Metanálise do uso de redes bayesianas no diagnóstico de câncer de mama

The aim of this study was to determine the accuracy of Bayesian networks in supporting breast cancer diagnoses. Systematic review and meta-analysis were carried out, including articles and papers published between January 1990 and March 2013. We included prospective and retrospective cross-sectional studies of the accuracy of diagnoses of breast lesions (target conditions) made using Bayesian networks (index test). Four primary studies that included 1,223 breast lesions were analyzed, 89.52% (444/496) of the breast cancer cases and 6.33% (46/727) of the benign lesions were positive based on the Bayesian network analysis. The area under the curve (AUC) for the summary receiver operating characteristic curve (SROC) was 0.97, with a Q* value of 0.92. Using Bayesian networks to diagnose malignant lesions increased the pretest probability of a true positive from 40.03% to 90.05% and decreased the probability of a false negative to 6.44%. Therefore, our results demonstrated that Bayesian networks provide an accurate and non-invasive method to support breast cancer diagnosis.

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The role of serum periostin in the diagnosis of asthma: A meta-analysis

Allergy and Asthma Proceedings ◽

10.2500/aap.2020.41.200038 ◽

2020 ◽

Vol 41 (4) ◽

pp. 240-247

Author(s):

Lei Yang ◽

Qingtao Zhao ◽

Shuyu Wang

Keyword(s):

Diagnostic Accuracy ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Negative Results ◽

Noninvasive Biomarker ◽

Sensitivity Specificity ◽

Serum Periostin

Background: Serum periostin has been proposed as a noninvasive biomarker for asthma diagnosis and management. However, its accuracy for the diagnosis of asthma in different populations is not completely clear. Methods: This meta-analysis aimed to evaluate the diagnostic accuracy of periostin level in the clinical determination of asthma. Several medical literature data bases were searched for relevant studies through December 1, 2019. The numbers of patients with true-positive, false-positive, false-negative, and true-negative results for the periostin level were extracted from each individual study. We assessed the risk of bias by using Quality Assessment of Diagnostic Accuracy Studies 2. We used the meta-analysis to produce summary estimates of accuracy. Results: In total, nine studies with 1757 subjects met the inclusion criteria. The pooled estimates of sensitivity, specificity, and diagnostic odds ratios for the detection of asthma were 0.58 (95% confidence interval [CI], 0.38‐0.76), 0.86 (95% CI, 0.74‐0.93), and 8.28 (95% CI, 3.67‐18.68), respectively. The area under the summary receiver operating characteristic curve was 0.82 (95% CI, 0.79‐0.85). And significant publication bias was found in this meta‐analysis (p = 0.39). Conclusion: Serum periostin may be used for the diagnosis of asthma, with moderate diagnostic accuracy.

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Long Noncoding RNA Serve as a Potential Predictive Biomarker for Breast Cancer: A Meta-Analysis

BioMed Research International ◽

10.1155/2020/9045786 ◽

2020 ◽

Vol 2020 ◽

pp. 1-15

Author(s):

Xuefeng Jiang ◽

Guijuan Zhang ◽

Jieyan Wu ◽

Shujun Lin ◽

Yusheng Liu ◽

...

Keyword(s):

Breast Cancer ◽

Long Noncoding Rna ◽

Noncoding Rna ◽

Meta Analysis ◽

Characteristic Curve ◽

Breast Cancer Diagnosis ◽

Predictive Biomarker ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic ◽

Diagnostic Efficacy

Purpose. The detection of long noncoding RNA (lncRNA) is a novel method for breast cancer diagnosis. The purpose of this meta-analysis was to evaluate the clinical significance of lncRNAs in identification of human breast cancer. Methods. Electronic databases, including PubMed (176), EMBASE (167), Cochrane Library (4), Web of Science (273), CNKI (41), VIP (18), and wanfang (21), were searched for relevant original articles. Diagnostic capacity of lncRNAs was assessed by pooled sensitivity and specificity, area under the summary receiver operating characteristic curve (AUC), diagnostic odds ratio (DOR), and subgroup and meta-regression analysis. Stata and Meta-Disc software were used to conduct the meta-analysis. Results. 33 articles including 4500 cases were identified in our meta-analysis. lncRNAs sustained a high diagnostic efficacy; the pooled sensitivity, specificity, AUC, and DOR of lncRNAs in differentiating BC from controls were 0.74 (95% CI: 0.69-0.78), 0.78 (95% CI: 0.72-0.83), 0.82 (95% CI: 0.79-0.85), and 10.01 (95% CI: 7.13-14.06), respectively. The subgroup analysis showed that the diagnostic efficacy of lncRNAs in Asian populations was higher than that in Caucasians; lncRNAs in BC were lower than those in TNBC and were higher in plasma and serum specimens than in tissues. In addition, heterogeneity was clearly apparent but was not caused by the threshold effect. Conclusion. This meta-analysis suggested that lncRNAs might be promising biomarkers for identifying breast cancer, and its clinical application warrants further investigation.

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Usefulness of Nasal Endoscopy for Diagnosing Patients With Chronic Rhinosinusitis: A Meta-Analysis

American Journal of Rhinology and Allergy ◽

10.1177/1945892419892157 ◽

2019 ◽

Vol 34 (2) ◽

pp. 306-314

Author(s):

Do Hyun Kim ◽

Youngjun Seo ◽

Kyung Min Kim ◽

Seoungmin Lee ◽

Se Hwan Hwang

Keyword(s):

Diagnostic Accuracy ◽

Chronic Rhinosinusitis ◽

Sensitivity And Specificity ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Nasal Endoscopy ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Endoscopic Score

Background We evaluated the accuracy of nasal endoscopy in diagnosing chronic rhinosinusitis (CRS) compared with paranasal sinus computed tomography (CT). Methods Two authors independently searched the 5 databases (PubMed, SCOPUS, Embase, the Web of Science, and the Cochrane database) up to March 2019. For all included studies, we calculated correlation coefficients between the endoscopic and CT scores. We extracted data on true-positive and false-positive and true-negative and false-negative results. Methodological quality was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool (version 2). Results We included 16 observational or retrospective studies. A high correlation ( r = .8543; 95% confidence interval [CI] [0.7685–0.9401], P < .0001, I2 = 76.58%) between endoscopy and CT in terms of the diagnostic accuracy for CRS was apparent. The odds ratio (Lund–Kennedy endoscopic score ≥1) was 7.915 (95% CI [4.435–14.124]; I2 = 28.361%). The area under the summary receiver operating characteristic curve was 0.765. The sensitivity and specificity were 0.726 (95% CI [0.584–0.834]) and 0.767 (95% CI [0.685–0.849]), respectively. However, high interstudy heterogeneity was evident given the different endoscopic score thresholds used (Lund–Kennedy endoscopic score ≥1 vs 2). In a subgroup analysis of studies using a Lund–Kennedy endoscopic score threshold ≥2, the area under the summary curve was 0.881, and the sensitivity and specificity were 0.874 (95% CI [0.783–0.930]) and 0.793 (95% CI [0.366–0.962]), respectively. Conclusion Nasal endoscopy is a useful diagnostic tool; the Lund–Kennedy score was comparable with that of CT.

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Diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation: a systematic review and meta-analysis

European Heart Journal ◽

10.1093/eurheartj/ehab724.0485 ◽

2021 ◽

Vol 42 (Supplement_1) ◽

Author(s):

C Diaz-Arocutipa ◽

A.C Gonzales-Luna ◽

A Branez-Condorena ◽

A.V Hernandez

Keyword(s):

Atrial Fibrillation ◽

Diagnostic Accuracy ◽

Left Atrial ◽

Meta Analysis ◽

Characteristic Curve ◽

Left Atrial Thrombus ◽

Summary Receiver Operating Characteristic ◽

Atrial Thrombus ◽

Cross Sectional ◽

D Dimer

Abstract Background There is limited evidence on the use of biomarkers to diagnose left atrial thrombus in atrial fibrillation. Purpose We evaluated the diagnostic accuracy of D-dimer to detect left atrial thrombus in patients with atrial fibrillation. Methods We searched four electronic databases from inception to December 16, 2020 for observational studies evaluating diagnostic accuracy of D-dimer. Reference standard was left atrial thrombus detected by transesophageal echocardiography. Study quality was assessed with the QUADAS-2 tool. We performed a bivariate random-effects meta-analysis to calculate the pooled sensitivity and specificity with their 95% confidence intervals (95% CI). In addition, a summary receiver operating characteristic curve and optimal cut-off were estimated. Results Eleven cross-sectional studies involving 4380 patients were included. The mean age ranged from 49.8 to 74.1 years and 70% of patients were men. Left atrial thrombus was present in 7% of cases. In seven studies, the pooled sensitivity of D-dimer at 500 ng/mL was 53% (95% CI, 26–79%) and the pooled specificity was 92% (95% CI, 80–97%). The pooled sensitivity of age-adjusted D-dimer was 35% (95% CI, 18–57%) and the pooled specificity was 100% (95% CI, 100–100%) in two studies. The optimal cut-off was 390 ng/mL in 10 studies with a pooled sensitivity of 68% (95% CI, 44–85%) and a pooled specificity of 73% (95% CI, 54–86%). The risk of bias was low or unclear for all domains. Concerns regarding applicability were generally low for almost all studies Conclusion Our meta-analysis suggests that D-dimer has the potential to be useful to the detection of left atrial thrombus in patients with atrial fibrillation. FUNDunding Acknowledgement Type of funding sources: None.

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

Bioscience Reports ◽

10.1042/bsr20190923 ◽

2019 ◽

Vol 39 (6) ◽

Cited By ~ 4

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.

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Diagnostic Value of Contrast-Enhanced Ultrasonography With SonoVue in the Differentiation of Benign and Malignant Breast Lesions: A Meta-Analysis

Technology in Cancer Research & Treatment ◽

10.1177/1533033820971583 ◽

2020 ◽

Vol 19 ◽

pp. 153303382097158

Author(s):

Jianghao Lu ◽

Peng Zhou ◽

Chunchun Jin ◽

Lifeng Xu ◽

Xiaomin Zhu ◽

...

Keyword(s):

Receiver Operating Characteristic Curve ◽

Receiver Operating Characteristic ◽

Meta Analysis ◽

Characteristic Curve ◽

Breast Lesions ◽

Summary Receiver Operating Characteristic ◽

Contrast Enhanced ◽

Malignant Breast ◽

Contrast Enhanced Ultrasonography ◽

Receiver Operating

Purpose: A meta-analysis was conducted to evaluate the diagnostic performance of contrast-enhanced ultrasonography using the contrast agent SonoVue to differentiate benign from malignant breast lesions. Method: A comprehensive search of the literature was performed using the Embase, PubMed, and Web of Science databases to retrieve studies published before February 2020. Data were extracted, and pooled sensitivity, specificity, and diagnostic odds ratios were calculated with meta-analysis software. Heterogeneity was evaluated via the Q test and I2 statistic. Meta-regression and subgroup analyses were applied to evaluate potential sources of heterogeneity. Publication bias was assessed using the Deeks’ funnel plot asymmetry test. A summary receiver operating characteristic curve (SROC) was constructed. Results: A total of 27 studies including 5378 breast lesions subjected to CEUS examination with SonoVue were included in the meta-analysis. The pooled sensitivity and specificity values were 0.90 (95% confidence interval [CI], 0.88–0.91; inconsistency index [ I2] = 75.7%) and 0.83 (95% CI, 0.82–0.85; I2 = 91.0%), respectively. The pooled diagnostic odds ratio was 48.35% (95% CI, 31.22–74.89; I2 = 77.6%). The area under the summary receiver operating characteristic curve (AUC) was 0.9354. Meta-regression analysis revealed the region of patient residence and dose of contrast agent as potential sources of heterogeneity (P < .01). Subgroup analysis showed a higher area under the summary receiver operating characteristic curve for European and higher contrast agent dose subgroups (P < .05). Conclusion: Contrast-enhanced ultrasonography with SonoVue displays high sensitivity, specificity, and accuracy when differentiating benign from malignant breast lesions. Despite its current limitations, this technique presents a promising tool for diagnosing breast lesions in clinical practice.

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Serum CA72-4 as a biomarker in the diagnosis of colorectal cancer: A meta-analysis

Open Medicine ◽

10.1515/med-2018-0026 ◽

2018 ◽

Vol 13 (1) ◽

pp. 164-171 ◽

Cited By ~ 3

Author(s):

Han Yanqing ◽

Dong Cheng ◽

Xu Ling

Keyword(s):

Colorectal Cancer ◽

Diagnostic Performance ◽

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Negative Likelihood Ratio ◽

Diagnostic Sensitivity ◽

Published Data ◽

Summary Receiver Operating Characteristic ◽

True Negative

AbstractThe purpose of this meta-analysis was to investigate the serum CA72-4 as a biomarker in the diagnosis of colorectal cancer by pooling the open published data. Methods. An electronic search of databases Pubmed, Medline, Web of Science, Cochrane Embase CBM, and CNKI were performed by two reviewers (Han Yanqing, Dong Cheng) independently to identify the studies relevant to serum CA72-4 as a biomarker in the diagnosis of colorectal cancer. The patient number of true positive(tp), false positive(fp), false negative(fn) and true negative(tn) were extracted from each included study. The diagnostic performance of serum CA72-4 as a biomarker in the diagnosis of colorectal cancer was assessed by pooled sensitivity, specificity and hierarchical summary receiver operating characteristic curve (HSROC). All the data was pooled by MetaDiSc 1.4 and Stata/SE 11.0 statistical software. Results A total of 22 studies with 2474 colorectal patients and 1576 controls were included in the present study and meta-analysis. The combined diagnostic sensitivity and specificity were 0.50 (95%CI:0.48-0.52) and 0.86 (95%CI:0.84-0.88) for serum CA72-4 as a biomarker in the diagnosis of colorectal cancer. The pooled positive and negative likelihood ratio were 3.41(95%CI:2.57-4.53) and 0.62(0.55-0.71). The pooled area under the ROC curve (AUC) was 0.73. Deeks’funnel plot and Egger’s line regression test (p=0.49) showed no significant publication bias in the present meta-analysis. Conclusion Due toits low diagnostic sensitivity, the diagnostic performance of serum CA72-4 as a biomarker for colorectal cancer screening is limited.

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Predictive value of olfactory and taste symptoms in the diagnosis of COVID-19: A systematic review and meta-analysis

Clinical and Experimental Otorhinolaryngology ◽

10.21053/ceo.2020.02369 ◽

2021 ◽

Author(s):

Minbum Kim ◽

Do Hyun Kim ◽

So Yeon Yoon ◽

Sung Won Kim ◽

Hansol Hong ◽

...

Keyword(s):

Meta Analysis ◽

Characteristic Curve ◽

False Negative ◽

Diagnostic Value ◽

The Other ◽

Summary Receiver Operating Characteristic ◽

True Negative ◽

Predictive Values ◽

Taste Changes ◽

Patient Reported

Objectives: This study evaluated the diagnostic value of the various symptoms of COVID-19 in the screening of this disease.Methods: Two authors (working independently) comprehensively reviewed six databases (PubMed, Cochrane database, Embase, Web of Science, SCOPUS, and Google Scholar) from their dates of inception until November 2020. Patient-reported symptoms, including otolaryngologic and general symptoms, were evaluated for their predictive values in adults who underwent testing for COVID-19. True-positive, true-negative, false-positive, and false-negative data were extracted from each study. The methodological quality of included studies was evaluated using the Quality Assessment of Diagnostic Accuracy Studies tool (ver. 2). Results: Twenty-eight prospective and retrospective studies were included in the meta-analysis. The diagnostic odds ratio (DOR) of a change in olfaction and/or taste was 10.20 (95% confidence interval [CI], 8.43; 12.34). The area under the summary receiver operating characteristic curve was 0.8. Olfactory and/or taste changes had a low sensitivity (0.57, 95%CI: 0.47; 0.66) but moderate negative (0.78, 95%CI: 0.69; 0.85] and positive (0.78, 95%CI: 0.66; 0.87) predictive values and a high specificity (0.91, (95%CI: 0.83; 0.96). Olfactory and/or taste changes had a higher diagnostic value than the other otolaryngologic symptoms, a higher DOR and specificity, and a similar or higher diagnostic value than the other general symptoms. Conclusions: Among otolaryngologic symptoms, olfactory and/or taste dysfunction was the most highly associated with COVID-19 and its general symptoms and should be considered when screening for the disease.

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

Journal of International Medical Research ◽

10.1177/0300060520986708 ◽

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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Accuracy of Contrast Extravasation on Computed Tomography for Diagnosing Severe Pelvic Hemorrhage in Pelvic Trauma Patients: A Meta-Analysis

Medicina ◽

10.3390/medicina57010063 ◽

2021 ◽

Vol 57 (1) ◽

pp. 63

Author(s):

Sung Nam Moon ◽

Jung-Soo Pyo ◽

Wu Seong Kang

Keyword(s):

Computed Tomography ◽

Meta Analysis ◽

Characteristic Curve ◽

Pelvic Trauma ◽

Test Accuracy ◽

Trauma Patients ◽

Positive Finding ◽

Summary Receiver Operating Characteristic ◽

Contrast Extravasation ◽

Pelvic Hemorrhage

Background and objective: The early detection of underlying hemorrhage of pelvic trauma has been a critical issue. The aim of this study was to systematically determine the diagnostic accuracy of computed tomography (CT) for detecting severe pelvic hemorrhage. Materials and Methods: Relevant articles were obtained by searching PubMed, EMBASE, and Cochrane databases through 28 November 2020. Diagnostic test accuracy results were reviewed to obtain the sensitivity, specificity, diagnostic odds ratio, and summary receiver operating characteristic curve of CT for the diagnosis in pelvic trauma patients. The positive finding on CT was defined as the contrast extravasation. As the reference standard, severe pelvic hemorrhage was defined as an identification of bleeding at angiography or by direct inspection using laparotomy that required hemostasis by angioembolization or surgery. A subgroup analysis was performed according to the CT modality that is divided by the number of detector rows. Result: Thirteen eligible studies (29 subsets) were included in the present meta-analysis. Pooled sensitivity of CT was 0.786 [95% confidence interval (CI), 0.574–0.909], and pooled specificity was 0.944 (95% CI, 0.900–0.970). Pooled sensitivity of the 1–4 detector row group and 16–64 detector row group was 0.487 (95% CI, 0.215–0.767) and 0.915 (95% CI, 0.848–0.953), respectively. Pooled specificity of the 1–4 and 16–64 detector row groups was 0.956 (95% CI, 0.876–0.985) and 0.906 (95% CI, 0.828–0.951), respectively. Conclusion: Multi-detector CT with 16 or more detector rows has acceptable high sensitivity and specificity. Extravasation on CT indicates severe hemorrhage in patients with pelvic trauma.

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