Comparison of the diagnostic accuracy of 18F-Fluorocholine PET and 11C-Methionine PET for parathyroid localization in primary hyperparathyroidism: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Fabio Bioletto ◽  
Marco Barale ◽  
Mirko Parasiliti-Caprino ◽  
Nunzia Prencipe ◽  
Alessandro Maria Berton ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Superior Performance ◽  
Parathyroid Localization ◽  
The Moment

Background. Primary hyperparathyroidism is characterized by an autonomous hypersecretion of parathyroid hormone by one or more parathyroid glands. Preoperative localization of the affected gland(s) is of key importance in order to allow minimally invasive surgery. At the moment, 11C-Methionine and 18F-Fluorocholine PET studies appear to be among the most promising second-line localization techniques; their comparative diagnostic performance, however, is still unknown. Methods. PubMed/Medline and Embase databases were searched up to October 2020 for studies estimating the diagnostic accuracy of 11C-Methionine PET or 18F-Fluorocholine PET for parathyroid localization in patients with primary hyperparathyroidism. Pooled sensitivity and positive predictive value were calculated for each tracer on a “per-lesion” basis and then compared using a random-effect model subgroup analysis. Results. Twenty-two studies were finally considered in the meta-analysis. Among these, 8 evaluated the diagnostic accuracy of 11C-Methionine and 14 that of 18F-Fluorocholine. No study directly comparing the two tracers was found. The pooled sensitivity of 18F-Fluorocholine was higher than that of 11C-Methionine (92% vs 80%, p < 0.01), while the positive predictive value was similar (95% vs 94%, p = 0.99). These findings were confirmed in multivariable meta-regression models, demonstrating their apparent independence from other possible predictors or confounders at a study level. Conclusion. This was the first meta-analysis that specifically compared the diagnostic accuracy of 11C-Methionine and 18F-Fluorocholine PET for parathyroid localization in patients with primary hyperparathyroidism. Our results suggested a superior performance of 18F-Fluorocholine in terms of sensitivity, while the two tracers had comparable accuracy in terms of positive predictive value.

scholarly journals Meta-Analysis: Diagnostic Accuracy of Anti-Cyclic Citrullinated Peptide Antibody for Juvenile Idiopathic Arthritis

2015 ◽  
Vol 2015 ◽  
pp. 1-12 ◽  
Author(s):  
Yan Wang ◽  
Fengyan Pei ◽  
Xingjuan Wang ◽  
Zhiyu Sun ◽  
Chengjin Hu ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Antibody Test ◽  
High Specificity ◽  
The Other ◽  
Effect Model ◽  
Higher Sensitivity

Objective. To estimate the diagnostic accuracy of the anti-CCP test in JIA and to evaluate factors associated with higher accuracy.Methods. Two investigators performed an extensive search of the literature published between January 2000 and January 2014. The included articles were assessed by the Quality Assessment of Diagnostic Accuracy Studies tool. The meta-analysis was performed using a summary ROC (SROC) curve and a bivariate random-effect model to estimate sensitivity and specificity across studies.Results. The bivariate meta-analysis yielded a pooled sensitivity and specificity of 10% (95% confidence interval (CI): 6.0%–15.0%) and 99.0% (95% CI: 98.0%–100.0%). The area under the SROC curve was 0.96. Sensitivity estimates were highly heterogeneous, which was partially explained by the higher sensitivity in the rheumatoid factor-positive polyarthritis (RF+ PA) subtype (48.0%; 95% CI: 31.0%–65.0%) than in the other subtypes (17.0%; 95% CI: 14.0%–20.0%) and the higher sensitivity of the Inova assay (17.0%; 95% CI: 14.0%–20.%%) than the other assays (0.05%; 95% CI: 2.0%–11.0%).Conclusions. Anti-CCP antibody test has a high specificity for the diagnosis of JIA. The sensitivity of this test is low and varies across populations but is higher in RF+ PA than in other JIA subtypes.

scholarly journals The Study of Diagnostic Value of Bipolarity Index for Bipolar Disorder in China: Meta-analysis of Sensitivity and Specificity

2020 ◽  
Author(s):  
Fengli Sun ◽  
Zhu Jianfeng ◽  
Tao Hejian ◽  
Jin Weidong
Keyword(s):  
Bipolar Disorder ◽  
Predictive Value ◽  
Case Reports ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Diagnostic Value ◽  
Psychiatric Clinic ◽  
Significant Heterogeneity ◽  
Study Results

Abstract BackgroundThe diagnosis of bipolar disorder is still one of the key problems in psychiatric clinic. Although DSM-5 has made some important changes, it has not completely changed the missed diagnosis and misdiagnosis of bipolar disorder.It was very important that diagnostic scale was used in clinic.But the study results of assist diagnostic scale for bipolar disorder should been concluded and analyzed.Bipolarity index was one of assist diagnostic scale,which should be analyzed comprehensively.MethodsWe searched CBM, CNKI , WANFANG and CSSCI in Chinese to find literature from Julyr 31 2004 to July 31 2020 related to Bipolarity Index in diagnosis for bipolar disorder ,among which results such as comments, letters, reviews and case reports were excluded. The rate of sensitivity,specificity,accuracy,positive predictive value and negative predictive value in diagnosis was synthesized and discussed.ResultsA total of 1237 subjects were included in 5 studies. Random effect model is used to account for the data by Revman 5.2. The results showed that the sensitivity of BI in diagnostic was 0.93 (95% CI: 0.93–1.00), the specificity was 85% (95% CI: 0.69–0.96). the positive predict value was 74% (95% CI: 0.53–0.91).the negative predict value was 95% (95% CI: 0.81–1.00).and accuracy was 86% (95% CI: 0.77–0.93). Significant heterogeneity was detected across studies regarding these incidence estimates. ConclusionThe idea diagnostic value of BI was found. although the significant heterogeneity detected in studies.We must interpret the results with caution and also put attention to this result,which include comparison to other diagnostic scale,perfecting sue of BI in clinical psychiatry.

Routine Use of Preoperative Neck Ultrasound in Primary Hyperparathyroidism Identifies Coexisting Thyroid Disease and Improves Parathyroid Localization

2021 ◽  
pp. 000313482199199
Author(s):  
Trenton Foster ◽  
Benzon Dy ◽  
Raffaele Rocco ◽  
Travis Mckenzie ◽  
Geoffrey Thompson ◽  
...  
Keyword(s):  
Primary Hyperparathyroidism ◽  
Positive Predictive Value ◽  
Predictive Value ◽  
Needle Aspiration ◽  
Inclusion Criteria ◽  
Neck Ultrasound ◽  
Thyroid Pathology ◽  
Mean Size ◽  
Partial Thyroidectomy ◽  
Parathyroid Localization

Background In Jan 2018, we began routinely obtaining neck ultrasound (US) with 123I/99Tc-sestamibi (MIBI) for parathyroid gland localization and to identify thyroid pathology in the setting of primary hyperparathyroidism (1HPT). The aim of this study is to assess if routine neck US is a useful adjunct to 123I/99Tc-MIBI in 1HPT. Methods Patients undergoing surgery for 1HPT with both 123I/99Tc-MIBI and US at our institution after implementation of routine US were reviewed. Biopsy and surgical management of thyroid pathology was evaluated. 123I/99Tc-MIBI and US results were compared to intraoperative findings to determine sensitivity and positive predictive value (PPV) for parathyroid localization. Results From January 2018 to September 2019, there were 423 patients (mean, 61 years) that met inclusion criteria (80% women). Thyroid nodules were found on US in 57%, mean size 1.3 + 0.8 cm. Fine needle aspiration (FNA) was performed in 87 patients with nodules (36%). 35 patients (8.5%) required total or partial thyroidectomy for diagnoses/treatment. Papillary thyroid cancer (PTC) was found in 3.5% of the cohort with micro-PTC 53% and PTC 1-2 cm 40%. A successful parathyroid operation for 1HPT was achieved in 98.6% of patients. Positive predictive value for localization of abnormal parathyroid glands was 97% when US and 123I/99Tc-MIBI had concordant findings. Discussion Routine use of US in 1HPT commonly identifies nodules that are benign or low-risk PTC. Ultrasound is less sensitive for parathyroid localization but when used with 123I/99Tc-MIBI, concordant imaging has a high PPV.

scholarly journals Meta-analysis of diagnostic performance of serological tests for SARS-CoV-2 antibodies up to 25 April 2020 and public health implications

2020 ◽  
Vol 25 (23) ◽  
Author(s):  
Saverio Caini ◽  
Federica Bellerba ◽  
Federica Corso ◽  
Angélica Díaz-Basabe ◽  
Gioacchino Natoli ◽  
...  
Keyword(s):  
Public Health ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Random Effects ◽  
Predictive Value ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Serological Tests ◽  
Random Effects Models ◽  
Health Implications

We reviewed the diagnostic accuracy of SARS-CoV-2 serological tests. Random-effects models yielded a summary sensitivity of 82% for IgM, and 85% for IgG and total antibodies. For specificity, the pooled estimate were 98% for IgM and 99% for IgG and total antibodies. In populations with ≤ 5% of seroconverted individuals, unless the assays have perfect (i.e. 100%) specificity, the positive predictive value would be ≤ 88%. Serological tests should be used for prevalence surveys only in hard-hit areas.

scholarly journals Comparative Diagnostic Accuracy of Fecal Protein Biomarkers for Colorectal Advanced Neoplasms: A Systematic Review and Meta-Analysis

2021 ◽  
Author(s):  
Atefeh Nasir Kansestani ◽  
Mohammad Erfan Zare ◽  
Qingchao Tong ◽  
Jun Zhang
Keyword(s):  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Negative Likelihood Ratio ◽  
Advanced Adenoma ◽  
Enzyme Linked Immunosorbent Assay ◽  
Fecal Occult Blood ◽  
Protein Biomarkers ◽  
Wide Range

Abstract Early diagnosis of colorectal advanced neoplasms (AN), including colorectal cancer (CRC) and advanced adenoma (AA), has positive effect on survival rate. As the first attempt, the aim of this meta-analysis was to compare the diagnostic accuracy of fecal protein biomarkers for detection of colorectal neoplasms with consideration of wide range covariates.Until Jun 10, 2021, a systematic literature search was performed on Web of Sciences, Scopus and PubMed. The diagnostic accuracies were calculated using the bivariate/hierarchical random effect model. Biomarkers were determined clinically applicable (CA) if they had area under the curves> 0.70, positive and negative likelihood ratio >2 and <0.5, respectively. A total of 47059 test results were extracted from 16 Immunochemical fecal occult blood test (iFOBT), 26 Pyruvate Kinase-M2 (PK-M2) and 23 Fecal Calprotectin (FC) studies. Only iFOBT, PK-M2 and FC for CRC plus iFOBT and PK-M2 for AN were CA. iFOBT had significantly superior accuracy (P= 0.02 versus PK-M2 and P< 0.01 versus FC for CRC; P< 0.01 versus PK-M2 for AN). Regarding covariates, lateral flow method of PK-M2 measurement increased its accuracy for CRC detection compared to enzyme-linked immunosorbent assay (P< 0.01). Briefly, iFOBT is the most accurate fecal biomarker for diagnosis of CRC and AN.

scholarly journals Predictive and Prognostic Role of Tumor Infiltrating Lymphocytes in Breast Cancer Patients With Different Molecular Subtypes: a Meta-Analysis

2020 ◽  
Author(s):  
Zhao-hua Gao ◽  
Cun-xin Li ◽  
Ming Liu ◽  
Jia-yuan Jiang
Keyword(s):  
Breast Cancer ◽  
Neoadjuvant Chemotherapy ◽  
Cancer Patients ◽  
Predictive Value ◽  
Molecular Subtypes ◽  
Molecular Subtype ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Breast Cancer Patients

Abstract Background Whether TILs plays different roles in different molecular subtypes breast cancer remains unknown. The prognostic and predictive value of TILs in different molecular subtypes breast cancer is still controversy. The aim of our meta-analysis is to assess the prognostic and predictive value of TILs in different molecular subtypes breast cancer by summarizing all relevant studies including multivariate analysis.MethodsPubMed, Embase, EBSCO, ScienceDirect, Cochrane Database and the Web of Science were comprehensively retrieved (until March 2020). Hazard ratio (HR), odds ratio (OR) and their 95% confidence intervals (CI) were used as effect measures to perform our meta-analysis. Random effect model was used. Stata software, version 15 (2017) (Stata Corp, College Station, TX, USA) was used to carried out statistical analysis. ResultsThirty-three studies including 18170 eligible breast cancer patients were analyzed. The meta-analysis showed that patients with high TILs expression were significantly correlated with increased pCR after neoadjuvant chemotherapy in HER2 enriched molecular subtype (OR = 1.137, 95% CI [1.061~1.218], p <0.001) and TNBC molecular subtype breast cancer (OR = 1.120, 95% CI [1.061~1.182], p <0.001). But, patients with high TILs expression were not significantly related to high pCR in luminal molecular subtype breast cancer after neoadjuvant chemotherapy (OR =1.154, 95% CI [0.789~1.690], p = 0.460). We carried out this meta-analysis on HR for OS and DFS to assess the prognostic value of TILs in breast cancer with different molecular subtypes more deeply. Our meta-analysis confirmed that high TILs had relationship with a significantly improved DFS in HER2 enriched molecular subtype [HR=0.940, 95%CI (0.903~0.979), p=0.003] and TNBC molecular subtype breast cancer patients [HR=0.907, 95%CI (0.862~0.954), p<0.001]. However, high TILs was not correlated with a significantly better DFS in luminal molecular subtype breast cancer patients [HR=0.998, 95%CI (0.977~1.019), p=0.840]. Furthermore, the results confirmed that high TILs had significant relationship with a better OS in HER2 enriched molecular subtype [HR=0.910, 95%CI (0.866~0.957), p <0.001] and TNBC molecular subtype breast cancer patients [HR=0.869, 95%CI (0.836~0.904), p <0.001]. Conversely, the summarized results indicated that high TILs was significantly correlated with a poor OS in luminal molecular subtype breast cancer patients [HR=1.077, 95%CI (1.016~1.141), p=0.012].ConclusionsOur meta-analysis confirms that high TILs is correlated with favourable survival and predicts pathological complete response in breast cancer patients with TNBC molecular subtypes and HER2-enriched molecular subtypes.

scholarly journals Accuracy of MSCT Coronary Angiography with 64 Row CT Scanner—Facing the Facts

2010 ◽  
Vol 4 ◽  
pp. CMC.S3864 ◽  
Author(s):  
M. Wehrschuetz ◽  
E. Wehrschuetz ◽  
H. Schuchlenz ◽  
G. Schaffler
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Angiography ◽  
Positive Predictive Value ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Diagnostic Potential ◽  
Coronary Artery Stenoses ◽  
Artery Disease ◽  
Msct Angiography

Improvements in multislice computed tomography (MSCT) angiography of the coronary vessels have enabled the minimally invasive detection of coronary artery stenoses, while quantitative coronary angiography (QCA) is the accepted reference standard for evaluation thereof. Sixteen-slice MSCT showed promising diagnostic accuracy in detecting coronary artery stenoses haemodynamically and the subsequent introduction of 64-slice scanners promised excellent and fast results for coronary artery studies. This prompted us to evaluate the diagnostic accuracy, sensitivity, specificity, and the negative und positive predictive value of 64-slice MSCT in the detection of haemodynamically significant coronary artery stenoses. Thirty-seven consecutive subjects with suspected coronary artery disease were evaluated with MSCT angiography and the results compared with QCA. All vessels were considered for the assessment of significant coronary artery stenosis (diameter reduction ≥ 50%). Thirteen patients (35%) were identified as having significant coronary artery stenoses on QCA with 6.3% (35/555) affected segments. None of the coronary segments were excluded from analysis. Overall sensitivity for classifying stenoses of 64-slice MSCT was 69%, specificity was 92%, positive predictive value was 38% and negative predictive value was 98%. The interobserver variability for detection of significant lesions had a κ-value of 0.43. Sixty-four-slice MSCT offers the diagnostic potential to detect coronary artery disease, to quantify haemodynamically significant coronary artery stenoses and to avoid unnecessary invasive coronary artery examinations.

scholarly journals Prevalence and risk factors for antibiotic utilization in Chinese children

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Shasha Guo ◽  
Qiang Sun ◽  
Xinyang Zhao ◽  
Liyan Shen ◽  
Xuemei Zhen
Keyword(s):  
Risk Factors ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Healthcare Research ◽  
Chinese Children ◽  
Rural Setting ◽  
Antibiotic Prescribing ◽  
Antibiotic Utilization ◽  
At Home

Abstract Background Antibiotic resistance poses a significant threat to public health globally. Irrational utilization of antibiotics being one of the main reasons of antibiotic resistant. Children as a special group, there's more chance of getting infected. Although most of the infection is viral in etiology, antibiotics still are the most frequently prescribed medications for children. Therefore, high use of antibiotics among children raises concern about the appropriateness of antibiotic prescribing. This systematic review aims to measuring prevalence and risk factors for antibiotic utilization in children in China. Methods English and Chinese databases were searched to identify relevant studies evaluating the prevalence and risk factors for antibiotic utilization in Chinese children (0-18 years), which were published between 2010 and July 2020. A Meta-analysis of prevalence was performed using random effect model. The Agency for Healthcare Research and Quality (AHRQ) and modified Jadad score was used to assess risk of bias of studies. In addition, we explored the risk factors of antibiotic utilization in Chinese children using qualitative analysis. Results Of 10,075 studies identified, 98 eligible studies were included after excluded duplicated studies. A total of 79 studies reported prevalence and 42 studies reported risk factors for antibiotic utilization in children. The overall prevalence of antibiotic utilization among outpatients and inpatients were 63.8% (35 studies, 95% confidence interval (CI): 55.1-72.4%), and 81.3% (41 studies, 95% CI: 77.3-85.2%), respectively. In addition, the overall prevalence of caregiver’s self-medicating of antibiotics for children at home was 37.8% (4 studies, 95% CI: 7.9-67.6%). The high prevalence of antibiotics was associated with multiple factors, while lacking of skills and knowledge in both physicians and caregivers was the most recognized risk factor, caregivers put pressure on physicians to get antibiotics and self-medicating with antibiotics at home for children also were the main factors attributed to this issue. Conclusion The prevalence of antibiotic utilization in Chinese children is heavy both in hospitals and home. It is important for government to develop more effective strategies to improve the irrational use of antibiotic, especially in rural setting.

scholarly journals A meta-analysis comparing short-term weight and cardiometabolic changes between olanzapine/samidorphan and olanzapine

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Manit Srisurapanont ◽  
Sirijit Suttajit ◽  
Surinporn Likhitsathian ◽  
Benchalak Maneeton ◽  
Narong Maneeton
Keyword(s):  
Weight Gain ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Dropout Rates ◽  
Lower Percentage ◽  
Current Evidence ◽  
Weight Changes ◽  
Short Term ◽  
Short Term Treatment

AbstractThis study compared weight and cardiometabolic changes after short-term treatment of olanzapine/samidorphan and olanzapine. Eligible criteria for an included trial were ≤ 24 weeks, randomized controlled trials (RCTs) that compared olanzapine/samidorphan and olanzapine treatments in patients/healthy volunteers and reported weight or cardiometabolic outcomes. Three databases were searched on October 31, 2020. Primary outcomes included weight changes and all-cause dropout rates. Standardized mean differences (SMDs) and risk ratios (RRs) were computed and pooled using a random-effect model. This meta-analysis included four RCTs (n = 1195). The heterogeneous data revealed that weight changes were not significantly different between olanzapine/samidorphan and olanzapine groups (4 RCTs, SDM = − 0.19, 95% CI − 0.45 to 0.07, I2 = 75%). The whole-sample, pooled RR of all-cause dropout rates (4 RCTs, RR = 1.02, 95% CI 0.84 to 1.23, I2 = 0%) was not significant different between olanzapine/samidorphan and olanzapine groups. A lower percentage of males and a lower initial body mass index were associated with the greater effect of samidorphan in preventing olanzapine-induced weight gain. Current evidence is insufficient to support the use of samidorphan to prevent olanzapine-induced weight gain and olanzapine-induced cardiometabolic abnormalities. Samidorphan is well accepted by olanzapine-treated patients.

scholarly journals Low versus high level of physical resemblance in simulation for the acquisition of basic surgical skill: a meta-analysis

2021 ◽  
pp. bmjstel-2020-000797
Author(s):  
Fabrizio Consorti ◽  
Gianmarco Panzera
Keyword(s):  
Undergraduate Students ◽  
Scoring System ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Surgical Skill ◽  
Undergraduate Medical Students ◽  
Study Selection ◽  
High Level ◽  
Physical Resemblance

BackgroundMany studies explored the use of simulation in basic surgical education, with a variety of devices, contexts and outcomes, with sometimes contradictory results.ObjectivesThe objectives of this meta-analysis were to focus the effect that the level of physical resemblance in a simulation has on the development of basic surgical skill in undergraduate medical students and to provide a foundation for the design and implementation of a simulation, with respect to its effectiveness and alignment with the learning outcomes.Study selectionWe searched PubMed and Scopus database for comparative randomised studies between simulations with a different level of resemblance. The result was synthesised as the standardised mean difference, under a random effect model.FindingsWe selected 12 out of 2091 retrieved studies, reporting on 373 undergraduate students (mean of subjects 15.54±6.89). The outcomes were the performance of simple skills and the time to complete a task. Two studies reported a scoring system; seven studies reported time for a task; and three studies reported both. The total number of measures included in the meta-analysis was 456 for score and 504 for time. The pooled effect size did not show any significant advantage in a simulation of a high level of physical resemblance over a lower level, both for the scoring system (−0.19, 95% CI −0.44 to 0.06) and for time (−0.14, 95% CI −0.54 to 0.27).ConclusionSimulations with a low level of physical resemblance showed the same effect as the simulation using a higher level of resemblance on the development of basic surgical skills in undergraduate students.

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