Diagnostic performance of plain radiography for sacroiliitis in patients with suspected axial spondyloarthritis: a systematic review and meta-analysis

2020 ◽  
pp. 028418512093062
Author(s):  
Youngjune Kim ◽  
Choong Guen Chee ◽  
Junghoon Kim ◽  
Jungheum Cho ◽  
Min A Yoon ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Axial Spondyloarthritis ◽  
Meta Analysis ◽  
Plain Radiography ◽  
Lower Sensitivity ◽  
Regression Analyses ◽  
Meta Regression ◽  
Prospective Study Design

Background Plain radiography serves a pivotal role in diagnosing axial spondyloarthritis. However, a broad range of diagnostic performance of plain radiography has been reported. Purpose To perform a systematic review and meta-analysis to measure the diagnostic performance of plain radiography for sacroiliitis in patients suspected of having axial spondyloarthritis using magnetic resonance imaging (MRI) findings as the reference standard. Material and Methods Studies comparing radiography and MRI in the diagnosis of sacroiliitis in patients suspected of having axial spondyloarthritis were searched in PubMed and EMBASE. Additionally, studies analyzed SPondyloaArthritis Caught Early (SPACE), DEvenir des Spondylarthropathies Indifferenciées Récentes (DESIR), GErman Spondyloarthritis Inception Cohort (GESPIC), and South Swedish Arthritis Treatment Group (SSATG) cohorts were manually searched. Pooled sensitivity and specificity of radiography were calculated by using a bivariate random-effects model. Meta-regression analyses were performed to identify the sources of heterogeneity. Results Eight eligible studies with 1579 patients were included. The pooled sensitivity and specificity of radiography were 0.55 (95% confidence interval [CI] = 0.40–0.69) and 0.87 (95% CI = 0.72–0.95). The meta-regression analyses showed prospective study design and criteria for MRI positivity considering only active bone marrow edema were associated with lower sensitivity. Conclusion The plain radiography showed low sensitivity and reasonable specificity in diagnosis of sacroiliitis in patients suspected of having axial spondyloarthritis.

scholarly journals Magnetic Resonance Imaging for Surveillance of Hepatocellular Carcinoma: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1665
Author(s):  
Dong Hwan Kim ◽  
Sang Hyun Choi ◽  
Ju Hyun Shim ◽  
So Yeon Kim ◽  
Seung Soo Lee ◽  
...  
Keyword(s):  
Magnetic Resonance Imaging ◽  
Hepatocellular Carcinoma ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Early Stage ◽  
Meta Analysis ◽  
Random Effects Model ◽  
Resonance Imaging ◽  
Meta Regression

Our meta-analysis aimed to evaluate the diagnostic performance of surveillance magnetic resonance imaging (sMRI) for detecting hepatocellular carcinoma (HCC), and to compare the diagnostic performance of sMRI between different protocols. Original articles about the diagnostic accuracy of sMRI for detecting HCC were found in major databases. The meta-analytic pooled sensitivity and specificity of sMRI for detecting HCC were determined using a bivariate random effects model. The pooled sensitivity and specificity of full MRI and abbreviated MRI protocols were compared using bivariate meta-regression. In the total seven included studies (1830 patients), the pooled sensitivity of sMRI for any-stage HCC and very early-stage HCC were 85% (95% confidence interval, 79–90%; I2 = 0%) and 77% (66–85%; I2 = 32%), respectively. The pooled specificity for any-stage HCC and very early-stage HCC were 94% (90–97%; I2 = 94%) and 94% (88–97%; I2 = 96%), respectively. The pooled sensitivity and specificity of abbreviated MRI protocols were 87% (80–94%) and 94% (90–98%), values that were comparable with those of full MRI protocols (84% [76–91%] and 94% [89–99%]; p = 0.83). In conclusion, sMRI had good sensitivity for detecting HCC, particularly very early-stage HCC. Abbreviated MRI protocols for HCC surveillance had comparable diagnostic performance to full MRI protocols.

scholarly journals Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253525
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Sahajal Dhooria ◽  
Kuruswamy Thurai Prasad ◽  
Inderpaul Singh Sehgal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Interferon Gamma ◽  
Meta Analysis ◽  
Paired Data ◽  
Ifn Γ ◽  
Meta Regression

Objective We compared diagnostic accuracy of pleural fluid adenosine deaminase (ADA) and interferon-gamma (IFN-γ) in diagnosing tuberculous pleural effusion (TPE) through systematic review and comparative meta-analysis. Methods We queried PubMed and Embase databases to identify studies providing paired data for sensitivity and specificity of both pleural fluid ADA and IFN-γ for diagnosing TPE. We used hierarchical summary receiver operating characteristic (HSROC) plots and HSROC meta-regression to model individual and comparative diagnostic performance of the two tests. Results We retrieved 376 citations and included 45 datasets from 44 publications (4974 patients) in our review. Summary estimates for sensitivity and specificity for ADA were 0.88 (95% CI 0.85–0.91) and 0.91 (95% CI 0.89–0.92), while for IFN-γ they were 0.91 (95% CI 0.89–0.94) and 0.96 (95% CI 0.94–0.97), respectively. HSROC plots showed consistently greater diagnostic accuracy for IFN-γ over ADA across the entire range of observations. HSROC meta-regression using test-type as covariate yielded a relative diagnostic odds ratio of 2.22 (95% CI 1.68–2.94) in favour of IFN-γ, along with better summary sensitivity and specificity figures. No prespecified subgroup variable significantly influenced the summary diagnostic accuracy estimates. Conclusion Pleural fluid IFN-γ estimation has better diagnostic accuracy than ADA estimation for diagnosis of TPE.

scholarly journals Progression to type 2 diabetes in women with a known history of gestational diabetes: systematic review and meta-analysis

BMJ ◽  
2020 ◽  
pp. m1361 ◽  
Author(s):  
Elpida Vounzoulaki ◽  
Kamlesh Khunti ◽  
Sophia C Abner ◽  
Bee K Tan ◽  
Melanie J Davies ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Systematic Review ◽  
Meta Analysis ◽  
Healthy Controls ◽  
Regression Analyses ◽  
White Population ◽  
History Of ◽  
Meta Regression

AbstractObjectiveTo estimate and compare progression rates to type 2 diabetes mellitus (T2DM) in women with gestational diabetes mellitus (GDM) and healthy controls.DesignSystematic review and meta-analysis.Data sourcesMedline and Embase between January 2000 and December 2019, studies published in English and conducted on humans.Eligibility criteria for selecting studiesObservational studies investigating progression to T2DM. Inclusion criteria were postpartum follow-up for at least 12 months, incident physician based diagnosis of diabetes, T2DM reported as a separate outcome rather than combined with impaired fasting glucose or impaired glucose tolerance, and studies with both a group of patients with GDM and a control group.ResultsThis meta-analysis of 20 studies assessed a total of 1 332 373 individuals (67 956 women with GDM and 1 264 417 controls). Data were pooled by random effects meta-analysis models, and heterogeneity was assessed by use of the I2 statistic. The pooled relative risk for the incidence of T2DM between participants with GDM and controls was estimated. Reasons for heterogeneity between studies were investigated by prespecified subgroup and meta-regression analyses. Publication bias was assessed by funnel plots and, overall, studies were deemed to have a low risk of bias (P=0.58 and P=0.90). The overall relative risk for T2DM was almost 10 times higher in women with previous GDM than in healthy controls (9.51, 95% confidence interval 7.14 to 12.67, P<0.001). In populations of women with previous GDM, the cumulative incidence of T2DM was 16.46% (95% confidence interval 16.16% to 16.77%) in women of mixed ethnicity, 15.58% (13.30% to 17.86%) in a predominantly non-white population, and 9.91% (9.39% to 10.42%) in a white population. These differences were not statistically significant between subgroups (white v mixed populations, P=0.26; white v non-white populations, P=0.54). Meta-regression analyses showed that the study effect size was not significantly associated with mean study age, body mass index, publication year, and length of follow-up.ConclusionsWomen with a history of GDM appear to have a nearly 10-fold higher risk of developing T2DM than those with a normoglycaemic pregnancy. The magnitude of this risk highlights the importance of intervening to prevent the onset of T2DM, particularly in the early years after pregnancy.Systematic review registrationPROSPERO CRD42019123079.

scholarly journals Diagnostic performance of lung ultrasound for transient tachypnea of the newborn: A meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248827
Author(s):  
Lili He ◽  
Yinghua Sun ◽  
Wei Sheng ◽  
Qiong Yao
Keyword(s):  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Large Scale ◽  
Lung Ultrasound ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Relevant Literature ◽  
Cochrane Library ◽  
Lower Sensitivity ◽  
Summary Receiver Operating Characteristic

Several recent studies demonstrated that lung ultrasound could achieve desired diagnostic accuracy for transient tachypnea of the neonate (TTN). However, the diagnostic performance of lung ultrasound for TTN has not been systematically studied to date. This meta-analysis aimed to investigate the performance of lung ultrasound in diagnosing TTN. The relevant literature was searched in PubMed, Medline, the Cochrane Library, and Embase databases without any restriction in terms of language and time until January 31, 2021. Studies that assessed the diagnostic performance of lung ultrasound for TTN were included. Seven studies with 1514 participants were summarized. The lung ultrasound provided more accurate performance for diagnosing TTN with pooled sensitivity and specificity of 0.67 [95% confidence interval (CI) = 0.63–0.71] and 0.97 (95% CI = 0.95–0.98), respectively. A higher summarized area under the summary receiver operating characteristic curve was observed as 0.9906. Lower sensitivity and area under the curve (AUC) of B-lines for TTN were observed as 0.330 (95% CI = 0.27–0.38) and 0.5000, respectively. Lung ultrasound provided highly accurate AUC, sensitivity, and specificity in detecting TTN. Large-scale studies are warranted in the future to confirm these results.

scholarly journals The relationship of COVID-19 severity with cardiovascular disease and its traditional risk factors: A systematic review and meta-analysis

2020 ◽  
Author(s):  
Kunihiro Matsushita ◽  
Ning Ding ◽  
Minghao Kou ◽  
Xiao Hu ◽  
Mengkun Chen ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Cardiovascular Disease ◽  
Meta Analysis ◽  
Multivariable Analysis ◽  
Renin Angiotensin System ◽  
Regression Analyses ◽  
Male Sex ◽  
Meta Regression ◽  
Traditional Risk Factors

AbstractBackgroundWhether cardiovascular disease (CVD) and its traditional risk factors predict severe coronavirus disease 2019 (COVID-19) is uncertain, in part, because of potential confounding by age and sex.MethodsWe performed a systematic review of studies that explored pre-existing CVD and its traditional risk factors as risk factors of severe COVID-19 (defined as death, acute respiratory distress syndrome, mechanical ventilation, or intensive care unit admission). We searched PubMed and Embase for papers in English with original data (≥10 cases of severe COVID-19). Using random-effects models, we pooled relative risk (RR) estimates and conducted meta-regression analyses.ResultsOf the 661 publications identified in our search, 25 papers met our inclusion criteria, with 76,638 COVID-19 patients including 11,766 severe cases. Older age was consistently associated with severe COVID-19 in all eight eligible studies, with RR >∼5 in >60-65 vs. <50 years. Three studies showed no change in the RR of age after adjusting for covariate(s). In univariate analyses, factors robustly associated with severe COVID-19 were male sex (10 studies; pooled RR=1.73, [95%CI 1.50-2.01]), hypertension (8 studies; 2.87 [2.09-3.93]), diabetes (9 studies; 3.20 [2.26-4.53]), and CVD (10 studies; 4.97 [3.76-6.58]). RR for male sex was likely to be independent of age. For the other three factors, meta-regression analyses suggested confounding by age. Only four studies reported multivariable analysis, but most of them showed adjusted RR ∼2 for hypertension, diabetes, and CVD. No study explored renin-angiotensin system inhibitors as a risk factor for severe COVID-19.ConclusionsDespite the potential for confounding, these results suggest that hypertension, diabetes, and CVD are independently associated with severe COVID-19 and, together with age and male sex, can be used to inform objective decisions on COVID-19 testing, clinical management, and workforce planning.

Inappropriate ICD shocks – a nightmare of the past or an ongoing problem?

2018 ◽  
Vol 1 (46) ◽  
pp. 49-50
Author(s):  
Paweł Syska
Keyword(s):  
Systematic Review ◽  
Ventricular Tachycardia ◽  
Meta Analysis ◽  
Regression Analyses ◽  
Single Chamber ◽  
Inappropriate Shocks ◽  
The Past ◽  
Meta Regression ◽  
Cardioverter Defibrillators

The discussed paper is a systematic review and meta-analysis of the studies concerning the inappropriate shocks (ISs) in single-chamber and subcutaneous cardioverter-defibrillators (S-ICDs). Based on the analysis of 16 selected articles, 6.4% of patients received an IS per year. Meta-regression analyses demonstrated that IS rates were lower in more recent studies and with longer follow-up. Use of S-ICDs and ventricular tachycardia zone programmed on did not significantly increase the risk of ISs. One of the studies showed markedly reduced annual ISs rate (1.9%).

Cross-cultural dementia screening using the Rowland Universal Dementia Assessment Scale: a systematic review and meta-analysis

2020 ◽  
Vol 32 (9) ◽  
pp. 1031-1044
Author(s):  
T. R. Nielsen ◽  
Kasper Jørgensen
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Diagnostic Performance ◽  
Formal Education ◽  
Meta Analysis ◽  
Assessment Scale ◽  
Screening Instruments ◽  
Middle Income ◽  
Brief Screening

ABSTRACTObjectives:To quantitatively synthesize data on the accuracy of the Rowland Universal Dementia Assessment Scale (RUDAS) in different sociocultural settings and compare its performance to other brief screening instruments for the detection of dementia.Design:Systematic review and meta-analysis. Literature searches were performed in PubMed, EMBASE, and CINAHL from January 1, 2004 until September 1, 2019.Setting:Community, outpatient clinic, and hospital settings in high-, and low- and middle-income countries.Participants:Twenty-six studies reporting diagnostic accuracy of the RUDAS were included with almost 4000 participants, including approximately 1700 patients with dementia.Measurements:Procedures for translation and cultural adaption of the RUDAS, and influence of demographic variables on diagnostic accuracy, were compared across studies. Bivariate random-effects models were used to pool sensitivity and specificity results, and diagnostic odds-ratios and the area under the hierarchical summary receiver operator characteristic curve were used to present the overall performance.Results:The pooled sensitivity and specificity for the detection of dementia were .82 (95% CI, .78–.86) and .83 (95% CI, .78–.87), respectively, with an area under the curve of .89. Subgroup analyses revealed that the RUDAS had comparable diagnostic performances across high-, and low- and middle-income settings (z = .63, P = .53) and in samples with a lower and higher proportion of participants with no formal education (z = −.15, P = .88). In 11 studies making direct comparison, the diagnostic performance of the RUDAS was comparable to that of the Mini-Mental State Examination (z = −.82, P = .41), with areas under the curve of .88 and .84, respectively.Conclusions:The RUDAS has good diagnostic performance for detecting dementia in different sociocultural settings. Compared to other brief screening instruments, advantages of the RUDAS include its limited bias in people with limited or no formal education and a minimal need for cultural or language adaptation.

scholarly journals Stigma for Common Mental Disorders in Racial Minorities and Majorities A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
ozlem eylem ◽  
Leonore de Wit ◽  
Annemieke van straten ◽  
Lena Steubl ◽  
Zaneta Melissourgaki ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mental Illness ◽  
Mental Disorders ◽  
Common Mental Disorders ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Racial Minorities ◽  
Mental Illness Stigma ◽  
Regression Analyses ◽  
Meta Regression

Abstract Background There is a strong stigma attached to mental disorders preventing those affected from getting psychological help. The consequences of stigma are worse for racial and/or ethnic minorities who often experience other social adversities such as poverty and discrimination within policies and institutions. This is the first systematic review and meta-analysis summarizing the evidence on the impact of differences in mental illness stigma between racial minorities and majorities. Methods This systematic review and meta-analysis included cross-sectional studies comparing mental illness stigma between racial minorities and majorities. Systematic searches were conducted in the bibliographic databases of PubMed, PsycINFO and EMBASE until 20th December 2018. Outcomes were extracted from published reports, meta-analyses and meta-regression analyses were conducted in CMA software. Results After screening 2,787 abstracts, 29 studies with 193,418 participants (N=35,836 in racial minorities) were eligible for analyses. Racial minorities showed more stigma than racial majorities (g=0.20 (95% CI: 0.12~0.27) for common mental disorders. Sensitivity analyses showed robustness of these results. Multivariate meta-regression analyses pointed to the possible moderating role of the number of studies with high risk of bias on the effect size. Racial minorities have more stigma for common mental disorders when compared with majorities. Limitations included moderate to high risk of bias, high heterogeneity, few studies in most comparisons, and the use of non-standardized outcome measures. Conclusions An important clinical implication of these findings would be to tailor anti-stigma strategies according to specific racial and/or ethnic backgrounds with the intention to improve mental health outreach. These limitations suggest a need for more high quality research on stigma. Key words: stigma; mental illness stigma; common mental disorders; racial minorities

scholarly journals Effect of Tocilizumab in Reducing the Mortality Rate in COVID-19 Patients: A Systematic Review with Meta-Analysis

2021 ◽  
Vol 11 (7) ◽  
pp. 628
Author(s):  
Valeria Conti ◽  
Graziamaria Corbi ◽  
Carmine Sellitto ◽  
Francesco Sabbatino ◽  
Chiara Maci ◽  
...  
Keyword(s):  
Systematic Review ◽  
Mortality Rate ◽  
Critically Ill Patients ◽  
Odds Ratio ◽  
Observational Studies ◽  
Meta Analysis ◽  
Regression Analyses ◽  
Log Odds ◽  
Meta Regression ◽  
Reduction Of Mortality

Data supporting the use of Tocilizumab (TCZ) in COVID-19 are contrasting and inconclusive. This meta-analysis aimed to assess TCZ effectiveness in reducing the mortality rate in COVID-19 patients. PubMed, Scopus, Embase, Cochrane, WILEY, and ClinicalTrials.gov were searched to evaluate observational studies and RCTs. The outcome was the mortality rate. Forty observational studies and seven RCTs, involving 9640 and 5556 subjects treated with Standard Therapy (ST) + TCZ or ST alone, respectively, were included. In patients treated with ST+TCZ, a higher survival (Log odds ratio = −0.41; 95% CI: −0.68 −0.14; p < 0.001) was found. Subgroups analyses were performed to better identify the possible interference of some parameters in modifying the efficacy of TCZ therapy on COVID-19 mortality. Separating observational from RCTs, no statistically significant (p = 0.70) TCZ-related reduction of mortality regarding RCTs was found, while a significant reduction (Log odds ratio = −0.52; 95% CI: −0.82 −0.22, p < 0.001) was achieved regarding the observational studies. Stratifying for the use of Invasive Mechanic Ventilation (IMV), a higher survival was found in patients treated with TCZ in the No-IMV and IMV groups (both p < 0.001), but not in the No-IMV/IMV group. Meta-regression analyses were also performed. The meta-analysis of observational studies reveals that TCZ is associated with reducing the mortality rate in both severe and critically ill patients. Although the largest RCT, RECOVERY, is in line with this result, the meta-analysis of RCTs failed to found any difference between ST + TCZ and ST. It is crucial to personalize the therapy considering the patients’ characteristics.

Temporal Trends in Children’s School Day Moderate to Vigorous Physical Activity: A Systematic Review and Meta-Regression Analysis

2021 ◽  
pp. 1-22
Author(s):  
Robert Glenn Weaver ◽  
Rafael M. Tassitano ◽  
Maria Cecília M. Tenório ◽  
Keith Brazendale ◽  
Michael W. Beets
Keyword(s):  
Physical Activity ◽  
Systematic Review ◽  
North America ◽  
Confidence Interval ◽  
Meta Analysis ◽  
Vigorous Physical Activity ◽  
Temporal Trends ◽  
Regression Analyses ◽  
School Day ◽  
Meta Regression

Background: Evidence from a limited sample of countries indicates that time for physical education and recess during school have declined. Schools are called to provide children with 30 minutes of moderate to vigorous physical activity (MVPA). This systematic review and meta-analysis estimated temporal trends in children’s school day MVPA. Methods: Three online databases were searched to identify studies with objectively measured MVPA, during school hours, in school aged children (5–18 y). Multilevel random-effects meta-analyses estimated MVPA by year, and meta-regression analyses estimated temporal trends in school day MVPA. Results: Studies (N = 65) providing 171 MVPA estimates, representing 60,779 unique children, from 32 countries, and spanning 2003–2019 were identified. Most studies were conducted in North America (n = 33) or Europe (n = 21). School day MVPA ranged from 18.1 (95% confidence interval, 15.1–21.1) to 47.1 (95% confidence interval, 39.4–54.8) minutes per day in any given year. Meta-regression analyses indicated that MVPA declined from 2003 to 2010 (approximately 15 min decline), plateaued from 2010 to 2015 (approximately 1 min decrease), and increased from 2015 to 2019 (approximately 5 min increase). Conclusions: School day MVPA decreased from 2003 to 2010 and has recently begun to increase. However, the majority of the evidence is from North America and Europe with some evidence from Oceania and very little evidence from Asia to South America.

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