scholarly journals Diagnostic test accuracy of Xpert MTB/RIF for tuberculous pericarditis: a systematic review and meta-analysis

F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 761
Author(s):  
Andrianto Andrianto ◽  
Ni Made Mertaniasih ◽  
Parama Gandi ◽  
Makhyan Jibril Al-Farabi ◽  
Yusuf Azmi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Test Accuracy ◽  
Test Results ◽  
Likelihood Ratios ◽  
Bivariate Model ◽  
Cross Sectional ◽  
Sensitivity Specificity

Introduction: Xpert MTB/RIF is a rapid diagnostic instrument for pulmonary tuberculosis (TB). However, studies reported varied accuracy of Xpert MTB/RIF in detecting Mycobacterium tuberculosis in pericardial effusion. Methods: We performed a systematic review of literature in PubMed, published up to February 1, 2020, according to PRISMA guidelines. We screened cross-sectional studies, observational cohort studies, and randomized control trials that evaluated the accuracy of Xpert MTB/RIF in diagnosing TB pericarditis. Papers with noninterpretable results of sensitivity and specificity, non-English articles, and unpublished studies were excluded. The primary outcomes were the sensitivity and specificity of Xpert MTB/RIF. We conducted a quality assessment using QUADAS-2 to evaluate the quality of the studies. A bivariate model pooled the overall sensitivity, specificity, positive likelihood ratios (PLRs), and negative likelihood ratios (NLRs) of included studies. Results: In total, 581 subjects from nine studies were analyzed in this meta-analysis. Our pooled analysis showed that the overall sensitivity, specificity, PLRs and NLRs of included studies were 0.676 (95% CI: 0.580–0.759), 0.994 (95% CI: 0.919–1.000), 110.11 (95% CI: 7.65–1584.57) and 0.326 (95% CI: 0.246–0.433), respectively. Conclusions: Xpert MTB/RIF had a robust specificity but unsatisfactory sensitivity in diagnosing TB pericarditis. These findings indicated that although positive Xpert MTB/RIF test results might be valuable in swiftly distinguishing the diagnosis of TB pericarditis, negative test results might not be able to rule out TB pericarditis. Registration: PROSPERO CRD42020167480 28/04/2020

scholarly journals Magnetic Resonance Imaging of the Small Bowel in Crohn’s Disease: A Systematic Review and Meta-Analysis

2016 ◽  
Vol 2016 ◽  
pp. 1-14 ◽  
Author(s):  
Osman Ahmed ◽  
David Mario Rodrigues ◽  
Geoffrey C. Nguyen
Keyword(s):  
Systematic Review ◽  
Crohn’S Disease ◽  
Magnetic Resonance ◽  
Small Bowel ◽  
Crohn's Disease ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Likelihood Ratios ◽  
Raw Data ◽  
Sensitivity Specificity

Introduction. Crohn’s disease is most commonly found in the terminal ileum and colonic region. Magnetic resonance has become a useful modality for assessing small bowel activity. In this study, we performed a systematic review and meta-analysis on the use of MR in detecting small bowel activity as well as extramural complications in Crohn’s patients.Methods. Two independent reviewers sorted through articles until October 2, 2014. We included both studies providing raw data for pooling and studies without raw data. Sensitivity, specificity, likelihood ratios, and 95% confidence intervals were calculated for each study.Results. There were 27 included studies, of which 19 were included in the pooled analysis. Pooled analysis of the 19 studies (1020 patients) with raw data revealed a sensitivity of 0.88 (95% CI 0.86 to 0.91) and specificity was 0.88 (95% CI 0.84 to 0.91). In regard to detecting stenosis, pooled sensitivity was 0.65 (95% CI 0.53 to 0.76) and specificity was 0.93 (95% CI 0.89 to 0.96).Conclusion. MR imaging provides a reliable alternative in detecting small bowel activity in patients with Crohn’s disease. Its advantages include high diagnostic accuracy and no radiation exposure while its disadvantages include high cost and limited availability.

scholarly journals Hierarchical Modeling for Diagnostic Test Accuracy Using Multivariate Probability Distribution Functions

Mathematics ◽  
2021 ◽  
Vol 9 (11) ◽  
pp. 1310
Author(s):  
Johny Pambabay-Calero ◽  
Sergio Bauz-Olvera ◽  
Ana Nieto-Librero ◽  
Ana Sánchez-García ◽  
Puri Galindo-Villardón
Keyword(s):  
Probability Distribution ◽  
Diagnostic Test ◽  
Sensitivity And Specificity ◽  
Goodness Of Fit ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Test Results ◽  
Goodness Of Fit Test ◽  
Bivariate Model ◽  
Copula Models

Models implemented in statistical software for the precision analysis of diagnostic tests include random-effects modeling (bivariate model) and hierarchical regression (hierarchical summary receiver operating characteristic). However, these models do not provide an overall mean, but calculate the mean of a central study when the random effect is equal to zero; hence, it is difficult to calculate the covariance between sensitivity and specificity when the number of studies in the meta-analysis is small. Furthermore, the estimation of the correlation between specificity and sensitivity is affected by the number of studies included in the meta-analysis, or the variability among the analyzed studies. To model the relationship of diagnostic test results, a binary covariance matrix is assumed. Here we used copulas as an alternative to capture the dependence between sensitivity and specificity. The posterior values were estimated using methods that consider sampling algorithms from a probability distribution (Markov chain Monte Carlo), and estimates were compared with the results of the bivariate model, which assumes statistical independence in the test results. To illustrate the applicability of the models and their respective comparisons, data from 14 published studies reporting estimates of the accuracy of the Alcohol Use Disorder Identification Test were used. Using simulations, we investigated the performance of four copula models that incorporate scenarios designed to replicate realistic situations for meta-analyses of diagnostic accuracy of the tests. The models’ performances were evaluated based on p-values using the Cramér–von Mises goodness-of-fit test. Our results indicated that copula models are valid when the assumptions of the bivariate model are not fulfilled.

scholarly journals P124 Are chronic pain syndromes associated with a unique cytokine profile? A systematic review and meta-analysis

Rheumatology ◽  
2021 ◽  
Vol 60 (Supplement_1) ◽  
Author(s):  
Luke Furtado O'Mahony ◽  
Arnav Srivastava ◽  
Puja Mehta ◽  
Coziana Ciurtin
Keyword(s):  
Systematic Review ◽  
Chronic Pain ◽  
Meta Analysis ◽  
Pooled Analysis ◽  
Cross Sectional ◽  
Pain Syndromes ◽  
Newcastle Ottawa Scale ◽  
Cytokine Milieu ◽  
Analysis Models ◽  
Chronic Pain Syndromes

Abstract Background/Aims  The aetiology of primary chronic pain syndromes (CPS) is highly disputed. One theory suggests that pain is due to a pro-inflammatory cytokine milieu leading to nociceptive activation. We performed a systematic review and meta-analysis aiming to assess differences in cytokines levels in CPS patients versus healthy controls (HC). Methods  Human studies published in English from PubMed, MEDLINE/Scopus and Cochrane databases were searched from inception up to January 2020. We included full text cross-sectional or longitudinal studies with cytokine measurements in CPS patients and HC. We excluded studies with underlying organic pathology. Quality assessment was completed using a modified version of the Newcastle-Ottawa Scale. Random-effects meta-analysis models were used to report pooled effects and 95% CIs. Study registered with PROSPERO (CRD42020193774). Results  Initial search yielded 324 papers, 36 studies (3229 participants) eligible for systematic review and 26 studies (2048 participants) suitable for metaanalysis. There were reproducible findings supporting trends of cytokine levels comparing CPS patients with HC. Eotaxin (chemokine) however was consistently raised in CPS. Meta-analysis showed significantly increased tumour necrosis factor (TNF) (SMD=0.39, p = 0.0009, %95I=0.16-0.63, p < 0.001; I2=70%, Q2 p < 0.001), interleukin (IL)-6 (SMD=0.15, 8 (SMD=0.26, p = 0.01, 95%CI =0.05-0.47; I2=61%, Q2 p = 0.005) and IL-10 (SMD=0.61; %95 = 0.34-0.89, p < 0.001; I2 = 10%, Q2 p = 0.34) in CPS compared to HC. Conclusion  We found significant differences in peripheral blood cytokine profiles of CPS patients compared to HC. However, the distinctive profile associated with CPS includes both pro-inflammatory (TNF-α, IL-6, IL-8), and anti-inflammatory cytokines (IL-10) in pooled analysis, as well as chemokine (eotaxin) signatures. Disclosure  L. Furtado O'Mahony: None. A. Srivastava: None. P. Mehta: None. C. Ciurtin: None.

scholarly journals Value of Xpert MTB/RIF Using Bronchoalveolar Lavage Fluid for the Diagnosis of Pulmonary Tuberculosis: A Systematic Review and Meta-Analysis

2020 ◽  
Author(s):  
Hong-Chao Liu ◽  
Yu-Lu Gao ◽  
Dan-Feng Li ◽  
Xi-Yi Zhao ◽  
Yuan-Qing Pan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Tuberculosis ◽  
Bronchoalveolar Lavage ◽  
Bronchoalveolar Lavage Fluid ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Culture Method ◽  
Lavage Fluid ◽  
Likelihood Ratios ◽  
Sensitivity Specificity

Background: The performance of Xpert MTB/RIF using bronchoalveolar lavage fluid (BAL) for the diagnosis of pulmonary tuberculosis (PTB) remains unclear. Therefore, a systematic review/meta-analysis was conducted. Methods: Studies published before December 31, 2019, were retrieved from the PubMed, Embase, and Web of Science databases using the keywords “pulmonary tuberculosis,” “Xpert MTB/RIF,” and “BAL.” Two independent evaluators extracted the data and assessed the bias risk of the included studies. A random-effects model was used to calculate the overall sensitivity, specificity, positive and negative likelihood ratios (PLR and NLR, respectively), diagnostic odds ratio (DOR), and the area under the curve (AUC), as well as the respective 95% confidence intervals (CIs). Results: Nineteen trials involving 3019 participants met the inclusion criteria. Compared to the culture method, the pooled sensitivity, specificity, PLR, NLR, DOR, and the AUC with 95% CIs of Xpert MTB/RIF were 0.87 (0.84–0.90), 0.92 (0.91–0.93), 10.21 (5.78–18.02), 0.16 (0.12–0.22), 78.95 (38.59–161.53), and 0.9467 (0.9462-0.9472), respectively. Relative to the composite reference standard, the observed values were 0.69 (0.65–0.72), 0.98 (0.98–0.99), 37.50 (18.59–75.62), 0.30 (0.21–0.43), 171.98 (80.82–365.96), and 0.9691 (0.9683–0.9699), respectively. All subgroups, except children, showed high sensitivity and specificity. Conclusions: The use of Xpert MTB/RIF in the context of BAL samples has a high diagnostic performance for PTB (except for children) and may serve as an alternative rapid diagnostic tool.

1267 Utility of Artificial Intelligence in the Cystoscopic Detection of Bladder Cancer: A Systematic Review and Meta-Analysis

2021 ◽  
Vol 108 (Supplement_6) ◽  
Author(s):  
S Ganesananthan ◽  
S Ganesananthan ◽  
B S Simpson ◽  
J M Norris
Keyword(s):  
Artificial Intelligence ◽  
Bladder Cancer ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
External Validation ◽  
High Sensitivity ◽  
Diagnostic Odds Ratio ◽  
Pooled Analysis ◽  
Likelihood Ratios ◽  
Novel Technology

Abstract Aim Detection of suspected bladder cancer at diagnostic cystoscopy is challenging and is dependent on clinician skill. Artificial Intelligence (AI) algorithms, specifically, machine learning and deep learning, have shown promise in accurate classification of pathological images in various specialties. However, utility of AI for urothelial cancer diagnosis is unknown. Here, we aimed to systematically review the extant literature in this field and quantitively summarise the role of these algorithms in bladder cancer detection. Method The EMBASE, PubMed and CENTRAL databases were searched up to December 22nd 2020 , in accordance with the PRISMA guidelines, for studies that evaluated AI algorithms for cystoscopic diagnosis of bladder cancer. Random-effects meta-analysis was performed to summarise eligible studies. Risk of Bias was assessed using the QUADAS-2 tool. Results Five from 6715 studies met criteria for inclusion. Pooled sensitivity and specificity values were 0.93 (95% CI 0.89–0.95) and 0.93 (95% CI 0.80–0.89) respectively. Pooled positive likelihood and negative likelihood ratios were 14 (95% CI 4.3–44) and 0.08 (95% CI: 0.05–0.11), respectively. Pooled diagnostic odds ratio was 182 (95% CI 61–546). Summary AUC curve value was 0.95 (95% CI 0.93–0.97). No significant publication bias was noted. Conclusions In summary, AI algorithms performed very well in detection of bladder cancer in this pooled analysis, with high sensitivity and specificity values. However, as with other clinical AI usage, further external validation through deployment in real clinical situations is essential to assess true applicability of this novel technology.

scholarly journals Systematic review and meta-analysis of test accuracy for the diagnosis of suspected pulmonary embolism

2020 ◽  
Vol 4 (18) ◽  
pp. 4296-4311
Author(s):  
Parth Patel ◽  
Payal Patel ◽  
Meha Bhatt ◽  
Cody Braun ◽  
Housne Begum ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Pulmonary Angiography ◽  
Evaluation Framework ◽  
Test Accuracy ◽  
Assessment Development ◽  
Life Threatening ◽  
D Dimer

Abstract Pulmonary embolism (PE) is a common, potentially life-threatening yet treatable condition. Prompt diagnosis and expeditious therapeutic intervention is of paramount importance for optimal patient management. Our objective was to systematically review the accuracy of D-dimer assay, compression ultrasonography (CUS), computed tomography pulmonary angiography (CTPA), and ventilation-perfusion (V/Q) scanning for the diagnosis of suspected first and recurrent PE. We searched Cochrane Central, MEDLINE, and EMBASE for eligible studies, reference lists of relevant reviews, registered trials, and relevant conference proceedings. 2 investigators screened and abstracted data. Risk of bias was assessed using Quality Assessment of Diagnostic Accuracy Studies-2 and certainty of evidence using the Grading of Recommendations Assessment, Development and Evaluation framework. We pooled estimates of sensitivity and specificity. The review included 61 studies. The pooled estimates for D-dimer sensitivity and specificity were 0.97 (95% confidence interval [CI], 0.96-0.98) and 0.41 (95% CI, 0.36-0.46) respectively, whereas CTPA sensitivity and specificity were 0.94 (95% CI, 0.89-0.97) and 0.98 (95% CI, 0.97-0.99), respectively, and CUS sensitivity and specificity were 0.49 (95% CI, 0.31-0.66) and 0.96 (95% CI, 0.95-0.98), respectively. Three variations of pooled estimates for sensitivity and specificity of V/Q scan were carried out, based on interpretation of test results. D-dimer had the highest sensitivity when compared with imaging. CTPA and V/Q scans (high probability scan as a positive and low/non-diagnostic/normal scan as negative) both had the highest specificity. This systematic review was registered on PROSPERO as CRD42018084669.

scholarly journals The diagnostic effect of α-defensin, D-dimer, and IL-6 in periprosthetic joint infection: A systematic review and diagnostic meta-analysis

2020 ◽  
Vol 28 (3) ◽  
pp. 230949902097186
Author(s):  
Baozhong Tian ◽  
Liwen Cui ◽  
Weihai Jiang
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Periprosthetic Joint Infection ◽  
Meta Analysis ◽  
Joint Infection ◽  
Common Complication ◽  
Online Databases ◽  
Artificial Joint Replacement ◽  
Sensitivity Specificity ◽  
D Dimer

Background: Periprosthetic joint infection (PJI) is the most common complication after artificial joint replacement as previously reported. However, the main problem at present is its difficulty in diagnosis. This systematic review and meta-analysis aimed to compare the diagnostic accuracy of α-defensin, D-dimer, and interleukin-6 (IL-6) in clinical practice. Method: Online databases were systematically searched until June 18th, 2020 with keywords and medical sub-headings terms. Studies mentioned the sensitivity and specificity of biological markers in detecting PJI were included in our study. The sensitivity, specificity, and diagnostic odds ratios (DORs) were obtained after integration. Results: A total of 34 studies with 1036 patients diagnosing as PJI were included for comparing α-defensin, D-dimer, and IL-6. The sensitivity and specificity of α-defensin for PJI were 0.88 and 0.96, and the DOR was 189 (95% CI 72–496), respectively. The sensitivity and specificity of D-dimer (0.82 and 0.72) and IL-6 (0.80 and 0.89) were lower than α-defensin. Conclusion: The detection of α-defensin is a promising biomarker for diagnosing PJI. The optional cut-off needs to be curtained when using other biomarkers.

scholarly journals Diagnostic Test Accuracy of the 4AT for Delirium Detection: A Systematic Review and Meta-Analysis

2020 ◽  
Vol 17 (20) ◽  
pp. 7515 ◽  
Author(s):  
Eunhye Jeong ◽  
Jinkyung Park ◽  
Juneyoung Lee
Keyword(s):  
Systematic Review ◽  
Diagnostic Test ◽  
Healthcare Professionals ◽  
Meta Analysis ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Summary Receiver Operating Characteristic ◽  
Bivariate Model ◽  
Data Synthesis

Under-recognition of delirium is an international problem. For the early detection of delirium, a feasible and valid screening tool for healthcare professionals is needed. This study aimed to present a scientific reason for using the 4 ‘A’s Test (4AT) through a systematic review and meta-analysis of studies on the diagnostic test accuracy. We systematically searched articles in the EMBASE, MEDLINE, CINAHL, and PsycINFO databases and selected relevant articles on the basis of the predefined inclusion criteria. The quality of the included articles was evaluated using the Quality Assessment of the Diagnostic Accuracy Studies-2 tool. We estimated the pooled values of diagnostic test accuracy by employing the bivariate model and the hierarchical summary receiver operating characteristic (HSROC) model in data synthesis. A total of 3729 patients of 13 studies were included in the analysis. The pooled estimates of sensitivity and specificity of the 4AT were 81.5% (95% confidence interval: 70.7%, 89.0%) and 87.5% (79.5%, 92.7%), respectively. Given the 4AT’s evidence of accuracy and practicality, we suggest healthcare professionals to utilize this tool for routine screening of delirium. However, for detecting delirium in the dementia population, further work is required to evaluate the 4AT with other cut-off points or scoring methods in order for it to be more sensitive and specific.

scholarly journals Faecal calprotectin to detect inflammatory bowel disease: a systematic review and exploratory meta-analysis of test accuracy

BMJ Open ◽  
2019 ◽  
Vol 9 (3) ◽  
pp. e027428 ◽  
Author(s):  
Karoline Freeman ◽  
Brian H Willis ◽  
Hannah Fraser ◽  
Sian Taylor-Phillips ◽  
Aileen Clarke
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Inflammatory Bowel Disease ◽  
Sensitivity And Specificity ◽  
Bowel Disease ◽  
Secondary Care ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Faecal Calprotectin ◽  
Inflammatory Bowel

ObjectiveTest accuracy of faecal calprotectin (FC) testing in primary care is inconclusive. We aimed to assess the test accuracy of FC testing in primary care and compare it to secondary care estimates for the detection of inflammatory bowel disease (IBD).MethodsSystematic review and meta-analysis of test accuracy using a bivariate random effects model. We searched MEDLINE, EMBASE, Cochrane Library and Web of Science until 31 May 2017 and included studies from auto alerts up until 31 January 2018. Eligible studies measured FC levels in stool samples to detect IBD in adult patients with chronic (at least 6–8 weeks) abdominal symptoms in primary or secondary care. Risk of bias and applicability were assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 criteria. We followed the protocol registered as PROSPERO CRD 42012003287.Results38 out of 2168 studies were eligible including five from primary care. Comparison of test accuracy by setting was precluded by extensive heterogeneity. Overall, summary estimates of sensitivity and specificity were not recorded. At a threshold of 50 µg/g, sensitivity from separate meta-analysis of four assay types ranged from 0.85 (95% CI 0.75 to 0.92) to 0.94 (95% CI 0.75 to 0.90) and specificity from 0.67 (95% CI 0.56 to 0.76) to 0.88 (95% CI 0.77 to 0.94). Across three different definitions of disease, sensitivity ranged from 0.80 (95% CI 0.76 to 0.84) to 0.97 (95% CI 0.91 to 0.99) and specificity from 0.67 (95% CI 0.58 to 0.75) to 0.76 (95% CI 0.66 to 0.84). Sensitivity appears to be lower in primary care and is further reduced at a revised threshold of 100 µg/g.ConclusionsConclusive estimates of sensitivity and specificity of FC testing in primary care for the detection of IBD are still missing. There is insufficient evidence in the published literature to support the decision to introduce FC testing in primary care. Studies evaluating FC testing in an appropriate primary care setting are needed.

scholarly journals Utility of the methylated SEPT9 test for the early detection of colorectal cancer: a systematic review and meta-analysis of diagnostic test accuracy

2020 ◽  
Vol 7 (1) ◽  
pp. e000355 ◽  
Author(s):  
Rohit Hariharan ◽  
Mark Jenkins
Keyword(s):  
Colorectal Cancer ◽  
Systematic Review ◽  
Early Detection ◽  
Positive Predictive Value ◽  
Negative Predictive Value ◽  
Diagnostic Test ◽  
Predictive Value ◽  
Meta Analysis ◽  
Test Accuracy ◽  
Sensitivity Specificity

BackgroundCirculating tumour DNA from colorectal cancer (CRC) is a biomarker for early detection of the disease and therefore potentially useful for screening. One such biomarker is the methylated SEPT9 (mSEPT9) gene, which occurs during CRC tumourigenesis. This systematic review and meta-analysis aims to establish the sensitivity, specificity and accuracy of mSEPT9 tests for the early diagnosis of CRC.MethodsA systematic search of the relevant literature was conducted using Medline and Embase databases. Data were extracted from the eligible studies and analysed to estimate pooled sensitivity, specificity and diagnostic test accuracy.ResultsBased on 19 studies, the pooled estimates (and 95% CIs) for mSEPT9 to detect CRC were: sensitivity 69% (62–75); specificity 92% (89–95); positive likelihood ratio 9.1 (6.1–13.8); negative likelihood ratio 0.34 (0.27–0.42); diagnostic OR 27 (15–48) and area under the curve 0.89 (0.86–0.91). The test has a positive predictive value of 2.6% and negative predictive value of 99.9% in an average risk population (0.3% CRC prevalence), and 9.5% (positive predictive value) and 99.6% (negative predictive value) in a high-risk population (1.2% CRC prevalence).ConclusionThe mSEPT9 test has high specificity and moderate sensitivity for CRC and is therefore a potential alternative screening method for those declining faecal immunochemical test for occult blood (FIT) or other screening modalities. However, it is limited by its poor diagnostic performance for precancerous lesions (advanced adenomas and polyps) and its relatively high costs, and little is known about its acceptability to those declining to use the FIT.

Sign in / Sign up

Export Citation Format

Share Document