scholarly journals Diagnostic Test Accuracy of First-Void Urine Human Papillomaviruses for Presence Cervical HPV in Women: Systematic Review and Meta-Analysis

2021 ◽  
Vol 18 (24) ◽  
pp. 13314
Author(s):  
Peter Bober ◽  
Peter Firment ◽  
Ján Sabo
Keyword(s):  
Patient Selection ◽  
Storage Temperature ◽  
Meta Analysis ◽  
Selection Index ◽  
Human Papillomaviruses ◽  
Cochrane Library ◽  
Screening Methods ◽  
Published Data ◽  
Test Accuracy ◽  
Index Test

First-void urine usually contains exfoliated cells of the debris and mucus from the female genital organs and cervix, i.e., high concentration of human papillomavirus deoxyribonucleic acid (HPV DNA). We conducted a meta-analysis of published data and determined an accuracy of HPV detection in first-void urine compared to the women’s cervix. According to Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, we carried out a comprehensive literature search. Eligible articles published from 2011 until 2021 were gathered by searching Embase, PubMed and Cochrane Library Central databases. The patient selection, index test, standard test, and patient flow were the factors involved in quality evaluation. A meta-analysis of 15 studies (3412 women) based on 5054 potential records was conducted. Pooled sensitivity for high-risk HPV detection in urine of 78% (70–84%) and specificity of 89% (81–94%) were calculated. Any HPV detection in urine of 87% (74–94%) and 91% (83–96%) were pooled sensitivity and specificity, respectively. HPV 16 and 18 had a pooled sensitivity of 77% (76–77%) and specificity of 98% (98–98%). Meta-analysis indicated variations between the pooled specificities and sensitivities. In meta-regression analysis, a heterogeneity in accuracy by using covariates (bias in patient selection, purpose, sample timing, storage temperature and HPV detection method) were not detected. Our meta-analysis demonstrates the accuracy of detection of HPV in urine for the presence of cervical HPV. Although progress is continuously made in urinary HPV detection, further studies are needed to evaluate and to improve the accuracy of the first-void urine test in order to be comparable with other screening methods.

scholarly journals Better survival of patients with oligo- compared with polymetastatic cancers:  a systematic review and meta-analysis of 173 studies

F1000Research ◽  
2021 ◽  
Vol 10 ◽  
pp. 423
Author(s):  
Fausto Petrelli ◽  
Antonio Ghidini ◽  
Michele Ghidini ◽  
Roberta Bukovec ◽  
Francesca Trevisan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Stage Iv ◽  
Progression Free Survival ◽  
Hazard Ratio ◽  
Modern Concept ◽  
Cochrane Library ◽  
Published Data ◽  
Risk Of Death ◽  
Personalized Approach ◽  
The Cochrane Library

Background: The modern concept of oligometastatic (OM) state has been initially developed to describe patients with a low burden of disease and with a potential for cure with local ablative treatments. We systematically assessed the risk of death and relapse of oligometastatic (OM) cancers compared to cancers with more diffuse metastatic spread, through a meta-analysis of published data.  Methods: PubMed, the Cochrane Library, and EMBASE were searched for studies reporting prognosis of patients with OM solid tumors. Risk of death and relapse were extracted and pooled to provide an adjusted hazard ratio with a 95% confidence interval (HR 95%CI).  The primary outcome of the study refers to overall mortality in OM vs. polymetastatic (PM) patients.  Results. Mortality and relapse associated with OM state in patients with cancer were evaluated among 104,234 participants (n=173 studies). Progression-free survival was better in patients with OM disease (hazard ratio [HR] = 0.62, 95% CI 0.57–0.68; P <.001; n=69 studies). Also, OM cancers were associated with a better overall survival (OS) (HR = 0.65, 95% CI 0.62-0.68; P<.01; n=161 studies). In colorectal (CRC), breast, non-small cell lung cancer (NSCLC) and renal cell carcinoma (RCC) the reduction in the risk of death for OM patients were 35, 38, 30 and 42%, respectively. Biliary tract and cervical cancer do not significantly better in OM stage likely for paucity of data. Conclusions. Patients with OM cancers have a significantly better prognosis than those with more widespread stage IV tumors. In OM cancer patients a personalized approach should be pursued.

scholarly journals The diagnostic accuracy of isothermal nucleic acid point-of-care tests for human coronaviruses: A systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Pakpoom Subsoontorn ◽  
Manupat Lohitnavy ◽  
Chuenjid Kongkaew
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Test ◽  
Point Of Care ◽  
Meta Analysis ◽  
Isothermal Amplification ◽  
Diagnostic Test Accuracy ◽  
Test Accuracy ◽  
Index Test ◽  
Point Of Care Tests

AbstractMany recent studies reported coronavirus point-of-care tests (POCTs) based on isothermal amplification. However, the performances of these tests have not been systematically evaluated. Cochrane Handbook for Systematic Reviews of Diagnostic Test Accuracy was used as a guideline for conducting this systematic review. We searched peer-reviewed and preprint articles in PubMed, BioRxiv and MedRxiv up to 28 September 2020 to identify studies that provide data to calculate sensitivity, specificity and diagnostic odds ratio (DOR). Quality Assessment of Diagnostic Accuracy Studies 2 (QUADAS-2) was applied for assessing quality of included studies and Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies (PRISMA-DTA) was followed for reporting. We included 81 studies from 65 research articles on POCTs of SARS, MERS and COVID-19. Most studies had high risk of patient selection and index test bias but low risk in other domains. Diagnostic specificities were high (> 0.95) for included studies while sensitivities varied depending on type of assays and sample used. Most studies (n = 51) used reverse transcription loop-mediated isothermal amplification (RT-LAMP) to diagnose coronaviruses. RT-LAMP of RNA purified from COVID-19 patient samples had pooled sensitivity at 0.94 (95% CI: 0.90–0.96). RT-LAMP of crude samples had substantially lower sensitivity at 0.78 (95% CI: 0.65–0.87). Abbott ID Now performance was similar to RT-LAMP of crude samples. Diagnostic performances by CRISPR and RT-LAMP on purified RNA were similar. Other diagnostic platforms including RT- recombinase assisted amplification (RT-RAA) and SAMBA-II also offered high sensitivity (> 0.95). Future studies should focus on the use of un-bias patient cohorts, double-blinded index test and detection assays that do not require RNA extraction.

scholarly journals Prognostic Role of miR-221 and miR-222 Expression in Cancer Patients: A Systematic Review and Meta-Analysis

Cancers ◽  
2019 ◽  
Vol 11 (7) ◽  
pp. 970 ◽  
Author(s):  
Gloria Ravegnini ◽  
Sarah Cargnin ◽  
Giulia Sammarini ◽  
Federica Zanotti ◽  
Justo Lorenzo Bermejo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Cancer Patients ◽  
Meta Analysis ◽  
Fine Tuning ◽  
High Expression ◽  
Cochrane Library ◽  
Published Data ◽  
Significant Heterogeneity ◽  
Free Survival

Background: A wealth of evidence has shown that microRNAs (miRNAs) can modulate specific genes, increasing our knowledge on the fine-tuning regulation of protein expression. miR-221 and miR-222 have been frequently identified as deregulated across different cancer types; however, their prognostic significance in cancer remains controversial. In view of these considerations, we performed an updated systematic review and meta-analysis of published data investigating the effects of miR-221/222 on overall survival (OS) and other secondary outcomes among cancer patients. A systematic search of PubMed, Web of Knowledge, and Cochrane Library databases was performed. Hazard ratios (HRs) and 95% confidence intervals (95% CIs) were used to assess the strength of association. Results: Fifty studies, analyzing 6086 patients, were included in the systematic review. Twenty-five studies for miR-221 and 17 studies for miR-222 which assessed OS were included in the meta-analysis. High expression of miR-221 and miR-222 significantly predicted poor OS (HR: 1.48, 95% CI: 1.14–1.93, p = 0.003 and HR: 1.90, 95% CI: 1.43–2.54, p < 0.001, respectively). Subgroup analysis revealed that the finding on miR-221 was not as robust as the one on miR-222. Furthermore, high miR-222 expression was also associated with worse progression-free survival and disease-free survival pooled with recurrence-free survival. Conclusions: The meta-analysis demonstrated that high expression of miR-222 is associated with poor prognosis in cancer patients, whereas the significance of miR-221 remains unclear. More work is required to fully elucidate the role of miR-221 and miR-222 in cancer prognosis, particularly in view of the limitations of existing results, including the significant heterogeneity and limited number of studies for some cancers.

Simultaneous compared to interval administration of mifepristone and misoprostol for medical abortion up to 10+0 weeks' gestation: a systematic review with meta-analyses

2020 ◽  
pp. bmjsrh-2019-200448
Author(s):  
Mia Schmidt-Hansen ◽  
Jonathan Lord ◽  
Elise Hasler ◽  
Sharon Cameron
Keyword(s):  
Systematic Review ◽  
Meta Analysis ◽  
Cochrane Collaboration ◽  
Medical Abortion ◽  
Cochrane Library ◽  
Published Data ◽  
Study Results ◽  
Randomised Controlled ◽  
Meta Analyses

BackgroundMedical abortion with mifepristone and misoprostol usually involves an interval of 36–48 hours between administering these drugs; however, it is possible that the clinical efficacy at early gestations may be maintained when the drugs are taken simultaneously. The objective of this systematic review was to determine the safety and effectiveness of simultaneous compared with interval administration of mifepristone and misoprostol for abortion up to 10+0 weeks’ gestation.MethodsWe searched Embase Classic, Embase; Ovid MEDLINE(R) including Daily, and Epub Ahead-of-Print, In-Process & Other Non-Indexed Citations; and Cochrane Library on 11 December 2019. We included randomised controlled trials (RCTs), published in English from 1985, comparing simultaneous to interval administration of mifepristone and misoprostol for early abortion. Risk of bias was assessed using the Cochrane Collaboration checklist for RCTs. Meta-analysis of risk ratios (RRs) using the Mantel-Haenszel method were performed. The quality of the evidence was assessed using GRADE.ResultsMeta-analyses of three RCTs (n=1280) showed no differences in ‘ongoing pregnancy’ (RR 1.78, 95% CI 0.38 to 8.36), ‘haemorrhage requiring transfusion or ≥500 mL blood loss’ (RR 0.11, 95% CI 0.01 to 2.03) and ‘incomplete abortion with the need for surgical intervention’ (RR 1.30, 95% CI 0.76 to 2.25) between the interventions. Individual study results showed no difference in patient satisfaction, or ‘need for repeat misoprostol’, although ‘time to onset of bleeding or cramping’ was longer after simultaneous than interval administration. The quality of evidence was very low to moderate.ConclusionThe published data support the use of simultaneous mifepristone and misoprostol for medical abortion up to 9+0 weeks in women who prefer this method of administration.

scholarly journals Weight loss as a predictor of cancer in primary care: a systematic review and meta-analysis

2018 ◽  
Vol 68 (670) ◽  
pp. e311-e322 ◽  
Author(s):  
Brian D Nicholson ◽  
William Hamilton ◽  
Jack O’Sullivan ◽  
Paul Aveyard ◽  
FD Richard Hobbs
Keyword(s):  
Primary Care ◽  
Weight Loss ◽  
Meta Analysis ◽  
Age Groups ◽  
Biliary Tree ◽  
Clinical Feature ◽  
Test Accuracy ◽  
Index Test ◽  
Likelihood Ratios ◽  
Predictive Values

BackgroundWeight loss is a non-specific cancer symptom for which there are no clinical guidelines about investigation in primary care.AimTo summarise the available evidence on weight loss as a clinical feature of cancer in patients presenting to primary care.Design and settingA diagnostic test accuracy review and meta-analysis.MethodStudies reporting 2 × 2 diagnostic accuracy data for weight loss (index test) in adults presenting to primary care and a subsequent diagnosis of cancer (reference standard) were included. QUADAS-2 was used to assess study quality. Sensitivity, specificity, positive likelihood ratios, and positive predictive values were calculated, and a bivariate meta-analysis performed.ResultsA total of 25 studies were included, with 23 (92%) using primary care records. Of these, 20 (80%) defined weight loss as a physician’s coding of the symptom; the remainder collected data directly. One defined unexplained weight loss using objective measurements. Positive associations between weight loss and cancer were found for 10 cancer sites: prostate, colorectal, lung, gastro-oesophageal, pancreatic, non-Hodgkin’s lymphoma, ovarian, myeloma, renal tract, and biliary tree. Sensitivity ranged from 2% to 47%, and specificity from 92% to 99%, across cancer sites. The positive predictive value for cancer in male and female patients with weight loss for all age groups ≥60 years exceeded the 3% risk threshold that current UK guidance proposes for further investigation.ConclusionA primary care clinician’s decision to code for weight loss is highly predictive of cancer. For such patients, urgent referral pathways are justified to investigate for cancer across multiple sites.

scholarly journals The Associations between VEGF Gene Polymorphisms and Diabetic Retinopathy Susceptibility: A Meta-Analysis of 11 Case-Control Studies

2014 ◽  
Vol 2014 ◽  
pp. 1-10 ◽  
Author(s):  
Liyuan Han ◽  
Lina Zhang ◽  
Wenhua Xing ◽  
Renjie Zhuo ◽  
XiaLu Lin ◽  
...  
Keyword(s):  
Diabetic Retinopathy ◽  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Recessive Model ◽  
Cochrane Library ◽  
Published Data ◽  
Case Control Studies ◽  
Asian Populations ◽  
Effect Model

Aims. Published data on the associations of VEGF polymorphisms with diabetic retinopathy (DR) susceptibility are inconclusive. A systematic meta-analysis was undertaken to clarify this topic.Methods. Data were collected from the following electronic databases: PubMed, Embase, OVID, Web of Science, Elsevier Science Direct, Excerpta Medica Database (EMBASE), and Cochrane Library with the last report up to January 10, 2014. ORs and 95% CIs were calculated for VEGF–2578C/A (rs699947), –1154G/A (rs1570360), –460T/C (rs833061), −634G>C (rs2010963), and +936C/T (rs3025039) in at least two published studies. Meta-analysis was performed in a fixed/random effect model by using the software STATA 12.0.Results. A total of 11 studies fulfilling the inclusion criteria were included in this meta-analysis. A significant relationship between VEGF+936C/T (rs3025039) polymorphism and DR was found in a recessive model (OR = 3.19, 95% CI = 1.20–8.41, andP(z)=0.01) in Asian and overall populations, while a significant association was also found between –460T/C (rs833061) polymorphism and DR risk under a recessive model (OR = 2.12, 95% CI = 1.12–4.01, andP(z)=0.02).Conclusions. Our meta-analysis demonstrates that +936C/T (rs3025039) is likely to be associated with susceptibility to DR in Asian populations, and the recessive model of –460T/C (rs833061) is associated with elevated DR susceptibility.

scholarly journals Detecting Melanoma Antigen Family A3 Expression in Solid/Non-Solid Human Tumor

2020 ◽  
Author(s):  
Haoran Jiang ◽  
Lihao Zhao ◽  
Han Yang ◽  
Mengjing Zhao ◽  
Yuxia Duan ◽  
...  
Keyword(s):  
Meta Analysis ◽  
Random Effect ◽  
Random Effect Model ◽  
Human Tumor ◽  
Squamous Carcinoma ◽  
Cochrane Library ◽  
Published Data ◽  
Melanoma Antigen ◽  
Effect Model ◽  
Positive Rate

Abstract Background: MAGEA3 is a member of melanoma antigen family and has been recognized to express in many types of human cancers recently. In spite of the development of cancer vaccine, the prognostic value of MAGEA3 has not been well evaluated, due to the variability of clinical data and lack of clinical trials on the prognostic values.Method: Studies that evaluated MAGEA3 expression with a follow-up for at least 36 months were selected by searching in PubMed, WOS, Cochrane library, Embase. Published data was recorded and calculated into odds ratios (OR) for mortality in three or five years with Mantel-Haenszel random-effect model. Results: 11 studies were selected. The median positive rate was 45%. MAGEA3 always combines with worse survival on three or five years survival. The correlation between MAGEA3 and squamous carcinoma seemed stronger than adenocarcinoma on three-year OS while things got a reverse when it came to five-year OS. Most importantly, we found that all solid tumors originated from endoderm seemed to enjoy a strongest correlation among all the three germ layers.Conclusion: In this meta-analysis, we found that the expression of MAGEA3 can connect with worse outcome, and it probably can be a predictor for patients’ prognosis in clinical practice.

scholarly journals Anti-DFS70 Antibodies for Differentiating Systemic Autoimmune Rheumatic Disease in Patients with Positive ANA Tests: A Systematic Review and Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (9) ◽  
pp. 1592
Author(s):  
Chiao-Feng Cheng ◽  
Ming-Chieh Shih ◽  
Ting-Yuan Lan ◽  
Ko-Jen Li
Keyword(s):  
Confidence Interval ◽  
Rheumatic Disease ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Test Accuracy ◽  
Summary Receiver Operating Characteristic ◽  
Bivariate Model ◽  
Autoimmune Rheumatic Disease ◽  
Systemic Autoimmune Rheumatic Disease ◽  
Test Result

Anti-DFS70 antibodies have been proposed as a marker to exclude systemic autoimmune rheumatic disease (SARD). We conducted this systematic diagnostic test accuracy review and meta-analysis to determine the performance of anti-DFS70 antibodies in patients with a positive anti-nuclear antibody (ANA) test result to exclude SARD. We searched PubMed, Embase, Web of Science, Scopus and the Cochrane Library up to 22 February 2021, and included studies examining the diagnostic accuracy of anti-DFS70 antibodies in patients with a positive ANA test result. The results were pooled using a hierarchical bivariate model and plotted in summary receiver operating characteristic curves. R software and Stata Statistical Software were used for the statistical analysis. Eight studies with 4168 patients were included. The summary sensitivity was 0.19 (95% confidence interval: 0.12–0.28) and the specificity was 0.93 (95% confidence interval: 0.88–0.96). The area under the curve was 0.69 (95% confidence interval: 0.64–0.72). The meta-regression analysis showed that targeting only ANA-associated rheumatic disease was associated with higher specificity. In addition, the studies with a non-SARD prevalence of <80% and using a chemiluminescence assay were associated with higher specificity. Anti-DFS70 antibodies have high specificity for the exclusion of SARD among patients presenting with a positive ANA test, but the sensitivity is low.

scholarly journals The association of MTHFR A1298C polymorphism with cervical cancer: An Updated Meta-Analysis Involving 2835 Subjects

2020 ◽  
Author(s):  
Chunyan Mu ◽  
Zhongcheng Wang ◽  
Yue Wang ◽  
Ying Li ◽  
Bing Gu ◽  
...  
Keyword(s):  
Cervical Cancer ◽  
Fixed Effects ◽  
Cancer Susceptibility ◽  
Meta Analysis ◽  
Recessive Model ◽  
Cochrane Library ◽  
Published Data ◽  
Mthfr A1298c ◽  
Increased Risk ◽  
A1298c Polymorphism

Abstract Background Published data have reported the relationships between MTHFR A1298C polymorphisms and cervical cancer susceptibility. However, the conclusions of these findings lack consistency.Methods A comprehensive literature search was performed using Web of Science, PubMed, EMBASE, Cochrane library, Wan Fang and CNKI databases. The pooled odds ratios (ORs) with 95% confidence intervals (CIs) were used to evaluate the correlation of MTHFR A1298C polymorphism and cervical cancer risk. Fixed-effects or random effects models was adopted according to heterogeneity test.Results A total of nine studies (1145 cases and 1690 controls) were included in this meta-analysis. Pooled data revealed that MTHFR A1298C polymorphism was significantly associated with an increased risk of cervical cancer in the allele model (P=0.028); the recessive model (P=0.028); and the heterozygous model (P=0.031).Conclusions Our results revealed that MTHFR A1298C polymorphism was associated with risk of cervical cancer.

scholarly journals Immunonutrition for traumatic brain injury in children and adolescents: protocol for a systematic review and meta-analysis

BMJ Open ◽  
2020 ◽  
Vol 10 (9) ◽  
pp. e037014
Author(s):  
Rong Peng ◽  
Hailong Li ◽  
Lijun Yang ◽  
Xinwei Chen ◽  
Linan Zeng ◽  
...  
Keyword(s):  
Systematic Review ◽  
Traumatic Brain Injury ◽  
Brain Injury ◽  
Evaluation Method ◽  
Clinical Decision Making ◽  
Meta Analysis ◽  
Risk Of Bias ◽  
Cochrane Library ◽  
Published Data ◽  
Pool Data

IntroductionTraumatic brain injury (TBI) is the leading cause of paediatric trauma death and disability worldwide. The ‘Guidelines for the Management of Severe Traumatic Brain Injury (Fourth Edition)’ recommend that nutritional goals should be achieved within 5–7 days of injury. Immune-enhancing nutrition or immunonutrition, referring to the addition of specialised nutrients, including glutamine, alanine, omega-3 fatty acids and nucleotides, to standard nutrition formulas, may improve surgical outcomes in the perioperative period. However, the role of immune-enhancing nutritional supplements for patients with paediatric TBI remains unclear. We will conduct a systematic review to determine the efficacy and safety of immunonutrition for patients with paediatric TBI and provide evidence for clinical decision-making.Methods and analysisStudies reporting immune-enhancing nutrition treatments for patients with paediatric TBI will be included. Outcomes of interest include the length of hospital stay, wound infections, all-cause mortality, non-wound infection, including pneumonia, urinary tract infection and bacteraemia, and the reports adverse events. Duration of follow-up has no restriction. Primary studies consisting of randomised controlled trials (RCTs) and non-RCTs will be eligible for this review, and only studies published in English will be included. We will search the Medline, Embase and Cochrane Library databases from their inception dates to January 2020. We will also search clinicaltrials.gov and the WHO International Clinical Trials Registry Platform for additional information. Two reviewers will independently select studies and extract data. Risk-of-bias will be assessed with tools based on the Cochrane risk-of-bias criteria and Newcastle-Ottawa Quality Assessment Scale. A meta-analysis will be used to pool data when there are sufficient studies with homogeneity. Heterogeneity of the estimates across studies will be assessed; if necessary, a subgroup analysis will be performed to explore the source of heterogeneity. The Grades of Recommendation, Assessment, Development and Evaluation method will be applied to assess the level of evidence obtained from this systematic review.Ethics and disseminationThe proposed systematic review and meta-analysis will be based on published data, and thus ethical approval is not required. The results of this review will be published.PROSPERO registration numberCRD42020154814.

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