Diagnostic Accuracy of Imaging Findings in Pleural Empyema: Systematic Review and Meta-Analysis

Computed tomography (CT) diagnosis of empyema is challenging because current literature features multiple overlapping pleural findings. We aimed to identify informative findings for structured reporting. The screening according to inclusion criteria (P: Pleural empyema, I: CT C: culture/gram-stain/pathology/pus, O: Diagnostic accuracy measures), data extraction, and risk of bias assessment of studies published between 01-1980 and 10-2021 on Pubmed, Embase, and Web of Science (WOS) were performed independently by two reviewers. CT findings with pooled diagnostic odds ratios (DOR) with 95% confidence intervals, not including 1, were considered as informative. Summary estimates of diagnostic accuracy for CT findings were calculated by using a bivariate random-effects model and heterogeneity sources were evaluated. Ten studies with a total of 252 patients with and 846 without empyema were included. From 119 overlapping descriptors, five informative CT findings were identified: Pleural enhancement, thickening, loculation, fat thickening, and fat stranding with an AUC of 0.80 (hierarchical summary receiver operating characteristic, HSROC). Potential sources of heterogeneity were different thresholds, empyema prevalence, and study year.

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Performance of Antibodies against Tissue Transglutaminase for the Diagnosis of Celiac Disease: Meta-Analysis

Clinical and Vaccine Immunology ◽

10.1128/cvi.13.2.187-192.2006 ◽

2006 ◽

Vol 13 (2) ◽

pp. 187-192 ◽

Cited By ~ 37

Author(s):

Elias Zintzaras ◽

Anastasios E. Germenis

Keyword(s):

Sensitivity Analysis ◽

Celiac Disease ◽

Guinea Pig ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Operating Characteristic ◽

Tissue Transglutaminase ◽

Meta Analysis ◽

Summary Receiver Operating Characteristic ◽

Screening Sensitivity

ABSTRACT A meta-analysis of studies investigating the diagnostic accuracy of enzyme-linked immunosorbent assays (ELISA) for antibodies against tissue transglutaminases (tTG) of various origins in celiac disease (CD) diagnosis was carried out. Twenty-one studies, with untreated CD patients and healthy/CD-free controls, were included in the meta-analysis. The diagnostic accuracy was estimated using a summary receiver operating characteristic (SROC) curve and pooled sensitivity (Se) and specificity (Sp). Multiple assays within a study were treated by considering all the assays within a study and by analyzing the most popular assay (i.e., the commercial anti-tTTG ELISA most frequently utilized in the papers in which multiple assays were included). The SROC curve indicated the absence of heterogeneity, and the superiority of recombinant human tTG (rh-tTG) and purified human tTG (ph-tTG) compared to guinea pig-tTG (gp-tTG). The sensitivities (most popular assay) for rh-tTG, ph-tTG, and gp-tTG were 94%, 90%, and 92%, respectively, and the specificities were 97%, 92%, and 96%, respectively. A sensitivity analysis (exclusion of studies with bias) altered the results of ph-tTG: Se, 95%; Sp, 98%. The sensitivities (all individual assays) for rh-tTG, ph-tTG, and gp-tTG were 94%, 94%, and 91%, respectively, and the specificities were 95%, 94%, and 89%, respectively. Human tTG ELISA is sensitive and specific, and it can be used for mass screening. Sensitivity analysis showed that ph-tTG might perform better.

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The Diagnostic Accuracy of Direct Agglutination Test for Serodiagnosis of Human Visceral Leishmaniasis: A Systematic Review with Meta-analysis

10.21203/rs.3.rs-19850/v4 ◽

2020 ◽

Author(s):

Mehdi Mohebali ◽

Hossein Keshavarz ◽

Sedigheh Shirmohammad ◽

Behnaz Akhoundi ◽

Alireza Borjian ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Sensitivity And Specificity ◽

Operating Characteristic ◽

Meta Analysis ◽

Agglutination Test ◽

Direct Agglutination Test ◽

Summary Receiver Operating Characteristic

Abstract Background: Direct agglutination test (DAT) as a simple, accurate and reliable method, has been widely used for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. The present study is a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL.Methods: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. We determined the pooled sensitivity and specificity rates of DAT for the diagnosis of human VL, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves parameters across the eligible studies.Results: Of the 2928 records identified in the mentioned electronic databases and after examining reference lists of articles, 24 articles met inclusion criteria and were enrolled in the systematic review and out of them 20 records qualified for meta-analysis. The pooled sensitivity and specificity rates of DAT was 96% [95% CI, 92–98] and 98% [95 % CI, 86–99], respectively. The likelihood ratio of a positive test (LR+) was found to be 21 [CI95%, 6.6–66.5] and the likelihood ratio of a negative test (LR−) was found to be 0.04 [(CI95%, 0.02–0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [467 (CI95%, 114-1912]). We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99).Conclusion: Referring to our analysis, we determined that DAT can be considered as a valuable tool for the serodiagnosis of human VL with high sensitivity and specificity. As DAT is a simple, accurate and efficient serological test, it can be recommended for serodiagnosis of human VL particularly in endemic areas.

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The Diagnostic Accuracy of Direct Agglutination Test for Serodiagnosis of Human Visceral Leishmaniasis: A Systematic Review with Meta-analysis

10.21203/rs.3.rs-19850/v3 ◽

2020 ◽

Author(s):

Mehdi Mohebali ◽

Hossein Keshavarz ◽

Sedigheh Shirmohammad ◽

Behnaz Akhoundi ◽

Alireza Borjian ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Likelihood Ratio ◽

Operating Characteristic ◽

Meta Analysis ◽

Agglutination Test ◽

Direct Agglutination Test ◽

Summary Receiver Operating Characteristic

Abstract Background: Direct agglutination test (DAT) as simple, accurate and non-expensive tool that has been used widely for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL. Methods: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. The study quality was evaluated using the QUADAS checklist. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic(ROC) curves parameters. Results: Of the 2928 records identified in the mentioned electronic databases and through articles’ reference lists, 25 articles met inclusion criteria and enrolled into the systematic review and among them 22 records were qualified for meta-analysis. The pooled sensitivity and specificity of DAT was 96% [(95% CI, 93–98])and 95% [(95% CI, 88–98]), respectively. The likelihood ratio of a positive test (LR+) was found to be 19.8 [CI95%, 7.6–51.8] and the likelihood ratio of a negative test (LR−) was found to be 0.04 [CI95%, 0.02–0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [454)136-1561]) ].We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99). Conclusion: Based on our analysis, we find DAT can be considered as valuable tool for the serodiagnosis and seroprevalence of human VL with high sensitivity and specificityrates. As DAT is simple, accurate, non-invasive and efficient serological test, it can be used for serodiagnosis of human VL particularly in endemic areas of the disease.

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A systematic and meta-analysis review on the diagnostic accuracy of antibodies in the serological diagnosis of COVID-19

Systematic Reviews ◽

10.1186/s13643-021-01689-3 ◽

2021 ◽

Vol 10 (1) ◽

Author(s):

Arthur Vengesai ◽

Herald Midzi ◽

Maritha Kasambala ◽

Hamlet Mutandadzi ◽

Tariro L. Mduluza-Jokonya ◽

...

Keyword(s):

Diagnostic Accuracy ◽

Point Of Care ◽

Data Extraction ◽

Meta Analysis ◽

Characteristic Curve ◽

Test Accuracy ◽

Summary Receiver Operating Characteristic ◽

Serological Tests ◽

Bivariate Model ◽

Prevalence Studies

Abstract Background Serological testing based on different antibody types are an alternative method being used to diagnose SARS-CoV-2 and has the potential of having higher diagnostic accuracy compared to the current gold standard rRT-PCR. Therefore, the objective of this review was to evaluate the diagnostic accuracy of IgG and IgM based point-of-care (POC) lateral flow immunoassay (LFIA), chemiluminescence enzyme immunoassay (CLIA), fluorescence enzyme-linked immunoassay (FIA) and ELISA systems that detect SARS-CoV-2 antigens. Method A systematic literature search was carried out in PubMed, Medline complete and MedRxiv. Studies evaluating the diagnostic accuracy of serological assays for SARS-CoV-2 were eligible. Study selection and data-extraction were performed by two authors independently. QUADAS-2 checklist tool was used to assess the quality of the studies. The bivariate model and the hierarchical summary receiver operating characteristic curve model were performed to evaluate the diagnostic accuracy of the serological tests. Subgroup meta-analysis was performed to explore the heterogeneity. Results The pooled sensitivity for IgG (n = 17), IgM (n = 16) and IgG-IgM (n = 24) based LFIA tests were 0.5856, 0.4637 and 0.6886, respectively compared to rRT-PCR method. The pooled sensitivity for IgG (n = 9) and IgM (n = 10) based CLIA tests were 0.9311 and 0.8516, respectively compared to rRT-PCR. The pooled sensitivity the IgG (n = 10), IgM (n = 11) and IgG-IgM (n = 5) based ELISA tests were 0.8292, 0.8388 and 0.8531 respectively compared to rRT-PCR. All tests displayed high specificities ranging from 0.9693 to 0.9991. Amongst the evaluated tests, IgG based CLIA expressed the highest sensitivity signifying its accurate detection of the largest proportion of infections identified by rRT-PCR. ELISA and CLIA tests performed better in terms of sensitivity compared to LFIA. IgG based tests performed better compared to IgM except for the ELISA. Conclusions We report that IgG-IgM based ELISA tests have the best overall diagnostic test accuracy. Moreover, irrespective of the method, a combined IgG/IgM test seems to be a better choice in terms of sensitivity than measuring either antibody type independently. Given the poor performances of the current LFIA devices, there is a need for more research on the development of highly sensitivity and specific POC LFIA that are adequate for most individual patient applications and attractive for large sero-prevalence studies. Systematic review registration PROSPERO CRD42020179112

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The Diagnostic Accuracy of Direct Agglutination Test for Serodiagnosis of Human Visceral Leishmaniasis: A Systematic Review with Meta-analysis

10.21203/rs.3.rs-19850/v1 ◽

2020 ◽

Author(s):

Mehdi Mohebali ◽

Hossein Keshavarz ◽

Sedigheh Shirmohammad ◽

Behnaz Akhoundi ◽

Alireza Borjian ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Likelihood Ratio ◽

Operating Characteristic ◽

Meta Analysis ◽

Agglutination Test ◽

Summary Receiver Operating Characteristic ◽

Receiver Operating

Abstract Background: agglutination test (DAT) as simple, accurate and non-expensive tool that has been used widely for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL.Methods: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019.The study quality was evaluated using the QUADAS checklist. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic(ROC) curves parameters.Results: Of the 2928 records identified in the mentioned electronic databases and through articles’ reference lists, 25 articles met inclusion criteria and enrolled into the systematic review and among them 22 records were qualified for meta-analysis. The pooled sensitivity and specificity of DAT was 96% [(95% CI, 93–98] )and 95% [(95 % CI, 88–98]), respectively. The likelihood ratio of a positive test (LR+) was found to be 19.8 [CI95%, 7.6–51.8] and the likelihood ratio of a negative test (LR−) was found to be 0.04 [CI95%, 0.02–0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [454 )136-1561]) ].We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99).Conclusion: Based on our analysis, we find DAT can be considered as valuable tool for the serodiagnosis and seroprevalence of human VL with high sensitivity and specificityrates. As DAT is simple, accurate ,non-invasive and efficient serological test, it can be used for serodiagnosis of human VL particularly in endemic areas of the disease.

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The diagnostic accuracy of direct agglutination test for serodiagnosis of human visceral leishmaniasis: a systematic review with meta-analysis

BMC Infectious Diseases ◽

10.1186/s12879-020-05558-7 ◽

2020 ◽

Vol 20 (1) ◽

Author(s):

Mehdi Mohebali ◽

Hossein Keshavarz ◽

Sedigheh Shirmohammad ◽

Behnaz Akhoundi ◽

Alireza Borjian ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Sensitivity And Specificity ◽

Operating Characteristic ◽

Meta Analysis ◽

Agglutination Test ◽

Direct Agglutination Test ◽

Summary Receiver Operating Characteristic

Abstract Background Direct agglutination test (DAT) as a simple, accurate and reliable method, has been widely used for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. The present study is a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL. Methods Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. We determined the pooled sensitivity and specificity rates of DAT for the diagnosis of human VL, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves parameters across the eligible studies. Results Of the 2928 records identified in the mentioned electronic databases and after examining reference lists of articles, 24 articles met inclusion criteria and were enrolled in the systematic review and out of them 20 records qualified for meta-analysis. The pooled sensitivity and specificity rates of DAT was 96% [95% CI, 92–98] and 95% [CI95% 86–99], respectively. The likelihood ratio of a positive test (LR+) was found to be 21 [CI95%, 6.6–66.5] and the likelihood ratio of a negative test (LR−) was found to be 0.04 [(CI95%, 0.02–0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [467 (CI95%, 114–1912]). We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99). Conclusion Referring to our analysis, we determined that DAT can be considered as a valuable tool for the serodiagnosis of human VL with high sensitivity and specificity. As DAT is a simple, accurate and efficient serological test, it can be recommended for serodiagnosis of human VL particularly in endemic areas.

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The Diagnostic Accuracy of Direct Agglutination Test for Serodiagnosis of Human Visceral Leishmaniasis: A Systematic Review with Meta-analysis

10.21203/rs.3.rs-19850/v2 ◽

2020 ◽

Author(s):

Mehdi Mohebali ◽

Hossein Keshavarz ◽

Sedigheh Shirmohammad ◽

Behnaz Akhoundi ◽

Alireza Borjian ◽

...

Keyword(s):

Systematic Review ◽

Visceral Leishmaniasis ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Likelihood Ratio ◽

Operating Characteristic ◽

Meta Analysis ◽

Agglutination Test ◽

Direct Agglutination Test ◽

Summary Receiver Operating Characteristic

Abstract Background: Direct agglutination test (DAT) as simple, accurate and reliable method that has been used widely for serodiagnosis of visceral leishmaniasis (VL) during the last three decades. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of DAT for serodiagnosis of human VL.Methods: Electronic databases, including MEDLINE (via PubMed), SCOPUS, Web of Science, SID and Mag Iran (two Persian scientific search engines) were searched from December 2004 to April 2019. We determined the sensitivities and specificities across studies, calculated positive and negative likelihood ratios (LR+ and LR-), and constructed summary receiver operating characteristic (ROC) curves parameters. Results: Of the 2928 records identified in the mentioned electronic databases and through articles’ reference lists, 25 articles met inclusion criteria and enrolled into the systematic review and among them 20 records were qualified for meta-analysis. The pooled sensitivity and specificity of DAT was 96% [(95% CI, 92–98] )and 95% [(95 % CI, 86–99]), respectively. The likelihood ratio of a positive test (LR+) was found to be 21 [CI95%, 6.6–66.5] and the likelihood ratio of a negative test (LR−) was found to be 0.04 [CI95%, 0.02–0.08]. The combined estimate of the diagnostic odds ratio for DAT was high [467 )114-1912]) ].We found that the summary receiver operating characteristic curve (SROC) is positioned near the upper left corner of the curve and the area under curve (AUC) was 0.98 (95% CI, 0.97 to 0.99).Conclusion: Based on our analysis, we find DAT can be considered as a valuable tool for the serodiagnosis and seroprevalence of human VL with high sensitivity and specificity rates. As DAT is simple, accurate and efficient serological test, it can be used for serodiagnosis of human VL particularly in endemic areas..

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Diagnostic accuracy of the LAMP assay for Neisseria meningitidis

10.21203/rs.2.13073/v2 ◽

2020 ◽

Author(s):

Shu- Jin Fan ◽

Xu-Guang Guo ◽

Hong-kun Tan ◽

Yu-cheng Xu ◽

Yuan-zhi Chen ◽

...

Keyword(s):

Bacterial Meningitis ◽

Diagnostic Accuracy ◽

Neisseria Meningitidis ◽

Publication Bias ◽

Operating Characteristic ◽

Web Of Science ◽

Meta Analysis ◽

Lamp Assay ◽

High Sensitivity ◽

Summary Receiver Operating Characteristic

Abstract Background Neisseria meningitidis is a major cause of bacterial meningitis, and these infections are associated with a high mortality rate. Rapid and reliable diagnosis of bacterial meningitis is critical in clinical practice. However, this disease often occurs in economically depressed areas, so an inexpensive, easy to use, and accurate technology is needed. We performed a meta-analysis to assess the potential of the recently developed loop-mediated isothermal amplification (LAMP) assay for detection of meningococcus. Methods Pubmed, Embase, and Web of Science were searched to identify original studies that used the LAMP assay to detect meningococcus. After pooling of data, the sensitivity and specificity were calculated, a summary receiver operating characteristic (SROC) curve was determined, and the area under the SROC curve was computed to determine diagnostic accuracy. Publication bias was assessed using Deek's funnel plot. Results We examined 14 studies within 6 publications. The LAMP assay had high sensitivity (94%) and specificity (100%) in the detection of meningococcus in all studies. The area under the SROC curve (0.980) indicated high overall accuracy of the LAMP assay. There was no evidence of publication bias. Conclusion The LAMP assay has accuracy comparable to bacterial culture and PCR for detection of meningococcus, but is less expensive and easier to use. We suggest adoption of the LAMP assay for detect meningococcus, especially in economically depressed areas.

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Diagnostic Accuracy of FDA Authorized Serology Tests to Detect SARS-CoV-2 Antibodies: A Systematic Review and Meta-analysis

10.1101/2020.10.07.20208553 ◽

2020 ◽

Author(s):

Rajesh Pandey ◽

Anand Gourishankar

Keyword(s):

Systematic Review ◽

Diagnostic Accuracy ◽

Receiver Operating Characteristic ◽

Test Performance ◽

Operating Characteristic ◽

Meta Analysis ◽

Time Interval ◽

Test Accuracy ◽

Summary Receiver Operating Characteristic ◽

Receiver Operating

AbstractImportanceSerology tests are diagnostic and complementary to molecular tests during the COVID-19 pandemic.ObjectiveTo evaluate the diagnostic accuracy of FDA authorized serology tests for the detection of SARS-CoV-2 infection.Data sourcesA search of MEDLINE, SCOPUS, CINAHL Plus, and EMBASE up to April 4, 2020, was performed to identify studies using the “COVID 19 testing” and “meta-analysis.” FDA website was accessed for the list of tests for emergency use authorization (EUA).Study SelectionManufacturer reported serology tests published in the FDA website were selected. Two reviewers independently assessed the eligibility of the selected reports.Data extraction and synthesisThe meta-analysis was performed in accordance with the PRISMA guidelines. A bivariate analysis using the “random-effects model” was applied for pooled summary estimates of sensitivity, specificity, and the summary receiver operating characteristic curves.Main outcomes and measuresThe primary outcome was the diagnostic accuracy of the serology test for detecting SARS-CoV-2 infection. Subgroup analysis of the diagnostic accuracy with lag time between symptom onset and testing were studied.ResultsSeven manufacturer listed reports were included. The pooled sensitivity was 87% (95% CI, 78% - 93%), the pooled specificity was 100% (95% CI, 97% - 100%), and the area under the hierarchical summary receiver operating characteristic curve was 0.97. At ≤ 7 days, sensitivity was 44% (95% CI, 21% - 70%), and for 8-14 days, sensitivity was 84% (95% CI, 67 % - 94%).For blood draws ≥ 15 days after the onset of symptoms, sensitivity was 96% (95% CI, 93% - 98%). Heterogeneity was substantial, and the risk of bias was low in this analysis.Conclusions and relevanceFDA authorized serology tests demonstrate high diagnostic accuracy for SARS-CoV-2 infection (certainty of evidence: moderate). There is a wide variation in the test accuracy based on the duration between the onset of symptoms and the tests (certainty of evidence: low).Key– pointsQuestionsWhat is the pooled diagnostic accuracy of FDA authorized serology tests to detect SARS-CoV-2 antibodies?FindingsIn this systematic review and meta-analysis of seven reports from FDA authorized serology tests to detect antibodies against SARS-CoV2 antibodies (3336 patients/ samples) pooled sensitivity was 87%, and pooled specificity was almost 100%. There was a wide variation in test performance based on the duration between the onset of symptoms and the tests.MeaningFDA authorized tests are highly accurate to detect antibodies against SARS-CoV-2 antibodies if tests are performed under a similar condition, as presented in the original report. There is a wide variation in the test performance based on the time interval between the onset of symptoms to the tests.

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