scholarly journals Sex difference for the risk of amputation in diabetic patients: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0243797
Author(s):  
Lei Fan ◽  
Xue-Jian Wu
Keyword(s):  
Systematic Review ◽  
Sex Difference ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Increased Risk

The risk of amputation is a sequelae of diabetic foot ulceration, which are significantly increased in diabetic patients and caused huge morbidly and mortality. However, whether the risk amputation in diabetic patients are differing in male and female remains inconclusive. We therefore conducted a systematic review and meta-analysis to assess the sex difference for the risk of amputation in diabetic patients. We systematically searched PubMed, EmBase, and the Cochrane library to identify eligible study from their inception up to November 2020. The diagnostic value of male patients on subsequent amputation risk were assessed by using sensitivity, specificity, positive and negative likelihood ratio (PLR and NLR), diagnostic odds ratio (DOR), and area under the receiver operating characteristic curve (AUC). Twenty-two studies recruited a total of 33,686,171 diabetic patients were selected for quantitative analysis. The risk of amputation in male diabetic patients was greater than female diabetic patients (DOR: 1.38; 95%CI: 1.13–1.70; P<0.001). The sensitivity and specificity for male diabetic patients on the risk of amputation were 0.72 (95%CI: 0.72–0.73), and 0.51 (95%CI: 0.51–0.51), respectively. Moreover, the PLR and NLR of male diabetic patients for predicting amputation were 1.13 (95%CI: 1.05–1.22), and 0.82 (0.72–0.94), respectively. Furthermore, the AUC for male diabetic patients on amputation risk was 0.56 (95%CI: 0.48–0.63). This study found male diabetic patients was associated with an increased risk of amputation than female diabetic patients, and the predictive value of sex difference on amputation risk in diabetic patients was mild.

scholarly journals Risk of Depression and Suicidality among Diabetic Patients: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 7 (11) ◽  
pp. 445 ◽  
Author(s):  
Rasha Elamoshy ◽  
Yelena Bird ◽  
Lilian Thorpe ◽  
John Moraros
Keyword(s):  
Systematic Review ◽  
Diabetes Management ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Diabetic Patients ◽  
Cross Sectional ◽  
Healthcare Settings ◽  
Completed Suicide ◽  
Treatment Of Depression ◽  
Increased Risk

The purpose of this study is to conduct a systematic review and meta-analysis to evaluate the risk of depression and suicidality among diabetic patients. Methods: Medline, PubMed, EMBASE, Cochrane library, and Psych INFO were searched for studies published from 2008 onwards. Meta-analysis was conducted to estimate the pooled effect size. Sources of heterogeneity were investigated by subgroup analysis and meta-regression. Results: In total, 5750 articles were identified and of those, 17 studies on suicidality and 36 on depression were included in this study. Our analysis suggests a positive relationship between diabetes and depression (cohort studies odds ratio (OR) 1.49, 95% confidence interval (CI): 1.36–1.64 and cross-sectional studies OR 2.04, 95% CI, 1.73–2.42). Pooled OR values for suicidal ideation, attempted suicide, and completed suicide were 1.89 (95% CI: 1.36–2.63), 1.45 (95% CI: 1.07–1.96), and 1.85 (95% CI: 0.97–3.52), respectively. All findings were statistically significant except for completed suicide. Conclusions: The increased risk of depression and suicidality in diabetic patients highlights the importance of integrating the evaluation and treatment of depression with diabetes management in primary healthcare settings. Further research in this area is needed.

Diagnostic accuracy of interleukin-27 in tuberculous pleurisy: a systematic review and meta-analysis

QJM ◽  
2020 ◽  
Author(s):  
Q Zhang ◽  
Y Ma ◽  
M Zhang ◽  
Y Wang ◽  
W Wu
Keyword(s):  
Systematic Review ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Characteristic Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Interleukin 27 ◽  
Tuberculous Pleurisy

Summary Objective This study aimed to conduct a systematic review of the diagnostic value of interleukin-27 (IL-27) for tuberculous pleurisy (TP). Methods Literature on IL-27 diagnosis of TP was retrieved and screened from six databases (four English databases and two Chinese databases). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and summary receiver operating characteristic curve (SROC) were measured to assess accurately the comprehensive evaluation of IL-27 for TP. Results Eleven studies with a total of 1454 patients were identified in the analysis. The combined diagnostic value of IL-27 for TP was as follows: sensitivity of 0.95 (95% confidence interval [CI]: 0.93–0.97), specificity of 0.91 (95% CI: 0.89–0.92), positive likelihood ratio of 13.99 (95% CI: 7.01–27.93), negative likelihood ratio of 0.07 (95% CI: 0.05–0.10), diagnostic odds ratio of 275.20 (95% CI: 112.83–671.23) and area under the SROC of 0.9830. Conclusion IL-27 has an excellent diagnostic value for TP and could be used as a diagnostic biomarker for TP.

scholarly journals Clinical value of thoracic ultrasonography in the diagnosis of pulmonary embolism: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Wu Chen ◽  
Kun Xu ◽  
Yiying Li ◽  
Meifang Hao ◽  
Yongsheng Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Clinical Value ◽  
Sensitivity Specificity

Aims: The present study investigated and evaluated the accuracy of thoracic ultrasonography (TUS) in the diagnosis of pulmonary embolism (PE) by conducting a systematic review and meta-analysis. Material and methods: The PubMed, Em-base and the Cochrane library databases were searched till March 2019 to retrieve relevant articles and the overall diagnostic accuracy of TUS in PE diagnosis was evaluated by meta-analysis. Results: Overall, 16 studies including 1,916 patients were enrolled in this meta-analysis. Of these, 762 (39.8%) had confirmed PE. The overall sensitivity, specificity, and area under the ROC curve (AUC) of TUS for PE were 82% (95% confidence interval (CI), 72%–88%), 89% (95% CI, 79%–95%), and 0.91 (95% CI, 0.88–0.93), respectively. Other efficacy parameters assessed demonstrated a positive likelihood ratio (PLR) of (7.6; 95% CI, 4.0–14.5), negative likelihood ratio of (NLR) (0.21; 95% CI, 0.14–0.30), and diagnostic odds’ ratio (DOR) of (36.86; 95% CI, 21.41–63.48). Conclusions: The current study suggested that although TUS cannot safely rule out PE, it is likely to be used as an aid or guidance to establish procedures and help to improve the diagnostic deficits in patients with PE.

scholarly journals Diagnostic value of RASSF1A methylation for breast cancer: a meta-analysis

2019 ◽  
Vol 39 (6) ◽  
Author(s):  
Mingyi Li ◽  
Chunpeng Wang ◽  
Binbin Yu ◽  
Xueyuan Zhang ◽  
Fang Shi ◽  
...  
Keyword(s):  
Breast Cancer ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
High Specificity ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Diagnostic Biomarker ◽  
Summary Receiver Operating Characteristic ◽  
Rassf1a Methylation

Abstract Background: Numerous studies reported that RAS-association domain family 1 isoform A (RASSF1A) methylation might act as diagnostic biomarker for breast cancer (BC), this meta-analysis aimed to evaluate the value of RASSF1A methylation for diagnosing BC. Methods: Such databases as PubMed, Cochrane Library and Web of Science databases were searched for literatures until May 2019. A meta-analysis was performed utilizing STATA and Revman softwares. Furthermore, subgroup analysis was adopted to determine likely sources of heterogeneity. Results: Totally 19 literatures with 1849 patients and 1542 controls were included in the present study. Sensitivity, specificity, diagnostic odds ratio (DOR) and the area under the summary receiver operating characteristic curve (AUC) of RASSF1A methylation for diagnosing BC were 0.49, 0.95, 19.0 and 0.83, respectively. The sensitivity (0.54 vs 0.43), DOR (30.0 vs 10.0) and AUC (0.84 vs 0.81) of RASSF1A methylation in Caucasian were higher than other ethnicities. The sensitivity (0.64 vs 0.57), DOR (21.0 vs 14.0) and AUC (0.89 vs 0.86) of methylation-specific PCR (MSP) were superior to other methods (q-MSP, OS-MSP and MethyLight). The sensitivity, DOR and AUC of serum RASSF1A methylation vs RASSF1A methylation in other samples (tissue or plasma) were 0.55 vs 0.40, 22.0 vs 14.0 and 0.86 vs 0.74, respectively. Conclusions: RASSF1A methylation might be a potential diagnostic biomarker for BC. Considering its low sensitivity and high specificity, it should combine with others to upgrade the sensitivity. Besides, under such conditions, MSP detection, serum RASSF1A methylation and Caucasian are shown to be more effective and suitable for diagnosing BC.

Appraising the Accuracy of Ischaemia-Modified Albumin in Diagnosing Stroke: A Systematic Review and Meta-Analysis

2021 ◽  
pp. 1-6
Author(s):  
Wenhua Shi ◽  
Guanghua Tang ◽  
Xianshi Zhou ◽  
Ye Ye
Keyword(s):  
Systematic Review ◽  
Acute Stroke ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Meta Regression ◽  
The Cochrane Library

<b><i>Introduction:</i></b> Ischaemia-modified albumin (IMA) is a new, sensitive marker of ischaemic diseases that has been approved for diagnosing myocardial ischaemia. However, the accuracy of IMA in the diagnosis of stroke remains to be clarified. The study’s purpose is to assess the potential role of IMA as a diagnostic indicator in stroke. <b><i>Methods:</i></b> We carried out a systematic search in Medline, the Cochrane Library, Embase, Scopus, Science Direct, ISI Web of Knowledge, and the reference lists of relevant articles from the databases’ inception to September 1, 2019. Studies that appraised the diagnostic accuracy of IMA for acute stroke patients were included in our study. Two reviewers extracted data independently and assessed the quality of the retrieved studies, and disagreements were resolved through discussions with a third reviewer. Sensitivities and specificities were pooled by using bivariate diagnostic meta-analysis. We calculated <i>I</i><sup>2</sup> to test the heterogeneity and used meta-regression to identify potential sources of heterogeneity. This systematic review and meta-analysis is registered in international prospective register of systematic reviews (number CRD42020149174). <b><i>Results:</i></b> Six studies with 605 patients were eligible for inclusion. Our meta-analysis produced the following outcomes: the mean sensitivity of IMA in diagnosing acute stroke was 0.80 (95% confidence interval [CI], 0.69–0.88) and the specificity was 0.80 (95% CI, 0.71–0.87). The area under the receiver operating characteristic curve was 0.86 (95% CI, 0.83–0.89), and the pooled diagnostic odds ratio was 16 (95% CI, 8–33). There was obvious heterogeneity between studies (<i>I</i><sup>2</sup> = 78%, 95% CI, 53–100). Sensitivity analysis and meta-regression could account for the heterogeneity. <b><i>Conclusion:</i></b> IMA is a helpful marker for consideration in the early diagnosis of stroke.

Accuracy of MRI Diagnosis of Meniscal Tears of the Knee: A Meta-Analysis and Systematic Review

2019 ◽  
Author(s):  
Wei Wang ◽  
Zheng Li ◽  
Hui-Ming Peng ◽  
Yan-Yan Bian ◽  
Ye Li ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Meniscal Tears ◽  
Summary Receiver Operating Characteristic ◽  
Cross Sectional

AbstractThis study aimed to evaluate the overall diagnostic value of magnetic resonance imaging (MRI) in patients with suspected meniscal tears. PubMed, Cochrane, Embase database updated to November 2017 were searched by the index words to identify qualified studies, including prospective cohort studies and cross-sectional studies. Literature was also identified by tracking using reference lists. Heterogeneity of the included studies was reviewed to select proper effects model for pooled weighted sensitivity, specificity, and diagnostic odds ratio (DOR). Summary receiver operating characteristic (SROC) analyses were performed for meniscal tears. A total of 17 studies were involved in this meta-analysis to explore the diagnostic accuracy of MRI for meniscal tears. The global sensitivity and specificity of MRI of meniscal tears were 92.0% (95% confidence interval [CI]: 88.0–95.0%) and 90.0% (95% CI: 85.0–95.0%) in medial meniscal tears, and 80.0% (95% CI: 66.0–89.0%) and 95.0% (95% CI: 91.0–97.0%) in lateral meniscal tears, respectively. Moreover, the global positive and negative likelihood ratio of MRI of meniscal tears were 10.33 (95% CI: 6.04–17.67) and 0.09 (95% CI: 0.05–0.14) in medial meniscal tears; 16.48 (95% CI: 8.81–30.83) and 0.21 (95% CI: 0.12–0.37) in lateral meniscal tears, respectively. The global DOR was 81.69 (95% CI: 37.94–175.91) in medial meniscal tears and 56.59 (95% CI: 22.51–142.28) in lateral meniscal tears. The results of area under the SROC indicated high accuracy in medial meniscal tears (area under the curve [AUC] = 0.97, 95% CI: 0.95–0.98) and lateral meniscal tears (AUC = 0.96, 95% CI: 0.94–0.97). This review presents a systematic review and meta-analysis to evaluate the diagnostic accuracy of MRI of meniscal tears. Moderate-to-strong evidence suggests that MRI appears to be associated with higher diagnostic accuracy for detecting medial and lateral meniscal tears.

scholarly journals MRA improves sensitivity than MRI for the articular-sided partial-thickness rotator cuff tears

2021 ◽  
Vol 104 (4) ◽  
pp. 003685042110599
Author(s):  
Lianxin Li ◽  
Jinlei Dong ◽  
Qinghu Li ◽  
Jinye Dong ◽  
Bingzhi Wang ◽  
...  
Keyword(s):  
Rotator Cuff ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Mr Arthrography ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Rotator Cuff Tears ◽  
Cochrane Library ◽  
Partial Thickness ◽  
Sensitivity Specificity

Background: This study aims to compare the diagnostic accuracy of magnetic resonance imaging (MRI) and MR arthrography (MRA) for the articular-sided partial-thickness rotator cuff tear (PTRCT). Methods: Three electronic databases, PubMed/Medline, Embase and Cochrane Library, were utilized to retrieve articles comparing the diagnostic value of MRA and MRI for detecting articular-sided PTRCTs. The pooled statistical indexes included sensitivity, specificity, positive/negative predictive value, diagnostic odds ratio (DOR) and the area under the receiver operating characteristic curve (AUC). Results: Eleven studies involving 1703 patients and 1704 shoulders were included. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRA to diagnose articular-sided PTRCTs were 0.81 (95% CI, 0.65–0.90), 0.96 (95% CI, 0.91–0.98), 68.14 (95% CI, 33.20–139.84) and 0.96 (95% CI, 0.94–0.97), respectively. The pooled sensitivity, specificity, DOR and AUC and their 95% CIs of MRI were 0.78 (95% CI, 0.65–0.87) and 0.97 (95% CI, 0.84–0.99), 47.82 (95% CI, 8.29–275.89) and 0.89 (95% CI, 0.86–0.92), respectively. Conclusions: This meta-analysis reveals that MRA has a better diagnostic value than that of MRI for the diagnosis of articular-sided partial-thickness rotator cuff tears because of an improvement of sensitivity.

scholarly journals Synovial calprotectin for the diagnosis of periprosthetic joint infection: a diagnostic meta-analysis

2022 ◽  
Vol 17 (1) ◽  
Author(s):  
Xinyu Peng ◽  
Haitao Zhang ◽  
Pengfei Xin ◽  
Guowen Bai ◽  
Yingjie Ge ◽  
...  
Keyword(s):  
Likelihood Ratio ◽  
Meta Analysis ◽  
Joint Infection ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Cochrane Library ◽  
Diagnostic Score ◽  
Joint Infections

Abstract Background Periprosthetic joint infections (PJI) are a rare but severe complication of total joint arthroplasty (TJA). However, the diagnosis of PJI remains difficult. It is one of the research that focuses about diagnosis for PJI for majority researchers to discover a novel biomarker. This meta-analysis tried to evaluate diagnostic value of synovial calprotectin for PJI. Methods This meta-analysis search of the literature was conducted in PubMed, EMBASE, Web of Science, and the Cochrane Library. Literature quality was appraised using Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) based on RevMan (version 5.3). The diagnostic value of calprotectin for PJI was evaluated by calculating sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), diagnostic score and area under SROC (AUC) based on the Stata version 14.0 software. We conduct subgroup analysis according to the study design, cutoff values, the country of study, and gold standard. Results Seven studies were included in this meta-analysis. The pooled sensitivity of synovial calprotectin for the diagnosis of PJI was 0.94 (95% CI, 0.87–0.98), and the specificity was 0.93 (95% CI, 0.87–0.96). The pooled AUC, PLR, and NLR for synovial calprotectin were 0.98 (95% CI, 0.96–0.99), 13.65 (95% CI, 6.89–27.07), and 0.06 (95% CI, 0.02–0.15), respectively. The pooled diagnostic score and DOR were 5.4 (95% CI, 3.96–6.85) and 222.32 (95% CI, 52.52–941.12), respectively. Conclusion In summary, this meta-analysis indicates that synovial calprotectin is a promising biomarker of assistant diagnosis for PJI, as well as recommended test for excluding diagnostic tool.

scholarly journals EXPRESS: Stroke risk following traumatic brain injury: systematic review and meta-analysis

2021 ◽  
pp. 174749302110042
Author(s):  
Grace Mary Turner ◽  
Christel McMullan ◽  
Olalekan Lee Aiyegbusi ◽  
Danai Bem ◽  
Tom Marshall ◽  
...  
Keyword(s):  
Systematic Review ◽  
Stroke Risk ◽  
Meta Analysis ◽  
Vitamin K Antagonists ◽  
Cochrane Library ◽  
Control Group ◽  
Large Sample Size ◽  
Hazard Ratios ◽  
Increased Risk ◽  
The Cochrane Library

Aims To investigate the association between TBI and stroke risk. Summary of review We undertook a systematic review of MEDLINE, EMBASE, CINAHL, and The Cochrane Library from inception to 4th December 2020. We used random-effects meta-analysis to pool hazard ratios (HR) for studies which reported stroke risk post-TBI compared to controls. Searches identified 10,501 records; 58 full texts were assessed for eligibility and 18 met the inclusion criteria. The review included a large sample size of 2,606,379 participants from four countries. Six studies included a non-TBI control group, all found TBI patients had significantly increased risk of stroke compared to controls (pooled HR 1.86; 95% CI 1.46-2.37). Findings suggest stroke risk may be highest in the first four months post-TBI, but remains significant up to five years post-TBI. TBI appears to be associated with increased stroke risk regardless of severity or subtype of TBI. There was some evidence to suggest an association between reduced stroke risk post-TBI and Vitamin K antagonists and statins, but increased stroke risk with certain classes of antidepressants. Conclusion TBI is an independent risk factor for stroke, regardless of TBI severity or type. Post-TBI review and management of risk factors for stroke may be warranted.

scholarly journals Accuracy of angiopoietin-2 for predicting organ failure in patients with acute pancreatitis: a systematic review and meta-analysis

2021 ◽  
Vol 49 (2) ◽  
pp. 030006052098670
Author(s):  
Yongcai Lv ◽  
Yanhua Yao ◽  
Qi Liu ◽  
Jingjing Lei
Keyword(s):  
Acute Pancreatitis ◽  
Organ Failure ◽  
Meta Analysis ◽  
Characteristic Curve ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Case Control Studies ◽  
Likelihood Ratios ◽  
Summary Receiver Operating Characteristic ◽  
Angiopoietin 2

Objective Our aim was to assess the accuracy of angiopoietin-2 (Ang-2) as a prognostic marker for acute pancreatitis (AP) with organ failure (OF). Methods We undertook a systematic search of the PubMed, Cochrane Library, Embase, Chinese Journals Full-text, Wanfang, China Biology Medicine disc, and Weipu databases to identify eligible cohort studies on the predictive value of Ang-2 for AP with OF. The main outcome measures were sensitivity and specificity. The effects were pooled using a bivariate mixed-effects model. Results Six articles with seven case-control studies (n = 650) were included. Pooled sensitivity, specificity, and positive and negative likelihood ratios with 95% confidence intervals (CI) for AP with OF were 0.93 (95%CI: 0.75–0.99), 0.85 (95%CI: 0.75–0.92), 6.40 (95%CI: 3.36–12.19), and 0.08 (95%CI: 0.02–0.36), respectively. The area under the summary receiver operating characteristic curve was 0.95 (95%CI: 0.92–0.96), and the diagnostic odds ratio was 83.18 (95%CI: 11.50–623.17). Subgroup analysis showed that admission time of AP onset (< or ≥24 hours) was a source of overall heterogeneity. Sensitivity analysis supported this finding. Conclusion Ang-2 had high diagnostic accuracy for AP with OF; the best prediction of Ang-2 may be 24 to 72 hours after onset of AP.

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