scholarly journals Blood-Based Circulating MicroRNAs are Potential Diagnostic Biomarkers for Leukemia: Result from a Meta-Analysis

2016 ◽  
Vol 38 (3) ◽  
pp. 939-949 ◽  
Author(s):  
Li-hua Xu ◽  
Yang Guo ◽  
Xue-Li Zhang ◽  
Jia-jia Chen ◽  
Shao-yan Hu
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Sensitivity Analyses ◽  
Cochrane Library ◽  
Circulating Mirnas ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas

Aims: Circulating microRNAs (miRNAs) as biomarkers for leukemia have been validated by emerging studies. This meta-analysis aims to estimate the overall diagnostic accuracy of blood-based circulating miRNAs for leukemia. Methods: We searched multiple databases (PubMed, EMBASE, Cochrane Library, CNKI, Wan Fang Data and CQVIP) up to June 18, 2015. Results: 32 studies from 10 publications were included in this meta-analysis. Diagnostic capacity was evaluated by pooled sensitivity, specifIcity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) through random-effects model. Sensitivity analyses were sequentially performed to find potential sources of heterogeneity. The quality of included studies was assessed by QUADAS (quality assessment for studies of diagnostic accuracy). Meta-Disc 1.4 and Stata 12.0 software were used to perform the meta-analysis. A high diagnostic accuracy was displayed, with a sensitivity of 0.84, a specificity of 0.88, a PLR of 7.20, a NLR of 0.18, a DOR of 52, and an AUC of 0.94. Subgroup analyses revealed better performance for combined miRNAs, acute myeloid leukemia patients and Asian population than other subgroups. Conclusion: Our analyses suggested that blood-based circulating miRNAs are promising diagnostic biomarkers for leukemia, especially combined miRNAs. Its clinical application awaits further study.

scholarly journals Identification of circulating microRNAs as diagnostic biomarkers for ovarian cancer: A pooled analysis of individual studies

2018 ◽  
Vol 33 (4) ◽  
pp. 379-388 ◽  
Author(s):  
Quan Zhou ◽  
Man-Zhen Zuo ◽  
Ze He ◽  
Hai-Rong Li ◽  
Wei Li
Keyword(s):  
Ovarian Cancer ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Circulating Mirnas ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas ◽  
Diagnostic Characteristics

Background: Circulating microRNAs (miRNAs) are proposed as promising non-invasive diagnostic biomarkers for many cancers. However, the diagnostic value of circulating miRNAs in ovarian cancer is inconsistent in different studies. Thus we performed this meta-analysis to systematically evaluate the diagnostic value of circulating miRNAs in ovarian cancer. Methods: Eligible studies that were published prior to 30 June 2017 were searched from the PubMed, EMBASE, Cochrane Library, and Chinese National Knowledge Infrastructure. All analyses were performed using STATA 12.0 software. A bivariate regression was used to calculate pooled diagnostic accuracy estimates. Results: A total of 36 studies from 16 publications were included in this meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio of circulating miRNAs for ovarian cancer diagnosis were 0.76 (95% confidence intervals (CI): 0.69, 0.81), 0.81 (95% CI 0.74, 0.87), 4.00 (95% CI 2.70, 5.30), 0.30(95% CI 0.24, 0.37) and 13.00 (95% CI 9.00, 19.00), respectively. The area under the summary receiver operating characteristic curve was 0.85 (95% CI 0.82, 0.88). Subgroup analyses showed that multiple miRNA assays yielded better diagnostic characteristics than a single miRNA assay, and plasma miRNAs were better than serum miRNAs for ovarian cancer detection. Conclusion: Circulating miRNAs, especially the combination of multiple circulating miRNAs, are promising biomarkers for the diagnosis of ovarian cancer. However, further large-scale prospective studies are necessary to validate the applicability of the miRNAs in the early detection of ovarian cancer.

scholarly journals Circulating MicroRNAs as Promising Diagnostic Biomarkers for Patients With Glioma: A Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Jimin He ◽  
Yao Jiang ◽  
Liang Liu ◽  
Zhihua Zuo ◽  
Chun Zeng
Keyword(s):  
Likelihood Ratio ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Significant Heterogeneity ◽  
Circulating Mirnas ◽  
Diagnostic Biomarkers ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Backgrounds and Purpose: Currently, circulating microRNAs (miRNAs) are considered to be non-invasive diagnostic biomarkers in a broad range of tumors. Nevertheless, so far, miRNAs have not been fully applied to the clinic for routine screening in glioma patients. Thus, our goal is to evaluate the diagnostic performance of circulating miRNAs for gliomas via a meta-analysis. The present study is registered on the PROSPERO website, with the number CRD42020195883.Methods: Literature retrieval was implemented in the PubMed, Embase, and Web of Science databases using the established search strategy. We pooled the sensitivity, specificity, and its 95% confidence intervals (CIs) for the included studies using the Stata 14.0 software. In addition, the heterogeneity between studies was assessed via the Q statistics and I2 values calculated by a Chi-square test. A bivariate random effects model was selected due to significant heterogeneity. Specifically, for exploring the factors influencing the heterogeneity, we implemented subgroup and meta-regression analyses. Ultimately, a Deek's funnel plot asymmetry test was used to estimate the potential publication bias.Results: A total of 18 articles covering 24 studies were included, containing 2,170 glioma patients and 1,456 healthy participants. The overall pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) were 0.84 (95%CI: 0.79–0.87), 0.84 (95%CI: 0.80–0.88), 5.3 (95%CI: 4.1–6.8), 0.19 (95%CI: 0.15–0.25), 27 (95%CI: 18–41), and 0.91 (95%CI: 0.88–0.93), respectively. Additionally, the findings revealed that serum miRNAs and miRNA panels presented superior diagnostic performance.Conclusion: Thus, circulating miRNAs have the potential to serve as diagnostic biomarkers for gliomas, but need to be verified via a large pool of prospective studies. Additionally, specific miRNAs still need to be elucidated in the diagnosis of a glioma, especially in the early screening stage. The findings may provide diagnostic and therapeutic strategies for the glioma population.

scholarly journals The Potential Diagnostic Accuracy of Circulating MicroRNAs for Leukemia: A Meta-Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110119
Author(s):  
Wen-Ting Zhang ◽  
Guo-Xun Zhang ◽  
Shuai-Shuai Gao
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Background: Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia. Methods: A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias. Results: 49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found. Conclusions: Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.

scholarly journals A Meta-Analysis of the Diagnostic Accuracy of Circular RNAs in Digestive System Malignancy

2018 ◽  
Vol 45 (3) ◽  
pp. 962-972 ◽  
Author(s):  
Zhiqiang Chen ◽  
Long Zhang ◽  
Guoyong Han ◽  
Xueliang Zuo ◽  
Yao Zhang ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Digestive System ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Circular Rnas ◽  
Cancer Type ◽  
Discriminative Ability

Background/Aims: Circular RNAs (circRNAs), a novel class of noncoding RNAs, have been found to be dysregulated in various cancers. However, the clinical application value of these circRNAs in digestive system cancers remains to be clarified. We aimed to comprehensively explore the potential role of circRNAs as diagnostic indicators in digestive system malignancies. Methods: Relevant studies were systematically retrieved from PubMed, Web of Science and the Cochrane Library. The data that were required to complete 2 × 2 contingency tables were obtained from the included studies. Stratified analyses by cancer type, sample size and publication year were performed. Results: Thirteen studies with 2,276 individuals were included in the meta-analysis. The pooled sensitivity and specificity of circRNAs in the diagnosis of digestive system malignancy were 0.72 [95% confidence interval (CI): 0.65-0.77] and 0.77 (95% CI: 0.72-0.81), respectively. The overall positive likelihood ratio was 3.09 (95% CI: 2.64-3.62), and the overall negative likelihood ratio was 0.37 (95% CI: 0.31-0.44). The pooled diagnostic odds ratio was 8.38 (95% CI: 6.86-10.25), and the overall area under the curve was 0.81 (95% CI: 0.77-0.84), indicating good discriminative ability of circRNAs as biomarkers for digestive system malignancy. Conclusion: circRNAs distinguish patients with digestive system cancer from controls with relatively high diagnostic accuracy. circRNAs may be used as potential biomarkers for the diagnosis of digestive system malignancy.

scholarly journals Diagnostic Accuracy of Monofilament Tests for Detecting Diabetic Peripheral Neuropathy: A Systematic Review and Meta-Analysis

2017 ◽  
Vol 2017 ◽  
pp. 1-12 ◽  
Author(s):  
Fengyi Wang ◽  
Jiaqi Zhang ◽  
Jiadan Yu ◽  
Shaxin Liu ◽  
Rengang Zhang ◽  
...  
Keyword(s):  
Peripheral Neuropathy ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Diabetic Peripheral Neuropathy ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Qualitative Synthesis

Objective. To systematically evaluate the diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy. Methods. We searched EMBASE (OvidSP), MEDLINE (OvidSP), the Cochrane Library, and Web of Science to identify diagnostic accuracy trials of monofilament tests for detecting diabetic peripheral neuropathy. We used a hierarchical summary receiver operating characteristics (HSROC) model to conduct the meta-analysis of diagnostic accuracy of monofilament tests for detecting diabetic peripheral neuropathy. Results. A total of 19 comparative trials met the inclusion criteria and were part of the qualitative synthesis. Eight trials using nerve conduction studies as the reference standard were selected for the meta-analysis. The pooled sensitivity and specificity of monofilament tests for detecting diabetic peripheral neuropathy were 0.53 (95% confidence interval (CI) 0.32 to 0.74) and 0.88 (95% CI 0.78 to 0.94), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 4.56 (95% CI 2.93 to 7.10) and 0.53 (95% CI 0.35 to 0.81), respectively. Conclusions. Our review indicated that monofilament tests had limited sensitivity for screening diabetic peripheral neuropathy. The clinical use of the monofilament test in the evaluation of diabetic peripheral neuropathy cannot be encouraged based on currently available evidence.

scholarly journals Potential Diagnostic Value of Circulating miRNA for Multiple Myeloma: A Meta-Analysis.

2020 ◽  
Author(s):  
Wen-Ting Zhang ◽  
Shuai-Shuai Gao ◽  
Yan-Jun Wang ◽  
Guo-Xun Zhang
Keyword(s):  
Multiple Myeloma ◽  
Early Diagnosis ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Circulating Mirna

Abstract Multiple myeloma (MM) is the second incurable hematological malignancy. In recent years, due to the rise of microRNA (miRNA), many scholars have participated in the study of its value in the diagnosis of MM, and have obtained good but inconsistent results. Therefore, in order to determine the role of miRNA in the early diagnosis of MM, we searched for related studies including PubMed, Web of Science, EMBASE, Cochrane Library, China National Knowledge Infrastructure (CNKI) and Wanfang Database as of July 20, 2020 to conduct this meta-analysis. To improve the accuracy, the quality assessment of Diagnostic Accuracy Study 2 (QUADAS-2) was used. We also applied random effects models to summarize sensitivity and specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR) and area under the curve (AUC) to measure diagnostic values, and subgroup analysis used to discover potential sources of heterogeneity. Finally, we collected 32 studies from 15 articles that included a total of 2053 MM patients and 1118 healthy controls. The overall sensitivity, specificity, PLR, NLR, DOR and AUC were 0.81, 0.85, 5.5, 0.22, 25 and 0.90, respectively. Subgroup analysis shows that the down-regulation of microRNA clusters with larger samples size of plasma type could carry out a better diagnostic accuracy of MM patients. In addition, publication bias was not found. In conclusion, circulating miRNA could be a potential non-invasive biomarker for early diagnosis of MM. However, multi-center, more rigorous, and larger-scale studies are needed to verify our conclusions.

scholarly journals The Role of circRNAs in the Diagnosis of Colorectal Cancer: A Meta-Analysis

2021 ◽  
Vol 8 ◽  
Author(s):  
Ru-Dong Li ◽  
Min Guan ◽  
Zhe Zhou ◽  
Shu-Xiao Dong ◽  
Qian Liu
Keyword(s):  
Colorectal Cancer ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Diagnostic Biomarker ◽  
Significant Difference ◽  
Sensitivity Specificity

Background: A novel category of non-coding circular RNAs (circRNAs) has been found to be dysregulated in colorectal cancer (CRC) and significantly contribute to its progression. However, the feasibility of using circRNA as a diagnostic biomarker for CRC remains to be elucidated. Herein, we aimed to comprehensively collect and analyze evidence regarding the potential application of circRNAs as diagnostic indicators for CRC.Methods: A comprehensive retrieval of relevant studies dating from January, 2015 to December 2020, was carried out in PubMed, Cochrane Library, and Web of Science. Data regarding the diagnostic accuracy of circRNA for CRC, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC), were obtained from the included studies. Quality assessment of diagnostic accuracy studies (QUADAS-2) was used to assess the methodological quality of each study. Statistical analysis was performed using STAT and RevMan software.Results: Eighteen studies, involving a total of 2021 individuals, were included in the present meta-analysis. The specimens examined included tissue, serum, and plasma. The pooled sensitivity, specificity, DOR, PLR, NLR, and AUC, with a 95% confidence interval (CI), of circRNAs in the diagnosis of CRC were 0.78 (0.71–0.83), 0.73 (0.68–0.78), 9.68 (6.76–13.85), 2.92 (2.45–3.50), 0.30 (0.23–0.39), and 0.81 (0.78–0.85), respectively. Subgroup analysis showed that the upregulated circRNAs in the tissue or plasma possessed relatively higher diagnostic values for CRC than the downregulated circRNAs. There was no significant difference between the tissue-derived and non-tissue-derived circRNA subgroups.Conclusion: circRNA may be used as a diagnostic biomarker for CRC because of its relatively high diagnostic accuracy in distinguishing CRC patients from normal controls. Further prospective studies are needed to identify more representative circRNAs as diagnostic markers for CRC.

scholarly journals Diagnostic Accuracy of the ADNEX Model for Ovarian Cancer at the 15% Cut-Off Value: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 ◽  
Author(s):  
Xiaotong Huang ◽  
Ziwei Wang ◽  
Meiqin Zhang ◽  
Hong Luo
Keyword(s):  
Ovarian Cancer ◽  
Diagnostic Accuracy ◽  
Publication Bias ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Meta Regression

ObjectivesTo evaluate the diagnostic accuracy of the ADNEX model for ovarian cancer at the 15% cut-off value.MethodsStudies on the identified diagnosis of the ADNEX model for ovarian cancer published in PubMed, Embase, the Cochrane Library and Web of Science databases from January 1st, 2014 to February 20th, 2021 were searched. Two researchers independently screened the retrieved studies and extracted the basic features and parameter data. The quality of the eligible studies was evaluated by Quality Assessment of Diagnostic Accuracy Studies-2, and the result was summarized by Review Manager 5.3. Meta-Disc 1.4 and STATA 16.0 were used in statistical analysis. Heterogeneity of this meta-analysis was calculated. Meta-regression was performed to investigate the potential sources of heterogeneity. Sensitivity analysis and Deek’s funnel plot analysis were conducted to evaluate the stability and publication bias, respectively.Results280 studies were initially retrieved through the search strategy, and 10 eligible studies were ultimately included. The random-effects model was selected for data synthesis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the area under the summary receiver operating characteristic curve were 0.92 (95% CI: 0.89–0.94), 0.82 (95% CI: 0.78–0.86), 5.2 (95% CI: 4.1–6.4), 0.10 (95% CI: 0.07–0.13), 54.0 (95% CI: 37.0–77.0) and 0.95 (95% CI: 0.91–0.95). Meta-regression based on study design, country, enrollment and blind method was not statistically significant. This meta-analysis was stable with no obvious publication bias.ConclusionsThe ADNEX model at the 15% cut-off had high diagnostic accuracy in identifying ovarian cancer.

scholarly journals Diagnostic Accuracy of Serum/Plasma Circular RNAs and the Combination of Circular RNAs and α-Fetoprotein for Detecting Hepatocellular Carcinoma: A Meta-Analysis

2021 ◽  
Vol 12 ◽  
Author(s):  
Guilin Nie ◽  
Dingzhong Peng ◽  
Bei Li ◽  
Jiong Lu ◽  
Yulong Cai ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Genomic Medicine ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Circular Rnas ◽  
Liquid Biopsies

The lack of an accurate biomarker in hepatocellular carcinoma (HCC) has hindered early detection, diagnosis, and treatment. Circular RNAs (circRNAs), which can be used as novel biomarkers in liquid biopsies, have been brought to light as a result of the advances in research on molecular biomarkers and the progression of genomic medicine. We conducted a meta-analysis of the diagnostic accuracy of serum/plasma circRNAs or the combination of circRNAs and α-fetoprotein (AFP) in HCC. We identified eight studies that met the inclusion/exclusion criteria from PubMed, Web of Science, EMBASE, and Cochrane Library databases. The data were pooled, and the sensitivity, specificity, diagnostic odds ratio (DOR), positive likelihood ratio (+LR), and negative likelihood ratio (-LR) with 95% confidence intervals (CIs) were calculated. The areas under the summary receiver operator characteristic (SROC) curves (AUCs) were also calculated. The sensitivity of circRNAs was 0.82 (95% CI: 0.78–0.85), and the specificity was 0.82 (95% CI: 0.78–0.86). The sensitivity of AFP was 0.65 (95% CI: 0.61–0.68), and the specificity was 0.90 (95% CI: 0.85–0.93). The AUC was 0.89 (95% CI: 0.86–0.91) for circRNAs and 0.77 (95% CI: 0.74–0.81) for AFP. The sensitivity of the combination of circRNAs and AFP was 0.88 (95% CI: 0.84–0.92), specificity was 0.86 (95% CI: 0.80–0.91), and AUC was 0.94 (95% CI: 0.91–0.96). Additionally, a subgroup analysis was conducted based on the control groups used; the diagnostic accuracy was particularly high in the comparison of HCC vs. healthy controls. In summary, serum/plasma circRNAs are accurate biomarkers suitable for clinical use for detecting HCC, and the combination of circRNAs and AFP improved the diagnostic accuracy.

scholarly journals Use of the A2DS2 scale to predict morbidity in stroke-associated pneumonia: a systematic review and meta-analysis

BMC Neurology ◽  
2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Jie Huang ◽  
Ming Liu ◽  
Weiliang He ◽  
Feifei Liu ◽  
Jinming Cheng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Random Effect Model ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Clinical Applicability ◽  
Test Probability

Abstract Background This review aims to evaluate the performance and clinical applicability of the A2DS2 scale via systematic review and meta-analysis. Methods The Medline, Embase, Cochrane Library, CBM, CNKI, and Wanfang databases were searched. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2). Funnel plots and Egger’s test were used to evaluate publication bias. The bivariate random-effect model was used for calculating the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the curve (AUC). A Fagan nomogram was applied to evaluate the clinical applicability of the A2DS2 scale. Results A total of 29 full-text articles met the inclusion criteria, including 19,056 patients. Bivariate mixed-effects regression models yielded a mean sensitivity of 0.78 (95 % CI: 0.73–0.83), a specificity of 0.79 (95 % CI: 0.73–0.84), a positive likelihood ratio of 3.7 (95 % CI: 2.9–4.6), and a negative likelihood ratio of 0.27 (95 % CI: 0.23–0.33). The area under the receiver operating characteristic curve was 0.85 (95 % CI: 0.82–0.88). If given a pre-test probability of 50 %, the Fagan nomogram showed that when A2DS2 was positive, the post-test probability improved to 79 %. In contrast, when A2DS2 was negative, it decreased to 22 %. The results of the subgroup analysis showed no effect on the diagnostic accuracy of the A2DS2 scale in predicting stroke-associated pneumonia, except for the optimal cut-off value. Conclusions The A2DS2 scale demonstrates high clinical applicability and could be a valid scale for the early prediction of stroke-associated pneumonia in stroke patients.

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