Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari syndrome: systematic review and meta-analysis

Objective: To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS). Methods: We performed a literature search in PubMed, Embase, and Scopus to identify articles reporting the diagnostic accuracy of Doppler ultrasound, CT, and MRI (either alone or in combination) for BCS using catheter venography or surgery as the reference standard. The quality of the included articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: 11 studies were found eligible for inclusion. Pooled sensitivities and specificities of Doppler ultrasound were 89% [95% confidence interval (CI), 81–94%, I2 = 24.7%] and 68% (95% CI, 3–99%, I2 = 95.2%), respectively. Regarding CT, the pooled sensitivities and specificities were 89% (95% CI, 77–95%, I2 = 78.6%) and 72% (95% CI, 21–96%, I2 = 91.4%), respectively. The pooled sensitivities and specificities of MRI were 93% (95% CI, 89–96%, I2 = 10.6%) and 55% (95% CI, 5–96%, I2 = 87.6%), respectively. The pooled DOR for Doppler ultrasound, CT, and MRI were 10.19 (95% CI: 1.5, 69.2), 14.57 (95% CI: 1.13, 187.37), and 20.42 (95% CI: 1.78, 234.65), respectively. The higher DOR of MRI than that of Doppler ultrasound and CT shows the better discriminatory power. The area under the curve for MRI was 90.8% compared with 88.4% for CT and 86.6% for Doppler ultrasound. Conclusion: Doppler ultrasound, CT and MRI had high overall diagnostic accuracy for diagnosis of BCS, but substantial heterogeneity was found. Prospective studies are needed to investigate diagnostic performance of these imaging modalities. Advances in knowledge: MRI and CT have the highest meta-analytic sensitivity and specificity, respectively for the diagnosis of BCS. Also, MRI has the highest area under curve for the diagnosis of BCS.

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

Technology in Cancer Research & Treatment ◽

10.1177/15330338211011958 ◽

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.

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Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

LaboratoriumsMedizin ◽

10.1515/labmed-2019-0152 ◽

2020 ◽

Vol 0 (0) ◽

Cited By ~ 1

Author(s):

Lei Xi ◽

Chunqing Yang

Keyword(s):

Hepatocellular Carcinoma ◽

Operating Characteristic ◽

Meta Analysis ◽

Area Under The Curve ◽

Diagnostic Odds Ratio ◽

Diagnostic Value ◽

Receiver Operating Characteristic Curves ◽

Sensitivity Specificity ◽

Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

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Diagnostic accuracy of prostate cancer antigen 3 (PCA3) prior to first prostate biopsy: A systematic review and meta-analysis

Canadian Urological Association Journal ◽

10.5489/cuaj.6008 ◽

2019 ◽

Vol 14 (5) ◽

Cited By ~ 2

Author(s):

Sandra Viviana Muñoz Rodríguez ◽

Herney Andrés García-Perdomo

Keyword(s):

Prostate Cancer ◽

Diagnostic Accuracy ◽

Prostate Biopsy ◽

Reference Lists ◽

Meta Analysis ◽

Area Under The Curve ◽

Diagnostic Odds Ratio ◽

Cancer Antigen ◽

Prostate Cancer Antigen

Introduction: We aimed to determine the diagnostic accuracy of the prostate cancer antigen 3 (PCA3) test before performing the first biopsy compared with prostate biopsy for the diagnosis of prostate cancer. Methods: A systematic search was performed in MEDLINE, EMBASE, CENTRAL, LILACS, reference lists, specialized journals in urology and cancer, and unpublished literature. The population was adults with suspected prostate cancer, and the intervention was the measurement of PCA3 in urine samples for the diagnosis of prostate cancer. The quality of studies was evaluated with the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. The operative characteristics were determined, and a meta-analysis was performed. Results: Nine studies of diagnostic tests were included based on a cutoff value of 35. The following overall values were obtained: the sensitivity was 0.69 (95% confidence interval [CI] 0.61–0.75); specificity was 0.65 (95% CI 0.553–0.733); the diagnostic odds ratio (DOR) was 4.244 (95% CI 3.487–5.166); and the area under the curve was 0.734 (95% CI 0.674–0.805) with a heterogeneity of 0%. Conclusions: Urinary PCA3 has an acceptable diagnostic accuracy, aids in the study of patients with suspected prostate cancer, and can be used as a guide for directing the performance of the first prostate biopsy and decreasing unnecessary biopsies.

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MicroRNAs as Biomarkers for the Diagnosis of Ankylosing Spondylitis: A Systematic Review and Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2021.701789 ◽

2021 ◽

Vol 8 ◽

Author(s):

Jiangbi Li ◽

Xiaoping Xie ◽

Weibing Liu ◽

Feng Gu ◽

Ke Zhang ◽

...

Keyword(s):

Ankylosing Spondylitis ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Good Diagnostic Accuracy ◽

Sensitivity Specificity

Background: Abnormal expression levels of microRNAs (miRNAs) were observed in ankylosing spondylitis (AS) in recent articles, suggesting that miRNAs may be used as biomarkers for AS diagnoses. In this paper, we conducted a meta-analysis to identify the overall diagnostic accuracy of miRNA biomarkers in AS patients.Methods: An extensive search was undertaken in PubMed, Embase, Cochrane databases, and Wan Fang database up to 30 December 2020 using the following key words: (“microRNAs” or “microRNA” or “miRNA” or “miR” or “RNA, Micro” or “Primary MicroRNA”) and (“Spondylitis Ankylosing” or “Spondyloarthritis Ankylopoietica” or “Ankylosing Spondylarthritis” or “Ankylosing Spondylarthritides” or “Spondylarthritides Ankylosing” or “Ankylosing Spondylitis”) and (“blood” or “serum” or “plasma”). Statistical evaluation of dysregulated miRNAs using the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC).Results: Twenty-nine articles reporting on the miRNAs of AS were included. A total of 42 miRNAs were observed to be up-regulated and 45 miRNAs were down-regulated in the AS cases compared with the controls. Besides, 29 studies from nine articles were included in our meta-analysis. The pooled sensitivity, specificity, PLR, NLR, DOR, and AUC were 0. 76 (95% CI, 0.70–0.81), 0.80 (95% CI, 0.74–0.85), 3.75 (95% CI, 2.82–5.01), 0.30 (95% CI, 0.24–0.39), 12.32 (95% CI, 7.65–19.83), 0.85 (95% CI, 0.81–0.88), respectively, suggesting a good diagnostic accuracy of miRNAs for AS.Conclusions: Circulating miRNAs are deregulated in AS patients. miRNAs may be used as a relatively non-invasive biomarkers for the detection of AS.

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Comparison of diagnostic accuracy of Midkine and AFP for detecting hepatocellular carcinoma: a systematic review and meta-analysis

Bioscience Reports ◽

10.1042/bsr20192424 ◽

2020 ◽

Vol 40 (3) ◽

Cited By ~ 2

Author(s):

Qingqing Lu ◽

Jie Li ◽

Hui Cao ◽

Chenlu Lv ◽

Xiaolin Wang ◽

...

Keyword(s):

Hepatocellular Carcinoma ◽

Diagnostic Accuracy ◽

Hepatitis Virus ◽

Early Stage ◽

Meta Analysis ◽

Area Under The Curve ◽

Cochrane Library ◽

Sensitivity Specificity ◽

The Cochrane Library

Abstract Objective: Midkine (MDK) has been proposed as one of the most promising markers for hepatocellular carcinoma (HCC). This meta-analysis was conducted to compare the diagnostic accuracy of MDK and α-fetoprotein (AFP) for HCC. Methods: We systematically searched PubMed/MEDLINE, Ovid/EMBASE, and the Cochrane Library for all relevant studies up to 18 May 2019. The Revised Quality Assessment for Studies of Diagnostic Accuracy tool (QUADAS-2) was used to assess the methodological quality of the included studies. The sensitivity, specificity, and the area under the curve (AUC) of MDK and AFP for detecting HCC were pooled using random-effects model. Results: Seventeen studies from five articles with a total of 1122 HCC patients and 2483 controls were included. The summary estimates using MDK and AFP for detecting HCC were as follows: sensitivity, 85 vs 52%, specificity, 82 vs 94%, and AUC, 0.90 vs 0.83. The summary estimates using MDK and AFP for detecting hepatitis virus-related HCC as follows: sensitivity, 93 vs 74%, specificity, 85 vs 97%, and AUC, 0.95 vs 0.97. The summary estimates using MDK and AFP for detecting early-stage HCC were as follows: sensitivity, 83.5 vs 44.4%, specificity, 81.7 vs 84.8%, and AUC, 0.87 vs 0.52. The summary estimates using MDK for detecting AFP-negative HCC as follows: sensitivity, 88.5%, specificity, 83.9%, and AUC, 0.91. Conclusion: MDK is more accurate than AFP in diagnosing HCC, especially for early-stage HCC and AFP-negative HCC. Both MDK and AFP had excellent diagnostic performance for hepatitis virus-related HCC.

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Blood Procalcitonin Level as A Diagnostic Marker of Pediatric Bacterial Meningitis: A Systematic Review and Meta-Analysis

Diagnostics ◽

10.3390/diagnostics11050846 ◽

2021 ◽

Vol 11 (5) ◽

pp. 846

Author(s):

Heeyeon Kim ◽

Yun-Ho Roh ◽

Seo-Hee Yoon

Keyword(s):

Bacterial Meningitis ◽

Diagnostic Accuracy ◽

Meta Analysis ◽

Characteristic Curve ◽

Area Under The Curve ◽

Diagnostic Odds Ratio ◽

Summary Receiver Operating Characteristic ◽

Mortality And Morbidity ◽

Meningitis In Children ◽

Sensitivity Specificity

Early diagnosis and treatment of bacterial meningitis in children are essential, due to the high mortality and morbidity rates. However, lumbar puncture is often difficult, and cerebrospinal fluid (CSF) culture takes time. This meta-analysis aims to determine the diagnostic accuracy of blood procalcitonin for detecting bacterial meningitis in children. We conducted a systematic search on electronic databases to identify relevant studies. Pooled sensitivity, specificity, and diagnostic odds ratio (DOR) were calculated, and a hierarchical summary receiver operating characteristic curve and area under the curve (AUC) were determined. Eighteen studies with 1462 children were included in the analysis. The pooled sensitivity, specificity, and the DOR of blood procalcitonin for detecting bacterial meningitis were 0.87 (95% confidence interval (CI): 0.78–0.93); 0.85 (95% CI: 0.75–0.91), and 35.85 (95% CI: 10.68–120.28), respectively. The AUC for blood procalcitonin was 0.921. Blood procalcitonin also showed higher diagnostic accuracy for detecting bacterial meningitis than other conventional biomarkers, including serum C-reactive protein and leukocyte count, CSF leukocyte and neutrophil count, and CSF protein and glucose levels. Blood procalcitonin can be a good supplemental biomarker with high diagnostic accuracy in detecting bacterial meningitis in children.

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The Performance of CT versus MRI in the Differential Diagnosis of Cerebral Venous Thrombosis

Thrombosis and Haemostasis ◽

10.1055/s-0038-1642636 ◽

2018 ◽

Vol 118 (06) ◽

pp. 1067-1077 ◽

Cited By ~ 2

Author(s):

Weilin Xu ◽

Liansheng Gao ◽

Tao Li ◽

Neha Ramdoyal ◽

Jianmin Zhang ◽

...

Keyword(s):

Differential Diagnosis ◽

Diagnostic Accuracy ◽

Venous Thrombosis ◽

Cerebral Venous Thrombosis ◽

Sinus Thrombosis ◽

Meta Analysis ◽

Area Under The Curve ◽

Significant Heterogeneity ◽

Summary Receiver Operating Characteristic ◽

Ct And Mri

Background Cerebral venous thrombosis (CVT) is a rare disease, and with poor prognosis. Computed tomography (CT) and magnetic resonance imaging (MRI) are the most commonly used image modalities for patients with non-specific neurologic symptoms. We present here a meta-analysis to assess the accuracy of CT and MRI in the differential diagnosis of CVT and cerebral venous sinus thrombosis (CVST). Materials and Methods A comprehensive search of the PubMed, EMBASE, Web of Science, Cochrane Database and Chinese Biomedical (CBM) databases was conducted prior to March 20, 2017. In this report, we assess the methodological quality of each article individually and perform a meta-analysis to obtain the summary of the diagnostic accuracy of CT and MRI in correctly identifying CVT and CVST. Results Twenty-four eligible articles comprising 48 studies (4,595 cases) were included. The pooled sensitivity for CT–CVT/CT–CVST groups is 0.79 (95% confidence interval [CI]: 0.76, 0.82)/0.81(95% CI: 0.78, 0.84), and pooled specificity is 0.90 (95% CI: 0.89, 0.91)/0.89 (0.88, 0.91), with an area under the curve (AUC) for the summary receiver operating characteristic (SROC) of 0.9314/0.9161, respectively. No significant heterogeneity and publication bias was observed across each study. For MRI–CVT/MRI–CVST, the pooled sensitivity is 0.82 (95% CI: 0.78, 0.85)/0.80 (95% CI: 0.76, 0.83), and pooled specificity is 0.92 (95% CI: 0.91, 0.94)/0.91(0.89, 0.92), with an AUC for the SROC of 0.9221/0.9273, respectively. Conclusion This meta-analysis indicates that both CT and MRI have a high level of diagnostic accuracy in the differential diagnosis of CVT and CVST, independent of stage, target for analysis or analysis methods. They could be chosen as alternative sub-optimal gold standards for diagnosing CVT and CVST, especially in emergency.

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Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

Medical Ultrasonography ◽

10.11152/mu-2971 ◽

2021 ◽

Author(s):

Jiangfeng Wu ◽

Yue Sun ◽

Yunlai Wang ◽

Lijing Ge ◽

Yun Jin ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Value ◽

Endobronchial Ultrasound ◽

Mediastinal Lymph Nodes ◽

Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

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Reliability of circulating fibrinogen in the diagnosis of prosthesis-related infections: a systematic review and meta-analysis

Journal of Orthopaedic Surgery and Research ◽

10.1186/s13018-020-02171-x ◽

2021 ◽

Vol 16 (1) ◽

Author(s):

Xingyang Zhu ◽

Haitao Zhang ◽

Xiaobo Sun ◽

Yijin Li ◽

Jiahao Li ◽

...

Keyword(s):

Likelihood Ratio ◽

Meta Analysis ◽

Joint Infection ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Small Sample ◽

Cochrane Library ◽

Sensitivity Specificity

Abstract Background Fibrinogen (FIB) has recently been used as a biomarker to diagnose periprosthetic joint infection (PJI), but its reliability is still questionable. The aim of this study was to investigate the accuracy of FIB in the diagnosis of PJI after joint replacement. Methods We searched for literatures published in PubMed, EMBASE, and the Cochrane Library from the time of database inception to September 2020 and screened the studies according to the inclusion criteria. Then, we calculated the diagnostic parameters of FIB, including the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), area under the curve (AUC), and diagnostic odds ratio (DOR). In addition, we implemented subgroup analyses to identify the sources of heterogeneity. Results Seven studies including 1341 patients were selected in our meta-analysis. The pooled sensitivity, specificity, PLR, NLR, and DOR of FIB for PJI diagnosis were 0.78 (95% confidence interval [CI], 0.73–0.82), 0.83 (95% CI, 0.81–0.86), 4.60 (95% CI, 3.30–6.42), 0.24 (95% CI, 0.18–0.34), and 20.13 (95% CI, 14.80–27.36), respectively, while the AUC was 0.896. Conclusion The present study indicated that FIB was a reliable detection method and might be introduced into the diagnostic criteria for PJI. However, more robust studies are still needed to confirm the current findings, because most of the included studies were retrospective and had small sample sizes.

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The role of D-dimer in periprosthetic joint infection: a systematic review and meta-analysis

Diagnosis ◽

10.1515/dx-2021-0032 ◽

2021 ◽

Vol 0 (0) ◽

Author(s):

Giovanni Balato ◽

Cristiano De Franco ◽

Fiamma Balboni ◽

Vincenzo De Matteo ◽

Tiziana Ascione ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Blood Sample ◽

Periprosthetic Joint Infection ◽

Meta Analysis ◽

Joint Infection ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Receiver Operating Curve ◽

Sensitivity Specificity ◽

D Dimer

Abstract Objectives The current literature on diagnosis of periprosthetic joint infection (PJI) provides controversial evidence on the diagnostic accuracy of D-dimer. Therefore, this critical literature search and meta-analysis was aimed to summarize the diagnostic accuracy of D-dimer for diagnosing PJI. Content We searched MEDLINE, Scopus, and Web of Science, for studies on D-dimer for diagnosing PJI, according to the PRISMA flowchart. QUADAS was used for assessing study quality. Sensitivity, specificity, positive (PLR) and negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were analyzed using bivariate diagnostic random-effects model. The area under the receiver-operating curve (AUC-ROC) was calculated. Subgroup analysis and univariate meta-regression were carried out for detecting potential sources of heterogeneity. Summary We included 12 articles, totaling 1,818 patients (539 with PJI). The pooled sensitivity and specificity of D-dimer for diagnosing PJI were 0.739 (95% CI: 0.616–0.833) and 0.785 (95% CI: 0.679–0.863). The pooled PLR, NLR, DOR were 3.359 (95% CI, 2.340–4.821), 0.295 (95% CI, 0.180–0.484), and 11.787 (95% CI, 5.785–24.018). The cumulative ROC plot displayed an AUC of 0.688 (95% CI, 0.663–0.713; p<0.001). No threshold effects could be observed. The type of blood sample was identified as possible source of heterogeneity for DOR (p=0.01). Outlook Evidence emerged from this meta-analysis suggests that D-dimer displays sufficient diagnostic accuracy to rule out PJI. The type of blood sample (plasma vs. serum) and the study design could influence the results in terms of DOR and sensitivity. However, further perspective studies would be needed to validate its potential diagnostic usefulness.

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