scholarly journals Comparing the diagnostic accuracy of five common tumour biomarkers and CA19-9 for pancreatic cancer: a protocol for a network meta-analysis of diagnostic test accuracy

BMJ Open ◽  
2017 ◽  
Vol 7 (12) ◽  
pp. e018175 ◽  
Author(s):  
Long Ge ◽  
Bei Pan ◽  
Fujian Song ◽  
Jichun Ma ◽  
Dena Zeraatkar ◽  
...  
Keyword(s):  
Pancreatic Cancer ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Test Accuracy ◽  
Cochrane Central Register ◽  
Resectable Pancreatic Cancer ◽  
Ras Gene ◽  
Patient Consent ◽  
Tumour Biomarkers

IntroductionSurgical resection is the only curative treatment for patients with resectable pancreatic cancer. Unfortunately, 80%–85% of patients present with locally advanced or metastatic unresectable pancreatic cancer at the time of diagnosis. Detection of pancreatic cancer at early stages remains a great challenge due to lack of accurate detection tests. Recommendations in existing clinical practice guidelines on early diagnosis of pancreatic cancer are inconsistent and based on limited evidence. Most of them endorse measuring serum CA19-9 as a complementary test, but also state that it is not recommended for diagnosing early pancreatic cancer. There are currently no other tumour-specific markers recommended for diagnosing early pancreatic cancer. This study aims to evaluate and compare the accuracy of five common tumour biomarkers (CA242,carcino-embryonic antigen (CEA)), CA125, microRNAs and K-ras gene mutation) and CA19-9 and their combinations for diagnosing pancreatic cancer using network meta-analysis method, and to rank these tests using a superiority index.Methods and analysisPubMed, EMBASE and the Cochrane Central Register of Controlled Trials will be searched from inception to April 2017. The search will include the above-mentioned tumour biomarkers for diagnosing pancreatic cancer, including CA19-9. The risk of bias for each study will be independently assessed as low, moderate or high using criteria adapted from the Quality Assessment of Diagnostic Accuracy Studies 2. Network meta-analysis will be performed using STATA V.12.0 and R software V.3.4.1. The competing diagnostic tests will be ranked by a superiority index.Ethics and disseminationEthical approval and patient consent are not required since this study is a network meta-analysis based on published studies. The results of this network meta-analysis will be submitted to a peer-reviewed journal for publication.PROSPERO registration numberCRD42017064627.

scholarly journals Diagnostic accuracy of the 4AT for delirium detection in older adults: systematic review and meta-analysis

2020 ◽  
Author(s):  
Zoë Tieges ◽  
Alasdair M J Maclullich ◽  
Atul Anand ◽  
Claire Brookes ◽  
Marica Cassarino ◽  
...  
Keyword(s):  
Systematic Review ◽  
Older Adults ◽  
Clinical Practice ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Methodological Quality ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Cochrane Central Register

Abstract Objective Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT) is a short (<2 minutes) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection. Methods We searched MEDLINE, EMBASE, PsycINFO, CINAHL, clinicaltrials.gov and the Cochrane Central Register of Controlled Trials, from 2011 (year of 4AT release on the website www.the4AT.com) until 21 December 2019. Inclusion criteria were: older adults (≥65 years); diagnostic accuracy study of the 4AT index test when compared to delirium reference standard (standard diagnostic criteria or validated tool). Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model. Results Seventeen studies (3,702 observations) were included. Settings were acute medicine, surgery, a care home and the emergency department. Three studies assessed performance of the 4AT in stroke. The overall prevalence of delirium was 24.2% (95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity was 0.88 (95% CI 0.82–0.92). Excluding the stroke studies, the pooled sensitivity was 0.86 (95% CI 0.77–0.92) and the pooled specificity was 0.89 (95% CI 0.83–0.93). The methodological quality of studies varied but was moderate to good overall. Conclusions The 4AT shows good diagnostic test accuracy for delirium in the 17 available studies. These findings support its use in routine clinical practice in delirium detection. PROSPERO Registration number CRD42019133702.

The Role of Staging Laparoscopy in Resectable and Borderline Resectable Pancreatic Cancer: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 36 (3) ◽  
pp. 251-260 ◽  
Author(s):  
Robert Ta ◽  
Donal B. O’Connor ◽  
Andrew Sulistijo ◽  
Benjamin Chung ◽  
Kevin C. Conlon
Keyword(s):  
Pancreatic Cancer ◽  
Meta Analysis ◽  
Locally Advanced ◽  
Staging Laparoscopy ◽  
Resectable Pancreatic Cancer ◽  
Borderline Resectable ◽  
Resectable Disease ◽  
Newcastle Ottawa Scale ◽  
Resectable Cancer ◽  
Additional Value

Aim: The study aimed to determine the additional value of staging laparoscopy in patients with pancreatic cancer deemed potentially resectable based on computed tomography imaging. Methods: A systematic literature search was performed using MEDLINE and the Cochrane Register of Controlled Trials (January 1995 to June 2017). Primary outcome measures were the overall yield and sensitivity to detect non-resectable disease. Quality of studies was assessed with the Newcastle-Ottawa Scale. Results: From 156 records, 15 studies including 2,776 patients met the inclusion criteria. In 12 studies, reporting outcomes on 1,756 patients with resectable disease after standard imaging, 350 (20%, range 14–38%) cases of non-resectable cancer were detected with staging laparoscopy. In 3 studies on 242 patients with locally advanced disease after standard imaging, staging laparoscopy detected metastases in 86 patients (36%). The failure rate of staging laparoscopy to detect non-resectable disease was 5% (64 of 1,406). Conclusion: Staging laparoscopy reduces the non-therapeutic laparotomy rate, and in locally advanced or borderline resectable disease, staging laparoscopy could more accurately select patients for neoadjuvant protocols.

scholarly journals Comment on “Systematic Review and Meta-Analysis of Diagnostic Accuracy of miRNAs in Patients with Pancreatic Cancer”

2018 ◽  
Vol 2018 ◽  
pp. 1-2 ◽  
Author(s):  
Rama Jayaraj ◽  
Chellan Kumarasamy ◽  
Madurantakam Royam Madhav ◽  
Venkatesh Pandey ◽  
Shanthi Sabarimurugan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pancreatic Cancer ◽  
Diagnostic Accuracy ◽  
Meta Analysis
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