Neutrophil-to-lymphocyte ratio predicts diagnosis and prognosis of patients with hepatocellular: A systematic review and meta-analysis

Abstract Background: Neutrophil-to-lymphocyte ratio (NLR) is one of the poor prognostic factors of Hepatocellular carcinoma (HCC) in patients. As contradictory data are seen concerning the predictive ability of NLR, a meta-analysis is performed for the determination of its prognostic value in patients with HCC in this study.Methods: We systematically searched several databases including PubMed, EMBASE, and Cochrane Library with the updated date of January 21, 2020. Pooled estimates of odds ratio (OR) and diagnostic odds ratio (DOR) were used to assess the prognostic performance of NLR in HCC patients.Results: Nine studies containing a total of 3,862 HCC patients were included. High baseline NLR was correlated with poor prognosis or recurrence significantly. The patient-based analysis of pooled estimates was as follows: sensitivity 0.68 [95% confidence interval (CI), 0.58-0.77], specificity 0.73 (95% CI, 0.61-0.82), and DOR 6.347 (95% CI, 5.450-7.391), respectively. The pooled positive likelihood ratio (PLR) and negative likelihood ratio (NLHR) were 2.5 (95% CI, 1.8-3.6) and 0.43 (95% CI, 0.33-0.57). Furthermore, the area under the curve (AUC) of summary receiver operating characteristic (SROC) reflecting the diagnostic accuracy was 0.76 (95% CI, 0.72-0.80). Results obtained from subgroup meta-analyses and overall meta-analyses were accordingly consistent with each other.Conclusions: Our findings suggested that NLR is an efficient prognostic factor for patients with HCC, especially for those from East Asian with high incidence. In the future, trails with larger sample sizes and more high-quality evidence are needed to further enhance the patient outcomes.

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The value of ultrasound in diagnosis of pneumoperitoneum in emergent or critical conditions: A meta-analysis

Hong Kong Journal of Emergency Medicine ◽

10.1177/1024907918805668 ◽

2018 ◽

Vol 26 (2) ◽

pp. 111-117 ◽

Cited By ~ 1

Author(s):

Libing Jiang ◽

Jing Wu ◽

Xia Feng

Keyword(s):

Confidence Interval ◽

Likelihood Ratio ◽

Meta Analysis ◽

Characteristic Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Abdominal Ultrasound ◽

Critical Conditions ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic

Background: Hollow organs perforation is a life-threatening condition. Early diagnosis and emergent intervention are important. Bedside ultrasound may be an alternative diagnostic tool for this condition. Objective: The aim of this study was to explore the diagnostic value of ultrasound of pneumoperitoneum in emergent or critical conditions through meta-analysis. Methods: PubMed, EMBASE, and Cochrane Library were systematically searched for potential studies. Then, two reviewers performed the processes of study selection, data extraction, and quality assessment independently. Finally, diagnostic indexes were analyzed with STATA 12.0 software (Serial No. 40120519635). Results: A total of five studies with moderate to high quality were eligible for meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio and their 95% confidence interval were 0.91 (95% confidence interval = 0.86–0.94), 0.96 (95% confidence interval = 0.75–0.99), 22.05 (95% confidence interval = 3.10–156.96), and 0.10 (95% confidence interval = 0.07–0.15), respectively. The area under the summary receiver operating characteristic curve was 0.92 (95% confidence interval = 0.90–0.94). Conclusion: Abdominal ultrasound is a useful alternative tool in diagnosing of pneumoperitoneum. However, due to limited evidence, it is not yet indicated for routine clinical use.

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Evaluation of the Diagnostic Efficacy of Xpert CT/NG for Chlamydia trachomatis and Neisseria gonorrhoeae

BioMed Research International ◽

10.1155/2020/2892734 ◽

2020 ◽

Vol 2020 ◽

pp. 1-16

Author(s):

Tian-Ao Xie ◽

Ye-Ling Liu ◽

Rui-Chun Meng ◽

Xiao-Shan Liu ◽

Ke-Ying Fang ◽

...

Keyword(s):

Chlamydia Trachomatis ◽

Neisseria Gonorrhoeae ◽

Likelihood Ratio ◽

Meta Analysis ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic ◽

Diagnostic Efficacy

Background. Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) are widely spread across the world. Asymptomatic or inconspicuous CT/NG infections are difficult to diagnose and treat. Traditional methods have the disadvantages of low detection rate, inaccurate results, and long detection time. However, Xpert CT/NG makes up for the aforementioned shortcomings and has research value and popularization significance. Methods. PubMed, Embase, Cochrane Library, and Web of Science were systematically searched, and studies were screened using Xpert CT/NG for diagnosing CT/NG. QUADAS-2 was used to evaluate the quality of the eligible studies. Then, two groups of researchers independently extracted data from these studies. Meta-analyses of sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and the area under the curve (AUC) of the summary receiver operating characteristic (SROC) curve were conducted using Meta-DiSc 1.4. Finally, Deek’s funnel plots were made using Stata 12.0 to evaluate publication bias. Results. 14 studies were identified, and 46 fourfold tables were extracted in this meta-analysis. The pooled SEN, SPE, PLR, NLR, DOR, and AUC in diagnosing CT were 0.94 (95% confidence interval (CI): 0.93–0.95), 0.99 (95% CI: 0.99–1.00), 97.17 (95% CI: 56.76–166.32), 0.07 (95% CI: 0.04–0.12), 1857.25 (95% CI: 943.78–3654.86), and 0.9960, respectively. The pooled SEN, SPE, PLR, NLR, DOR, and AUC in diagnosing NG were 0.95 (95% CI: 0.93–0.96), 1.00 (95% CI: 1.00–1.00), 278.15 (95% CI: 152.41–507.63), 0.08 (95% CI: 0.06–0.12), 4290.70 (95% CI: 2161.78–8516.16), and 0.9980, respectively. Conclusions. Xpert CT/NG had high diagnostic sensitivity and specificity for CT and NG. However, more evidence is required to confirm that Xpert CT/NG might serve as the primary method for detecting CT and NG and even the gold standard for diagnosis in the future.

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Accumulate evidence for IP-10 in diagnosing pulmonary tuberculosis

10.21203/rs.2.11284/v1 ◽

2019 ◽

Author(s):

Xia Qiu ◽

Tao Xiong ◽

Xiaojuan Su ◽

Yi Qu ◽

Long Ge ◽

...

Keyword(s):

Pulmonary Tuberculosis ◽

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Assay Method ◽

Cochrane Library ◽

Summary Receiver Operating Characteristic ◽

Sensitivity Specificity

Abstract Backgrounds Pulmonary tuberculosis (PTB) is a major health and economic burden. Accurate PTB detection is an important step to eliminating TB globally. Interferon gamma-induced protein 10 (IP-10) has been reported as a potential diagnostic marker for PTB since 2007. In this study, a meta-analysis approach was used to assess diagnostic value of IP-10 for PTB. Methods Web of Science, PubMed, the Cochrane Library, and Embase databases were searched for studies published in English up to February 2019. The pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and hierarchical summary receiver operating characteristic (HSROC) curve were estimated by a HSROC model. Results Eighteen studies including 2836 total participants met our inclusion criteria. The pooled sensitivity, specificity, PLR, and NLR of IP-10 for PTB detection were 86%, 88%, 7.00, and 0.16, respectively. The pooled DOR was 43.01, indicating a very powerful discriminatory ability of IP-10. Meta-regression showed that there was no heterogeneity with respect to TB burden, study design type, age, IP-10 assay method, IP-10 condition and HIV-infection status. Conclusions Our results showed that IP-10 is a promising marker for differentiating PTB from non-TB.

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Value of the Neutrophil-Lymphocyte Ratio in Predicting COVID-19 Severity: A Meta-analysis

Disease Markers ◽

10.1155/2021/2571912 ◽

2021 ◽

Vol 2021 ◽

pp. 1-10

Author(s):

Ying Wang ◽

Jingyi Zhao ◽

Lan Yang ◽

Junhui Hu ◽

Yinhui Yao

Keyword(s):

Likelihood Ratio ◽

Clinical Decision Making ◽

Meta Analysis ◽

Severe Disease ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Cochrane Library ◽

Neutrophil Lymphocyte Ratio ◽

Lymphocyte Ratio

Background. Coronavirus disease 2019 (COVID-19) is highly contagious and continues to spread rapidly. However, there are no simple and timely laboratory techniques to determine the severity of COVID-19. In this meta-analysis, we assessed the potential of the neutrophil-lymphocyte ratio (NLR) as an indicator of severe versus nonsevere COVID-19 cases. Methods. A search for studies on the NLR in severe and nonsevere COVID-19 cases published from January 1, 2020, to July 1, 2021, was conducted on the PubMed, EMBASE, and Cochrane Library databases. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio (DOR), and area under the curve (AUC) analyses were done on Stata 14.0 and Meta-disc 1.4 to assess the performance of the NLR. Results. Thirty studies, including 5570 patients, were analyzed. Of these, 1603 and 3967 patients had severe and nonsevere COVID-19, respectively. The overall sensitivity and specificity were 0.82 (95% confidence interval (CI), 0.77-0.87) and 0.77 (95% CI, 0.70-0.83), respectively; positive and negative correlation ratios were 3.6 (95% CI, 2.7-4.7) and 0.23 (95% CI, 0.17-0.30), respectively; DOR was 16 (95% CI, 10-24), and the AUC was 0.87 (95% CI, 0.84-0.90). Conclusion. The NLR could accurately determine the severity of COVID-19 and can be used to identify patients with severe disease to guide clinical decision-making.

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The value of glycosylated hemoglobin in the diagnosis of diabetic retinopathy: a systematic review and Meta-analysis

BMC Endocrine Disorders ◽

10.1186/s12902-021-00737-2 ◽

2021 ◽

Vol 21 (1) ◽

Author(s):

Bo Zhang ◽

Bingjie Zhang ◽

Zhulin Zhou ◽

Yutong Guo ◽

Dan Wang

Keyword(s):

Diabetic Retinopathy ◽

Likelihood Ratio ◽

Roc Curve ◽

Meta Analysis ◽

Glycosylated Hemoglobin ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Biomedical Literature ◽

Cochrane Library ◽

Clinical Value

AbstractObjectiveGlycosylated hemoglobin (HbA1c) has obvious clinical value in the diagnosis of diabetes, but the conclusions on the diagnostic value of diabetic retinopathy (DR) are not consistent. This study aims to comprehensively evaluate the accuracy of glycosylated hemoglobin in the diagnosis of diabetic retinopathy through the meta-analysis of diagnostic tests.MethodsCochrane Library, Embase, PubMed, Web of Science, China National Knowledge Infrastructure (CNKI), China Wanfang Database, Chinese Biomedical Literature Database (CBM) were searched until November, 2020. The Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool was used to assess the quality of the included studies. The pooled sensitivity, specificity, positive likelihood ratio (+LR), negative likelihood ratio (-LR), diagnostic odds ratio (DOR) and areas under the receiver operating characteristic (ROC) curve were calculated by Stata 15.0 software.ResultsAfter screening, 18 high-quality papers were included. The results of meta-analysis showed that the combined DOR = 18.19 (95% CI: 10.99–30.11), the sensitivity= 0.81 (95% CI): 0.75 ~ 0.87), specificity = 0.81 (95%CI: 0.72 ~ 0.87), +LR = 4.2 (95%CI: 2.95 ~ 6.00), −LR = 0.23 (95%CI: 0.17 ~ 0.31), and the area under the Summary ROC curve was 0.88 (95%CI: 0.85 ~ 0.90).ConclusionThe overall accuracy of HbA1cC forin diagnosing diabetic retinopathy is good. As it is more stable than blood sugar and is not affected by meals, it may be a suitable indicator for diabetic retinopathy.

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Pooled analysis of T2 Candida for rapid diagnosis of candidiasis

BMC Infectious Diseases ◽

10.1186/s12879-019-4419-z ◽

2019 ◽

Vol 19 (1) ◽

Cited By ~ 3

Author(s):

Dong-Lan Tang ◽

Xiao Chen ◽

Chang-Guo Zhu ◽

Zhong-wei Li ◽

Yong Xia ◽

...

Keyword(s):

Likelihood Ratio ◽

Web Of Science ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Pooled Analysis ◽

Current Evidence ◽

Cochrane Library ◽

Research Subjects

Abstract Background The present meta-analysis examined the diagnostic accuracy of T2 Candida for candidiasis. Methods The literature databases, such as PubMed, Embase, DVIO, Cochrane library, Web of Science, and CNKI, were searched on T2 Candida detection. Results A total of 8 articles, comprising of 2717 research subjects, were included in the study. The pooled sensitivity and specificity were 0.91 (95% confidence interval (CI): 0.88–0.94) and 0.94 95% CI: 0.93–0.95), respectively. The pooled positive likelihood ratio and negative likelihood ratio was 10.16 (95% CI: 2.75–37.50) and 0.08 (95% CI: 0.02–0.35), respectively. The combined diagnostic odds ratio is 133.65 95% CI: 17.21–1037.73), and the AUC of SROC is 0.9702 [(SE = 0.0235), Q* = 0.9201(SE = 0.0381)]. Conclusions The current evidence supported that T2 Candida has high accuracy and sensitivity and is of major clinical significance in the diagnosis of Candida infection.

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Systematic Review and Meta-Analysis of the Utility of Circular RNAs as Biomarkers of Hepatocellular Carcinoma

Canadian Journal of Gastroenterology and Hepatology ◽

10.1155/2019/1684039 ◽

2019 ◽

Vol 2019 ◽

pp. 1-13 ◽

Cited By ~ 2

Author(s):

Qingqin Hao ◽

Yadi Han ◽

Wei Xia ◽

Qinghui Wang ◽

Huizhong Qian

Keyword(s):

Likelihood Ratio ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Clinicopathological Characteristics ◽

Cochrane Library ◽

Circular Rnas ◽

Clinical Value ◽

Sensitivity Specificity

Emerging studies have reported circRNAs were dysregulated in HCC. However, the clinical value of these circRNAs remains to be clarified. Herein, we aimed to comprehensively explore their association with the diagnosis, prognosis, and clinicopathological characteristics of HCC. PubMed, EMBASE, Web of Science, and Cochrane Library databases were comprehensively searched for eligible studies up to October 30, 2018. The diagnostic effect was evaluated by the pooled sensitivity, specificity, and other indexes. The pooled hazard ratio (HR) for overall survival (OS) and recurrence free survival (RFS) was calculated to assess the prognostic value. Ten studies on diagnosis, 12 on prognosis, and 23 on clinicopathology were identified from the databases. A total of 11 upregulated and 11 downregulated circRNAs showed an association with clinicopathological features of HCC. For the diagnosis analyses, the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) of circRNAs for HCC were 0.74 (95%CI: 0.65-0.82) and 0.76 (95%CI: 0.70-0.81), 3.1 (95%CI: 2.5-3.8), 0.34 (95%CI: 0.25-0.47), and 9 (95%CI: 6-14), respectively. The area under SROC curve (AUC) was 0.81 (95% CI: 0.78–0.84), indicating moderate diagnostic accuracy. In stratified analyses, the diagnostic performance of circRNAs varied based on the source of control and specimen type. For the prognosis analyses, increased expression of upregulated circRNAs was associated with worse OS (HR: 3.67, 95%: 2.07-6.48), while high expression of downregulated circRNAs was associated with better OS (HR: 0.38, 95%: 0.30-0.48). In conclusion, this study reveals that circRNAs may serve as promising diagnostic and prognostic biomarkers for HCC. However, further investigations are still required to explore the clinical value of circRNAs.

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Prognostic Value of N-terminal Probrain Natriuretic Peptide for Patients with Acute Respiratory Distress Syndrome: A Systematic Review and Meta-Analysis

BioMed Research International ◽

10.1155/2020/3472615 ◽

2020 ◽

Vol 2020 ◽

pp. 1-9

Author(s):

Qi Ni ◽

Chaoqian Li ◽

Hua Lin

Keyword(s):

Systematic Review ◽

Acute Respiratory Distress Syndrome ◽

Likelihood Ratio ◽

Odds Ratio ◽

Distress Syndrome ◽

Meta Analysis ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Diagnostic Odds Ratio ◽

Sensitivity Specificity

Objectives. The mortality rate of patients with acute respiratory distress syndrome (ARDS) is high. Hence, it is crucial to identify a reliable biomarker with wide clinical applications for predicting the prognosis of patients with ARDS. This systematic review and meta-analysis was conducted to investigate the value of plasma N-terminal probrain natriuretic peptide (NT-proBNP) for predicting mortality in patients with ARDS. Methods. An electronic search of databases including PubMed, Web of Science, Cochrane Library, and Chinese National Knowledge Infrastructure was conducted up to May 31, 2019, without language restrictions. The quality of the included studies was evaluated using QUADAS-2. Data were extracted and analyzed to obtain pooled estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio. A forest graph was used to evaluate heterogeneity. Potential causes of heterogeneity were further explored by subgroup analysis based on the testing day, testing method, observation endpoint, or cut-off points. A summary receiver operating characteristic curve was drawn to obtain the pooled area under the curve. Results. A total of 7 studies involving 581 patients with ARDS were included. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were as follows: 0.79 (95% CI: 0.72–0.84), 0.79 (95% CI: 0.66–0.88), 3.68 (95% CI: 2.16–6.28), 0.27 (95% CI: 0.20–0.38), and 13.58 (95% CI: 6.17–29.90), respectively. The results of subgroup analysis showed that the testing day influenced the summary sensitivity and that the cut-off points influenced the summary sensitivity and specificity. Conclusion. Our results indicate that elevated plasma NT-proBNP levels have a moderate value for predicting the mortality of patients with ARDS.

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Diagnostic Value of T-SPOT.TB Assay for Tuberculous Peritonitis: A Meta-Analysis

Frontiers in Medicine ◽

10.3389/fmed.2020.585180 ◽

2020 ◽

Vol 7 ◽

Author(s):

Ying Luo ◽

Ying Xue ◽

Liyan Mao ◽

Qun Lin ◽

Guoxing Tang ◽

...

Keyword(s):

Likelihood Ratio ◽

Meta Analysis ◽

Characteristic Curve ◽

Area Under The Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Abdominal Tuberculosis ◽

Tuberculous Peritonitis ◽

Summary Receiver Operating Characteristic ◽

Sensitivity Specificity

Background: Tuberculous peritonitis (TP) is a common form of abdominal tuberculosis (TB). Diagnosing TP remains challenging in clinical practice. The aim of the present meta-analysis was to evaluate the diagnostic accuracy of peripheral blood (PB) T-SPOT and peritoneal fluid (PF) T-SPOT for diagnosing TP.Methods: PubMed, EmBase, Cochrane, Scopus, Google scholar, China national knowledge internet, and Wan-Fang databases were searched for relevant articles from August 1, 2005 to July 5, 2020. Statistical analysis was performed using Stata, Revman, and Meta-Disc software. Diagnostic parameters including pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR) were determined. Summary receiver operating characteristic curve was used to determine the area under the curve (AUC).Results: Twelve studies were eligible and included in the meta-analysis. The analysis showed that the pooled sensitivity and specificity of PB T-SPOT in diagnosing TP were 0.91 (95% CI, 0.88–0.94) and 0.78 (95% CI, 0.73–0.81), respectively, while the pooled PLR, NLR, and DOR were 4.05 (95% CI, 2.73–6.01), 0.13 (95% CI, 0.07–0.23), and 37.8 (95% CI, 15.04–94.98), respectively. On the other hand, the summary estimates of sensitivity, specificity, PLR, NLR, and DOR of PF T-SPOT for TP diagnosis were 0.90 (95% CI, 0.85–0.94), 0.78 (95% CI, 0.72–0.83), 6.35 (95% CI, 2.67–15.07), 0.14 (95% CI, 0.09–0.21), and 58.22 (95% CI, 28.76–117.83), respectively. Furthermore, the AUC of PB T-SPOT and PF T-SPOT for TP diagnosis were 0.91 and 0.94, respectively.Conclusions: Our results indicate that both PB T-SPOT and PF T-SPOT can be served as sensitive approaches for the diagnosis of TP. However, the unsatisfactory specificities of these two methods limit their application as rule-in tests for TP diagnosis. Furthermore, the standardization of the operating procedure of PF T-SPOT is further needed.

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The Diagnostic Accuracy of HE4 in Lung Cancer: A Meta-Analysis

Disease Markers ◽

10.1155/2015/352670 ◽

2015 ◽

Vol 2015 ◽

pp. 1-7 ◽

Cited By ~ 8

Author(s):

Daye Cheng ◽

Ying Sun ◽

Hu He

Keyword(s):

Lung Cancer ◽

Diagnostic Accuracy ◽

Likelihood Ratio ◽

Meta Analysis ◽

Characteristic Curve ◽

Positive Likelihood Ratio ◽

Negative Likelihood Ratio ◽

Large Sample Size ◽

Summary Receiver Operating Characteristic ◽

Diagnosis Of Lung Cancer

The diagnostic value of serum HE4 in patients with lung cancer remains controversial. Thus, we performed a systematic review and meta-analysis to assess the diagnostic accuracy of serum HE4 for lung cancer. We conducted a comprehensive literature search in PubMed, EMBASE, Chinese National Knowledge Infrastructure (CNKI), and WANFANG databases between Jan. 1966 and Nov. 2014. The diagnostic sensitivity (SEN), specificity (SPE), positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and summary receiver operating characteristic curve (SROC) were pooled by Meta-DiSc 1.4 software. A total of seven articles including 715 cases and 549 controls were included for analysis. The summary estimates for serum HE4 in the diagnosis of lung cancer in these studies were pooled SEN 0.72 (95% CI: 0.68–0.75), SPE 0.85 (95% CI: 0.81–0.88), PLR 4.68 (95% CI: 3.23–6.78), NLR 0.31 (95% CI: 0.24–0.39), and DOR 17.14 (95% CI: 9.72–30.20), and the area under the curve (AUC) was 0.8557. This meta-analysis indicated that serum HE4 is a potential tool in the diagnosis of lung cancer. In addition, considering the high heterogeneity and potential publication bias, further studies with rigorous design and large sample size are needed in the future.

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