A protocol for a systematic review and meta-analysis of the diagnostic accuracy of mid-regional pro-adrenomedullin in predicting invasive bacterial infection in children

Introduction: The value of inflammatory biomarkers in the diagnosis of bacterial infection induced acute exacerbation of chronic obstructive pulmonary disease (AECOPD) is currently unclear. Our objective was to investigate the diagnostic accuracy of on-admission inflammatory biomarkers in differentiating bacterial origin in AECOPD.Methods: Systematic literature search was performed to include cross-sectional studies on AECOPD patients with microbiological culture results as gold standard, and at least one on-admission inflammatory biomarker determined from serum: C-reactive protein (CRP), procalcitonin (PCT), neutrophil/lymphocyte ratio, eosinophil percentage, CD64index; or sputum: neutrophil elastase, tumor necrosis factor alfa, interleukin-1-beta (IL-1b), interleukin-8, sputum color, as index tests. We ranked index tests by superiority indices in a network meta-analysis and also calculated pooled sensitivity and specificity.Results: Altogether, 21 eligible articles reported data on 2,608 AECOPD patients (44% bacterial). Out of the 14 index tests, sputum IL-1b showed the highest diagnostic performance with a pooled sensitivity of 74% (CI: 26–97%) and specificity of 65% (CI: 19–93%). Pooled sensitivity for CRP and PCT were: 67% (CI: 54–77%) and 54% (CI: 39–69%); specificity 62% (CI: 52–71%) and 71% (CI: 59–79%), respectively.Conclusion: Admission inflammatory biomarkers are inaccurate indicators of bacterial infection in AECOPD.Systematic Review Registration:https://www.crd.york.ac.uk/prospero/#myprospero, identifier: 42020161301.

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Diagnostic Value of Mid-regional Pro-adrenomedullin (MR-proADM) as a Biomarker of Invasive Bacterial Infection in Children: A Systematic Review.

10.21203/rs.3.rs-63023/v1 ◽

2020 ◽

Author(s):

Michael Corr ◽

Derek Fairley ◽

James McKenna ◽

Michael Shields ◽

Thomas Waterfield

Keyword(s):

Systematic Review ◽

Antimicrobial Resistance ◽

Diagnostic Accuracy ◽

Bacterial Infection ◽

Bacterial Infections ◽

Viral Infections ◽

Signs And Symptoms ◽

Test Accuracy ◽

Systematic Analysis ◽

Invasive Bacterial Infection

Abstract BackgroundIn children differentiating between the early stages of an invasive bacterial infection (IBI) and a benign self-limiting viral infection remains clinically challenging. This often leads to an over-use of antimicrobial drugs with resultant antimicrobial resistance due to the concern of not detecting a deteriorating child. Hence research into novel biomarkers for the early identification of IBI in children is of increasing interest. A more timely diagnosis through more accurate biomarkers may lead to improved clinical outcomes for children and reduced antimicrobial resistance. Mid-regional pro-adrenomedullin (MR-proADM) is a biomarker that is found at elevated levels in patients with IBI compared with those with viral infections. The aim of this systematic review was to determine the diagnostic accuracy of MR-proADM at identifying children with IBI. MethodsWe searched MEDLINE, Embase, Web of Science and Scopus from 1980 to the present day for all human clinical trials involving children that report the test accuracy of MR-proADM. Eligibility was assessed by screening titles and abstracts of articles found during the search process. This was then followed by full-text assessment and data extraction. The Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool was used to assess the methodological quality of identified studies. The following test characteristics were extracted into 2 × 2 tables for all included studies: true positives, false positives, true negatives, and false negatives. ResultsA total of 501 articles were initially identified. After the removal of duplicates and abstract screening 11 texts were fully reviewed. 4 studies (totaling 1404 patients) were able to be included in the systematic analysis. Only one study was of a high quality and that study accounted for the vast majority of patients. A single study reported the diagnostic accuracy of MR-proADM for invasive bacterial infection reporting an Area under the Curve of 0.69. The paucity of available studies made meta-analysis and studies of heterogeneity impossible.ConclusionThere is a paucity of research regarding the diagnostic accuracy of MR-proADM in the diagnosis of invasive bacterial infections in children. Initial results would suggest that MR-proADM testing alone is poor at identifying IBI in young children. It remains unclear if MR-proADM performs differently in older children or in children with signs and symptoms of IBI. Trial registrationPROSPERO CRD42018096295

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Diagnostic accuracy of transvaginal sonography (TVS) for non-invasive diagnosis of rectosigmoidal endometriosis – a systematic review and meta-analysis

Geburtshilfe und Frauenheilkunde ◽

10.1055/s-0031-1278538 ◽

2011 ◽

Vol 71 (05) ◽

Author(s):

G Hudelist ◽

J English ◽

A Thomas ◽

A Tinelli ◽

C Singer ◽

...

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Transvaginal Sonography ◽

Non Invasive

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Faculty of 1000 evaluation for Diagnostic accuracy and radiation dose of CT coronary angiography in atrial fibrillation: Systematic review and meta-analysis.

F1000 - Post-publication peer review of the biomedical literature ◽

10.3410/f.717985130.793473208 ◽

2013 ◽

Author(s):

Paolo Della Bella ◽

Pasquale Vergara

Keyword(s):

Atrial Fibrillation ◽

Systematic Review ◽

Radiation Dose ◽

Coronary Angiography ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Ct Coronary Angiography

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A systematic review and meta-analysis of the diagnostic accuracy of the spot urinary protein creatinine ratio (PCR) and the spot urinary albumin creatinine ratio (ACR) in the management of suspected pre-eclampsia

Archives of Disease in Childhood - Fetal and Neonatal Edition ◽

10.1136/adc.2011.300163.4 ◽

2011 ◽

Vol 96 (Supplement 1) ◽

pp. Fa98-Fa98

Author(s):

R. K. Morris ◽

M. Doug ◽

M. D. Kilby

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Urinary Albumin ◽

Urinary Protein ◽

Creatinine Ratio ◽

Albumin Creatinine Ratio

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Evaluation of diagnostic accuracy of loop-mediated isothermal amplification method (LAMP) compared with polymerase chain reaction (PCR) for Leptospira spp. in clinical samples: a systematic review and meta-analysis

Diagnostic Microbiology and Infectious Disease ◽

10.1016/j.diagmicrobio.2021.115369 ◽

2021 ◽

Vol 100 (3) ◽

pp. 115369

Author(s):

Shan Gunasegar ◽

Vasantha Kumari Neela

Keyword(s):

Systematic Review ◽

Polymerase Chain Reaction ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Isothermal Amplification ◽

Clinical Samples ◽

Chain Reaction ◽

Amplification Method ◽

Leptospira Spp ◽

Polymerase Chain

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Standard echocardiography versus handheld echocardiography for the detection of subclinical rheumatic heart disease: a systematic review and meta-analysis of diagnostic accuracy

BMJ Open ◽

10.1136/bmjopen-2020-038449 ◽

2020 ◽

Vol 10 (10) ◽

pp. e038449

Author(s):

Lisa Helen Telford ◽

Leila Hussein Abdullahi ◽

Eleanor Atieno Ochodo ◽

Liesl Joanna Zuhlke ◽

Mark Emmanuel Engel

Keyword(s):

Systematic Review ◽

Heart Disease ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Rheumatic Heart Disease ◽

Operating Characteristic ◽

Meta Analysis ◽

Endemic Areas ◽

Rheumatic Heart ◽

Receiver Operating

ObjectiveTo summarise the accuracy of handheld echocardiography (HAND) which, if shown to be sufficiently similar to that of standard echocardiography (STAND), could usher in a new age of rheumatic heart disease (RHD) screening in endemic areas.DesignSystematic review and meta-analysis.Data sourcesPubMed, Scopus, EBSCOHost and ISI Web of Science were initially searched on 27 September 2017 and again on 3 March 2020 for studies published from 2012 onwards.Eligibility criteriaStudies assessing the accuracy of HAND compared with STAND when performed by an experienced cardiologist in conjunction with the 2012 World Heart Federation criteria among populations of children and adolescents living in endemic areas were included.Data extraction and synthesisTwo reviewers independently extracted data and assessed the methodological quality of included studies against review-specific Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 criteria. A meta-analysis using the hierarchical summary receiver operating characteristic model was conducted to produce summary results of sensitivity and specificity. Forest plots and scatter plots in receiver operating characteristic space in combination with subgroup analyses were used to investigate heterogeneity. Publication bias was not investigated.ResultsSix studies (N=4208) were included in the analysis. For any RHD detection, the pooled results from six studies were as follows: sensitivity: 81.56% (95% CI 76.52% to 86.61%) and specificity: 89.75% (84.48% to 95.01%). Meta-analytical results from five of the six included studies were as follows: sensitivity: 91.06% (80.46% to 100%) and specificity: 91.96% (85.57% to 98.36%) for the detection of definite RHD only and sensitivity: 62.01% (31.80% to 92.22%) and specificity: 82.33% (65.15% to 99.52%) for the detection of borderline RHD only.ConclusionsHAND displayed good accuracy for detecting definite RHD only and modest accuracy for detecting any RHD but demonstrated poor accuracy for the detection of borderline RHD alone. Findings from this review provide some evidence for the potential of HAND to increase access to echocardiographic screening for RHD in resource-limited and remote settings; however, further research into feasibility and cost-effectiveness of wide-scale screening is still needed.PROSPERO registration numberCRD42016051261.

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