scholarly journals Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis

2022 ◽  
Vol 38 (3) ◽  
Author(s):  
Liqin Jing ◽  
Yanchun Song
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Diagnostic Accuracy ◽  
English Language ◽  
Cardiac Computed Tomography ◽  
Meta Analysis ◽  
Transoesophageal Echocardiography ◽  
Cochrane Central Register ◽  
Index Test ◽  
Creative Commons

Objective: To investigate the comparative diagnostic accuracy of cardiac computed tomography (CT) and transoesophageal echocardiography (TEE) for detecting infective endocarditis. Methods: Original publications published in English language before July, 2021 were thoroughly search in PubMed, CENTRAL (Cochrane Central Register of Controlled Trials), and Google Scholar literature databases. Studies were included if they used CT and/or TEE as an index test, presented data on valvular complications related to infective endocarditis, and used surgical findings as to the reference standard. Results:­­­ Literature screening identified fifteen studies that fulfilled the inclusion criteria. Meta-analysis showed that CT sensitivity for detecting valvular abscesses was higher than that of TEE [0.88 (95% confidence interval [CI]: 0.82 to 0.94; 11 studies involving 842 subjects) versus 0.74 (95% CI: 0.65 to 0.84) P = 0.015; 12 studies involving 917 subjects]. TEE showed statistically significantly greater sensitivity than CT for detecting valvular vegetation [0.91 (95% CI: 0.84 to 0.97, 11 studies involving 971 subjects) versus 0.80 (95% CI: 0.69 to 0.82), 12 studies involving 915 subjects, P =0.019. In case of leaflet detection, TEE showed statistically significantly higher sensitivity than CT (0.76 vs 0.46, P =0.010). Conclusion: CT performs statistically significantly better than TEE for detecting abscesses while TEE provides statistically significant superior results for detecting vegetation. There is a need for well-designed prospective studies to further corroborate these findings. doi: https://doi.org/10.12669/pjms.38.3.5139 How to cite this:Jing L, Song Y. Comparing the diagnostic accuracy of computed tomography vs transoesophageal echocardiography for infective endocarditis − A meta-analysis . Pak J Med Sci. 2022;38(3):---------. doi: https://doi.org/10.12669/pjms.38.3.5139 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

scholarly journals Cardiac Computed Tomography Versus Transesophageal Echocardiography for the Detection of Left Atrial Appendage Thrombus: A Systemic Review and Meta‐Analysis

2021 ◽  
Author(s):  
Shandong Yu ◽  
Heping Zhang ◽  
Hongwei Li
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Left Atrial ◽  
Posterior Probability ◽  
Left Atrial Appendage ◽  
Cardiac Computed Tomography ◽  
Meta Analysis ◽  
Systemic Review ◽  
Imaging Studies ◽  
Delayed Imaging

Background Transesophageal echocardiography (TEE) has been considered the gold standard for left atrial appendage (LAA) thrombus detection. Nevertheless, TEE may sometimes induce discomfort and cause complications. Cardiac computed tomography has been studied extensively for LAA thrombus detection. We performed this systemic review and meta‐analysis to assess the diagnostic accuracy of cardiac computed tomography for LAA thrombus detection compared with TEE. Methods and Results A systemic search was conducted in the PubMed, Embase, and Cochrane Library databases from January 1977 to February 2021. Studies performed for assessment diagnostic accuracy of cardiac computed tomography on LAA thrombus compared with TEE were included. Summary sensitivity, specificity, and posterior probability of LAA thrombus was calculated by using bivariate random‐effects model. The Quality Assessment of Diagnostic Accuracy Studies‐2 tool was used for the quality assessment. A total of 27 studies involving 6960 patients were included in our study. The summary sensitivity of early imaging studies was 0.95 (95% CI, 0.79–0.99), and the specificity was 0.89 (95% CI, 0.85–0.92). The positive posterior probability was 19.11%, and the negative posterior probability was 0.16%. The summary sensitivity of delayed imaging studies was 0.98 (95% CI, 0.92–1.00), and the specificity was 1.00 (95% CI, 0.98–1.00). The positive posterior probability was 95.76%, and the negative posterior probability was 0.12%. The delayed imaging method significantly improved the specificity (1.00 versus 0.89; P <0.05) and positive posterior probability (95.76% versus 19.11%; P <0.05). Conclusions Cardiac computed tomography with a delayed imaging is a reliable alternative to TEE. It may save the patient and health care from an excess TEE. Registration URL: https://www.crd.york.ac.uk/PROSPERO ; Unique identifier: CRD42021236352.

scholarly journals Cone-beam computed tomography versus periapical radiograph for diagnosing external root resorption: A systematic review and meta-analysis

2016 ◽  
Vol 87 (2) ◽  
pp. 328-337 ◽  
Author(s):  
Jianru Yi ◽  
Yimin Sun ◽  
Yu Li ◽  
Chunjie Li ◽  
Xiaobing Li ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Cone Beam Computed Tomography ◽  
Area Under Curve ◽  
Root Resorption ◽  
Meta Analysis ◽  
Cone Beam ◽  
Cochrane Central Register ◽  
External Root Resorption

ABSTRACT Objective: To compare the diagnostic accuracy of cone-beam computed tomography (CBCT) and periapical radiographs (PR) for the detection of external root resorption (ERR). Material and Methods: An electronic search in databases, including the Cochrane Central Register of Controlled Trials, PubMed, Embase, the China National Knowledge Infrastructure, and System for Information on Grey Literature in Europe (SIGLE), was performed until August 2016. A manual search of relevant journals and reference lists of enrolled studies was conducted. The studies investigating the diagnostic accuracy of CBCT or PR for ERR, with simulated ERR as the reference test, were considered eligible. The diagnostic accuracy of CBCT and PR was statistically pooled using a bivariate model. Meta-regression and subgroup analysis were performed to explore the sources of heterogeneity. Sensitivity analysis was used to test the stability of the overall results in the meta-analysis. Results: A total of 15 studies were included in this systematic review. The pooled results showed that CBCT had significantly higher sensitivity (0.89; 95% confidence interval [CI]: 0.77–0.96) and area under curve (0.96; 95% CI: 0.77–0.96) than PR (sensitivity: 0.68; 95% CI: 0.56–0.78; area under curve: 0.88; 95% CI: 0.85–0.90). No difference in sensitivity, specificity, and area under the curve between conventional and digital PR was observed. Conclusions: Currently available evidence suggests that CBCT could be reliable to detect the presence of ERR in clinical practice and has a higher diagnostic efficacy than PR.

The Diagnostic Accuracy of Low-Dose Computed Tomography in Diagnosing Urolithiasis: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Shichu Liang ◽  
Lingyu Chang ◽  
Cui Wang ◽  
Shengli Lu ◽  
Shihan Zhang ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Standard Dose ◽  
Meta Analysis ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Index Test ◽  
Meta Analyses

Abstract Background: Urolithiasis is a prevalent health issue all over the world,To evaluate the diagnostic accuracy of low-lose computed tomography(LDCT) for detecting urolithiasis. Methods: Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was followed. PubMed, EMBASE and The Cochrane Library were searched for original diagnostic studies to identify all relevant studies published prior to May 2020. The index test was LDCT, and the reference standards were comprehensive diagnosis or standard-dose CT (SDCT). Results: 17 studies with 1,761 patients and 2,053 stones were included for the quantitative analysis. The pooled sensitivity was 0.95 (95%CI: 0.93-0.97) in patient-based studies and 0.86 (95%CI: 0.76-0.93) in urolithiasis-based studies. The pooled specificity of LDCT were 0.97 (95%CI: 0.95-0.99) in patient-based studies and 0.98 (95%CI: 0.63-1.00) in urolithiasis-based studies. The Fagan nomogram of LDCT for diagnosis of urolithiasis showed that the probability of urolithiasis is 98% if the LDCT scan is positive and 6% if the LDCT scan is negative. The likelihood ratio plot showed that the summary positive pooled likelihood ratio (LRP) and negative likelihood ratio (LRN) for LDCT was in the left upper quadrant(LUQ) area. Conclusions: LDCT has excellent diagnostic value in urolithiasis. LDCT can detect the urolithiasis specifically, but is limited to differentiate the contents of the stones.

scholarly journals Utility of 3-dimensional transoesophageal echocardiography for mitral annular sizing in transcatheter mitral valve replacement procedures: a cardiac computed tomography comparative study

2021 ◽  
Vol 22 (Supplement_1) ◽  
Author(s):  
A Coisne ◽  
F Pontana ◽  
S Aghezzaf ◽  
S Mouton ◽  
H Ridon ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Mitral Valve ◽  
Valve Replacement ◽  
Mitral Valve Replacement ◽  
Cardiac Computed Tomography ◽  
Transoesophageal Echocardiography ◽  
3 Dimensional ◽  
Ct Measurements ◽  
Good Ability ◽  
Transcatheter Mitral Valve Replacement

Abstract Funding Acknowledgements Type of funding sources: None. Background.  3-dimensional transoesophageal echocardiography (3D-TEE) is frequently used as an initial screening tool in the evaluation of patients who are candidates to Transcatheter Mitral Valve Replacement (TMVR). However, little is known about the imaging correlation with the gold-standard computed tomography (CT) imaging. We aimed at testing the quantitative differences between these two modalities and finding the best 3D-TEE parameters for TMVR screening. Methods. We included 57 patients referred to our Heart Valve Clinic for TMVR with prostheses specifically designed for the mitral valve. Mitral annulus (MA) analyses were performed using commercially available software in 3D-TEE and CT. Results. 3D-TEE was feasible in 52 patients (91%). Although 3D-TEE measurements were slightly lower than in CT, both measurements of projected MA area and perimeter showed excellent correlation with small differences between the two modalities (r = 0.88 and r = 0.92 respectively, p &lt; 0.0001). Correlations were significant but lower for MA diameters (r = 0.68 to 0.72, p &lt; 0.0001) and mitro-aortic angle (r = 0.53, p = 0.0001). ROC curve analyses showed that 3D-TEE had a good ability to predict TMVR screening success defined by constructors based on CT measurements with a range of 12.9 to 15cm² for MA area (AUC = 0.88-0.91, p &lt; 0.0001), 128 to 139mm for MA perimeter (AUC = 0.85-0.91, p &lt; 0.0001), 35 to 39mm for anteroposterior diameter (AUC = 0.79-0.84 p &lt; 0.0001) and 37 to 42mm for posteromedial-anterolateral diameter (AUC = 0.81-0.89, p &lt; 0.0001) (Figure 1). Conclusion. 3D-TEE measurements of MA dimensions display strong correlation with CT measurements in patients undergoing TMVR screening process. 3D-TEE should be proposed as a reasonable alternative to CT in this vulnerable population. Abstract Figure.

Cardiac computed tomography in the contemporary evaluation of infective endocarditis

2021 ◽  
Author(s):  
Omar K. Khalique ◽  
Mahdi Veillet-Chowdhury ◽  
Andrew D. Choi ◽  
Gudrun Feuchtner ◽  
Juan Lopez-Mattei
Keyword(s):  
Computed Tomography ◽  
Infective Endocarditis ◽  
Cardiac Computed Tomography

scholarly journals Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

2019 ◽  
Vol 179 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Hanneke E. M. van der Hoek-Snieders ◽  
Antonius J. M. L. van den Heuvel ◽  
Harmieke van Os-Medendorp ◽  
Digna M. A. Kamalski
Keyword(s):  
At Risk ◽  
Diagnostic Accuracy ◽  
Cleft Palate ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Fetal Mri ◽  
Diagnostic Study ◽  
Index Test ◽  
Orofacial Clefts ◽  
Prenatal Detection

AbstractThis systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (reference test) in fetuses at risk for orofacial clefts. Methodological quality was assessed using the QUADAS-2. A meta-analysis was performed with a random-effects model, calculating the pooled sensitivity, specificity, and area under the curve. The search resulted in eight studies (334 fetuses) to be included: four prospective and four retrospective studies. The applicability concern was low. There was, however, a risk of selection and information bias. All studies showed that MRI well predicted the chance of cleft palate. The sensitivity results were homogeneous, but heterogeneity was assumed regarding the specificity estimate (Cochrane’s Q test: p = 0.00). The pooled sensitivity was 0.97 (95% CI 0.93–0.99); the pooled specificity was 0.94 (0.89–0.97). The area under the curve was 0.98 (95% CI 0.98–0.99).Conclusion: This meta-analysis shows that MRI has an excellent sensitivity and good to excellent specificity for diagnosing cleft palate in fetuses at risk for orofacial clefts. Future research should assess applicability for clinical care.What is Known:• Using ultrasound for prenatal detection of cleft palate leads to misdiagnosis frequently.• MRI could potentially improve the prenatal detection rate of cleft palate.What is New:• Eight studies describe the diagnostic accuracy of MRI for detecting cleft palate.• Combined results show excellent sensitivity and good to excellent specificity.

scholarly journals The diagnostic accuracy of isothermal nucleic acid point-of-care tests for human coronaviruses: A systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pakpoom Subsoontorn ◽  
Manupat Lohitnavy ◽  
Chuenjid Kongkaew
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Point Of Care ◽  
Meta Analysis ◽  
Isothermal Amplification ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Index Test ◽  
Point Of Care Tests

AbstractMany recent studies reported coronavirus point-of-care tests (POCTs) based on isothermal amplification. However, the performances of these tests have not been systematically evaluated. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy was used as a guideline for conducting this systematic review. We searched peer-reviewed and preprint articles in PubMed, BioRxiv and MedRxiv up to 28 September 2020 to identify studies that provide data to calculate sensitivity, specificity and diagnostic odds ratio (DOR). Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was applied for assessing quality of included studies and Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) was followed for reporting. We included 81 studies from 65 research articles on POCTs of SARS, MERS and COVID-19. Most studies had high risk of patient selection and index test bias but low risk in other domains. Diagnostic specificities were high (> 0.95) for included studies while sensitivities varied depending on type of assays and sample used. Most studies (n = 51) used reverse transcription loop-mediated isothermal amplification (RT-LAMP) to diagnose coronaviruses. RT-LAMP of RNA purified from COVID-19 patient samples had pooled sensitivity at 0.94 (95% CI: 0.90–0.96). RT-LAMP of crude samples had substantially lower sensitivity at 0.78 (95% CI: 0.65–0.87). Abbott ID Now performance was similar to RT-LAMP of crude samples. Diagnostic performances by CRISPR and RT-LAMP on purified RNA were similar. Other diagnostic platforms including RT- recombinase assisted amplification (RT-RAA) and SAMBA-II also offered high sensitivity (> 0.95). Future studies should focus on the use of un-bias patient cohorts, double-blinded index test and detection assays that do not require RNA extraction.

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