious Meningitis and Encephalitis

2021 ◽  
Author(s):  
Min Lin ◽  
Chun-Lu Chen ◽  
Le-Yao Qi ◽  
Cong Shen ◽  
Ye-Ling Liu ◽  
...  
Keyword(s):  
Full Text ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Evaluation Standard ◽  
Sensitivity Specificity

Abstract Background: Infectious Meningitis/Encephalitis (M/E) is caused by pathogens. The FilmArray M/E panel can quickly detect 14 kinds of pathogens and facilitate diagnosis for patients with M/E. This study aimed to perform a evaluation of the sensitivity and specificity of the FilmArray M/E panel compared with classic method of diagnosing M/E.Methods: Relevant studies published before August 15, 2021, were identified by searching Web of Science, PubMed, Cochrane Library, and Embase, using keywords Meningitis, Encephalitis, and FilmArray M/E panel. After the initial screening, EndNoteX9 was used to manage the studies and extract data. The quality of the study was based mainly on the quality evaluation standard of diagnostic tests recommended by Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Meta-DiSc 1.4 statistical software was used to determine the sensitivity, specificity, 95% confidence interval (CI), diagnostic odds ratio (DOR), positive likelihood ratios (PLR) and negative likelihood ratios (NLR) of each group of data, and summary receiver operating characteristic curve (SROC). All P values were two sided, and P <0.05 was considered statistically significant.Results: A total of 269 studies were retrieved, and 16 full-text studies were identified. The sensitivity of all the full-text studies was 0.93 (95% CI: 0.91–0.95) and the specificity 0.98 (95% CI: 0.98–0.98). Conclusions: Compared with the gold standard, the FilmArray M/E panel had a sensitivity of 0.93 and a specificity of 0.98 to 16 pathogens. Further studies are needed to determine whether the FilmArray M/E panel can be used as a clinical standard for the diagnosis of M/E.

scholarly journals Identifying the diagnostic value of microRNA-421 in gastric cancer patients: a meta-analysis

2018 ◽  
Author(s):  
Yan Miao ◽  
Ying Zhang ◽  
Lina Wang ◽  
Lihong Yin
Keyword(s):  
Gastric Cancer ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Summary Receiver Operating Characteristic ◽  
Gastric Cancer Patients ◽  
Sensitivity Specificity

ABSTRACTObjectivesEmerging evidence has shown that the expression level of microRNA-421 (miR-421) was significantly different between gastric cancer (GC) patients and healthy individuals. However, the diagnostic accuracy of miR-421 in the reports remains inconsistent. This meta-analysis aims to assess the diagnostic value of miR-421 in GC detection.MethodsAll related articles on miR-421 in GC diagnosis were retrieved until September 2018. The QUADAS-2 checklist was used to assess the methodological quality of each study. The diagnostic performance of miR-421 for GC were assessed by using Meta-DiSc 1.4 and STATA 14.0 statistical software.ResultsA total of 172 GC patients and 154 healthy controls from three articles (four studies) were enrolled in this meta-analysis. The results of pooled sensitivity, specificity, diagnostic odds ratio (DOR) with 95% confidence interval (CI) were 0.90 (95% CI: 0.85 to 0.93), 0.83 (95% CI: 0.77 to 0.87), and 37.18 (95% CI: 8.61 to 160.49), respectively. The area under the summary receiver operating characteristic curve (SROC) was 0.8977.ConclusionsThis study indicates that miR-421 could serve as a promising biomarker for GC detecting. Further studies are needed to verify the generalizability of these findings.

Diagnostic accuracy of magnetic resonance angiography for acute pulmonary embolism - a systematic review and meta-analysis

VASA ◽  
2016 ◽  
Vol 45 (2) ◽  
pp. 149-154 ◽  
Author(s):  
Jie Li ◽  
Lei Feng ◽  
Jiangbo Li ◽  
Jian Tang
Keyword(s):  
Pulmonary Embolism ◽  
Magnetic Resonance ◽  
Magnetic Resonance Angiography ◽  
Diagnostic Accuracy ◽  
Acute Pulmonary Embolism ◽  
Meta Analysis ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Acute Pe ◽  
Limited Sensitivity

Abstract. Background: The aim of this meta-analysis was to evaluate the diagnostic accuracy of magnetic resonance angiography (MRA) for acute pulmonary embolism (PE). Methods: A systematic literature search was conducted that included studies from January 2000 to August 2015 using the electronic databases PubMed, Embase and Springer link. The summary receiver operating characteristic (SROC) curve, sensitivity, specificity, positive likelihood ratios (PLR), negative likelihood ratios (NLR), and diagnostic odds ratio (DOR) as well as the 95 % confidence intervals (CIs) were calculated to evaluate the diagnostic accuracy of MRA for acute PE. Meta-disc software version 1.4 was used to analyze the data. Results: Five studies were included in this meta-analysis. The pooled sensitivity (86 %, 95 % CI: 81 % to 90 %) and specificity (99 %, 95 % CI: 98 % to 100 %) demonstrated that MRA diagnosis had limited sensitivity and high specificity in the detection of acute PE. The pooled estimate of PLR (41.64, 95 % CI: 17.97 to 96.48) and NLR (0.17, 95 % CI: 0.11 to 0.27) provided evidence for the low missed diagnosis and misdiagnosis rates of MRA for acute PE. The high diagnostic accuracy of MRA for acute PE was demonstrated by the overall DOR (456.51, 95 % CI: 178.38 - 1168.31) and SROC curves (AUC = 0.9902 ± 0.0061). Conclusions: MRA can be used for the diagnosis of acute PE. However, due to limited sensitivity, MRA cannot be used as a stand-alone test to exclude acute PE.

The role of serum periostin in the diagnosis of asthma: A meta-analysis

2020 ◽  
Vol 41 (4) ◽  
pp. 240-247
Author(s):  
Lei Yang ◽  
Qingtao Zhao ◽  
Shuyu Wang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
False Negative ◽  
Summary Receiver Operating Characteristic ◽  
True Negative ◽  
Negative Results ◽  
Noninvasive Biomarker ◽  
Sensitivity Specificity ◽  
Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

scholarly journals Accuracy of angiopoietin-2 for predicting organ failure in patients with acute pancreatitis: a systematic review and meta-analysis

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098670
Author(s):  
Yongcai Lv ◽  
Yanhua Yao ◽  
Qi Liu ◽  
Jingjing Lei
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Angiopoietin 2

Objective Our aim was to assess the accuracy of angiopoietin-2 (Ang-2) as a prognostic marker for acute pancreatitis (AP) with organ failure (OF). Methods We undertook a systematic search of the PubMed, Cochrane Library, Embase, Chinese Journals Full-text, Wanfang, China Biology Medicine disc, and Weipu databases to identify eligible cohort studies on the predictive value of Ang-2 for AP with OF. The main outcome measures were sensitivity and specificity. The effects were pooled using a bivariate mixed-effects model. Results Six articles with seven case-control studies (n = 650) were included. Pooled sensitivity, specificity, and positive and negative likelihood ratios with 95% confidence intervals (CI) for AP with OF were 0.93 (95%CI: 0.75–0.99), 0.85 (95%CI: 0.75–0.92), 6.40 (95%CI: 3.36–12.19), and 0.08 (95%CI: 0.02–0.36), respectively. The area under the summary receiver operating characteristic curve was 0.95 (95%CI: 0.92–0.96), and the diagnostic odds ratio was 83.18 (95%CI: 11.50–623.17). Subgroup analysis showed that admission time of AP onset (< or ≥24 hours) was a source of overall heterogeneity. Sensitivity analysis supported this finding. Conclusion Ang-2 had high diagnostic accuracy for AP with OF; the best prediction of Ang-2 may be 24 to 72 hours after onset of AP.

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