scholarly journals Diagnostic Accuracy of Computed Tomography for the Prediction of the Need for Laparotomy for Traumatic Hollow Viscus Injury: Systematic Review and Meta-Analysis

2021 ◽  
Vol 11 (12) ◽  
pp. 1269
Author(s):  
Cheng-Chieh Hsia ◽  
Chen-Yu Wang ◽  
Jen-Fu Huang ◽  
Chih-Po Hsu ◽  
Ling-Wei Kuo ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Final Analysis ◽  
Performance Outcomes ◽  
Summary Receiver Operating Characteristic ◽  
Hollow Viscus ◽  
Hollow Viscus Injury ◽  
Positive Rate

Background: Traumatic hollow viscus injury (THVI) is one of the most difficult challenges in the trauma setting. Computed tomography (CT) is the most common modality used to diagnose THVI; however, various performance outcomes of CT have been reported. We conducted a systematic review and meta-analysis to analyze how precise and reliable CT is as a tool for the assessment of THVI. Method: A systematic review and meta-analysis were conducted on studies on the use of CT to diagnose THVI. Publications were retrieved by performing structured searches in databases, review articles and major textbooks. For the statistical analysis, summary receiver operating characteristic (SROC) curves were constructed using hierarchical models. Results: Sixteen studies enrolling 12,514 patients were eligible for the final analysis. The summary sensitivity and specificity of CT for the diagnosis of THVI were 0.678 (95% CI: 0.501–0.809) and 0.969 (95% CI: 0.920–0.989), respectively. The summary false positive rate was 0.031 (95% CI 0.011–0.071). Conclusion: In this meta-analysis, we found that CT had indeterminate sensitivity and excellent specificity for the diagnosis of THVI.

scholarly journals 67 Echocardiography vs. computed tomography and cardiac magnetic resonance for the detection of left heart thrombosis: a systematic review and meta-analysis

2020 ◽  
Vol 22 (Supplement_N) ◽  
pp. N28-N44
Author(s):  
Alberto Aimo ◽  
Georgios Ntritsos ◽  
Pier-Giorgio Masci ◽  
Stefano Figliozzi ◽  
Dimitrios Klettas ◽  
...  
Keyword(s):  
Computed Tomography ◽  
Systematic Review ◽  
Cardiac Magnetic Resonance ◽  
Magnetic Resonance ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Techniques ◽  
High Accuracy ◽  
Summary Receiver Operating Characteristic

Abstract Aims Accurate and reproducible diagnostic techniques are essential to detect left-sided cardiac thrombi (either in the left ventricle [LV] or in the left atrial appendage [LAA]) and to guide the onset and duration of antithrombotic treatment while minimizing the risk for thromboembolic and hemorrhagic events. Methods and results We conducted a systematic review and meta-analysis aiming to compare the diagnostic performance of transthoracic echocardiography (TTE) vs. cardiac magnetic resonance (CMR) for the detection of LV thrombi, and transesophageal echocardiography (TEE) vs. computed tomography (CT) for the detection of LAA thrombi. Six studies were included in the first meta-analysis. Pooled sensitivity and specificity values were 62% (95% confidence interval [CI], 37-81%) and 97% (95% CI, 94-99%). The shape of the hierarchical summary receiver operating characteristic (HSROC) curve and the area under the curve (AUC) of 0.96 suggested a high accuracy. Ten studies were included in the meta-analysis of the diagnostic accuracy of CT vs. TEE. The pooled values of sensitivity and specificity were 97% (95% CI, 77-100%) and 94% (95% CI, 87-98%). The pooled DOR was 500 (95% CI, 52-4810), and the pooled LR+ and LR- values were 17% (95% CI, 7-40%) and 3% (95% CI, 0-28%). The shape of the HSROC curve and the 0.99 AUC suggested a high accuracy of CT vs. TEE. Conclusion TTE is a valid alternative to DE-CMR for the identification of LV thrombi, and CT has a good accuracy compared to TEE for the detection of LAA thrombosis.

scholarly journals Systematic Review of Lumbar Provocation Discography in Asymptomatic Subjects with a Meta-analysis of False-positive Rates

2008 ◽  
Vol 4;11 (8;4) ◽  
pp. 513-538
Author(s):  
Lee Wolfer
Keyword(s):  
Systematic Review ◽  
Low Back Pain ◽  
Back Pain ◽  
False Positive ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Healthcare Research ◽  
Low Back ◽  
Positive Rate ◽  
Asymptomatic Subjects

Background: Lumbar provocation discography is a controversial diagnostic test. Currently, there is a concern that the test has an unacceptably high false-positive rate. Study Design: Systematic review and meta-analysis. Objective: To perform a systematic review of lumbar discography studies in asymptomatic subjects and discs with a meta-analysis of the specificity and false-positive rate of lumbar discography. Methods: A systematic review of the literature was conducted via a PUBMED search. Studies were included/excluded according to modern discography practices. Study quality was scored using the Agency for Healthcare Research and Quality (AHRQ) instrument for diagnostic accuracy. Specific data was extracted from studies and tabulated per published criteria and standards to determine the false-positive rates. A meta-analysis of specificity was performed. Strength of evidence was rated according to the AHRQ U.S. Preventive Services Task Force (USPSTF) criteria. Results: Eleven studies were identified. Combining all extractable data, a false-positive rate of 9.3% per patient and 6.0% per disc is obtained. Data pooled from asymptomatic subjects without low back pain or confounding factors, shows a false-positive rate of 3.0% per patient and 2.1% per disc. In data pooled from chronic pain patients, asymptomatic of low back pain, the false-positive rate is 5.6% per patient and 3.85% per disc. Chronic pain does not appear to be a confounding factor in a chronic low back pain patient’s ability to distinguish between positive (pathologic) and negative (non-pathologic) discs. Among additional asymptomatic patient subgroups analyzed, the false-positive rate per patient and per disc is as follows: iliac crest pain 12.5% and 7.1%; chronic neck pain 0%; somatization disorder 50% and 22.2%, and, post-discectomy 15% and 9.1%, respectively. In patients with chronic backache, no false-positive rate can be calculated. Low-pressure positive criteria (≤ 15 psi a.o.) can obtain a low false-positive rate. Based on meta-analysis of the data, using the ISIS standard, discography has a specificity of 0.94 (95% CI 0.88 – 0.98) and a false-positive rate of 0.06. Conclusions: Strength of evidence is level II-2 based on the Agency for Healthcare Research Quality (USPSTF) for the diagnostic accuracy of discography. Contrary to recently published studies, discography has a low false-positive rate for the diagnosis of discogenic pain. Key words: Meta-analysis, lumbar discography, false-positive, asymptomatic subjects

Identification of and Correction for Publication Bias: Comment

2019 ◽  
Author(s):  
Amanda Kvarven ◽  
Eirik Strømland ◽  
Magnus Johannesson
Keyword(s):  
Publication Bias ◽  
False Positive ◽  
Large Scale ◽  
Meta Analysis ◽  
False Positive Rate ◽  
Effect Sizes ◽  
Replication Studies ◽  
Moderate Reduction ◽  
Positive Rate ◽  
Meta Analyses

Andrews & Kasy (2019) propose an approach for adjusting effect sizes in meta-analysis for publication bias. We use the Andrews-Kasy estimator to adjust the result of 15 meta-analyses and compare the adjusted results to 15 large-scale multiple labs replication studies estimating the same effects. The pre-registered replications provide precisely estimated effect sizes, which do not suffer from publication bias. The Andrews-Kasy approach leads to a moderate reduction of the inflated effect sizes in the meta-analyses. However, the approach still overestimates effect sizes by a factor of about two or more and has an estimated false positive rate of between 57% and 100%.

scholarly journals Detection of three pandemic causing coronaviruses from non-respiratory samples: systematic review and meta-analysis

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Chandan Mishra ◽  
Suneeta Meena ◽  
Jitendra Kumar Meena ◽  
Suman Tiwari ◽  
Purva Mathur
Keyword(s):  
Systematic Review ◽  
Detection Rate ◽  
Meta Analysis ◽  
Total Sample ◽  
Urine Samples ◽  
Pathogenic Potential ◽  
Clinical Specimens ◽  
Qrt Pcr ◽  
Corona Virus ◽  
Positive Rate

AbstractSARS-CoV-2 has posed an unprecedented challenge to the world. Pandemics have been caused previously by viruses of this family like Middle East Respiratory Corona Virus (MERS CoV), Severe Acute Respiratory Syndrome Corona Virus (SARS CoV). Although these viruses are primarily respiratory viruses, but they have been isolated from non-respiratory samples as well. Presently, the detection rate of SARS‐CoV‐2 RNA from different clinical specimens using Real Time Reverse Transcriptase Polymerized Chain Reaction (qRT‐PCR) after onset of symptoms is not yet well established. Therefore, the aim of this systematic review was to establish the profile of detecting SARS‐CoV‐2, MERS CoV, SARS CoV from different types of clinical specimens other than the respiratory using a standard diagnostic test (qRT‐PCR). A total of 3429 non-respiratory specimens were recorded: SARS CoV (total sample—802), MERS CoV (total sample—155), SARS CoV-2 (total sample—2347). Out of all the samples studied high positive rate was seen for saliva with 96.7% (14/14; 95% CI 87.6–100.0%) for SARS CoV and 57.5% (58/250; 95% CI − 1.2 to 116.2%) for SARS CoV-2, while low detection rate in urine samples for SARS CoV-2 with 2.2% (8/318; 95% CI 0.6–3.7%) and 9.6% (12/61; 95% CI − 0.9 to 20.1%) for SARS CoV but there was relatively higher positivity in urine samples for MERS CoV with detection rate of 32.4% (2/38; 95% CI − 37.3 to 102.1%). In Stool sample positivity was 54.9% (396/779; 95% CI 41.0–68.8%), 45.2% (180/430; 95% CI 28.1–62.3%) and 34.7% (4/38; 95% CI − 29.5 to 98.9%) for SARS CoV-2, MERS CoV, and SARS CoV, respectively. In blood sample the positivity was 33.3% (7/21; 95% CI 13.2–53.5%), 23.7% (42/277; 95% CI 10.5–36.9%) and 2.5% (2/81; 95% CI 0.00–5.8%) for MERS CoV, SARS CoV-2 and SARS CoV respectively. SARS‐CoV‐2 along with previous two pandemic causing viruses from this family, were highly detected stool and saliva. A low positive rate was recorded in blood samples. Viruses were also detected in fluids along with unusual samples like semen and vaginal secretions thus highlighting unique pathogenic potential of SARS‐CoV‐2.

scholarly journals Pretherapeutic Imaging for Axillary Staging in Breast Cancer: A Systematic Review and Meta-Analysis of Ultrasound, MRI and FDG PET

2021 ◽  
Vol 10 (7) ◽  
pp. 1543
Author(s):  
Morwenn Le Boulc’h ◽  
Julia Gilhodes ◽  
Zara Steinmeyer ◽  
Sébastien Molière ◽  
Carole Mathelin
Keyword(s):  
Systematic Review ◽  
Sensitivity And Specificity ◽  
Meta Analysis ◽  
False Negative ◽  
Significant Proportion ◽  
False Negative Rate ◽  
True Positive Rate ◽  
Axillary Staging ◽  
Positron Emission ◽  
Positive Rate

Background: This systematic review aimed at comparing performances of ultrasonography (US), magnetic resonance imaging (MRI), and fluorodeoxyglucose positron emission tomography (PET) for axillary staging, with a focus on micro- or micrometastases. Methods: A search for relevant studies published between January 2002 and March 2018 was conducted in MEDLINE database. Study quality was assessed using the QUality Assessment of Diagnostic Accuracy Studies checklist. Sensitivity and specificity were meta-analyzed using a bivariate random effects approach; Results: Across 62 studies (n = 10,374 patients), sensitivity and specificity to detect metastatic ALN were, respectively, 51% (95% CI: 43–59%) and 100% (95% CI: 99–100%) for US, 83% (95% CI: 72–91%) and 85% (95% CI: 72–92%) for MRI, and 49% (95% CI: 39–59%) and 94% (95% CI: 91–96%) for PET. Interestingly, US detects a significant proportion of macrometastases (false negative rate was 0.28 (0.22, 0.34) for more than 2 metastatic ALN and 0.96 (0.86, 0.99) for micrometastases). In contrast, PET tends to detect a significant proportion of micrometastases (true positive rate = 0.41 (0.29, 0.54)). Data are not available for MRI. Conclusions: In comparison with MRI and PET Fluorodeoxyglucose (FDG), US is an effective technique for axillary triage, especially to detect high metastatic burden without upstaging majority of micrometastases.

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

Medicina ◽  
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.

scholarly journals 18F-Fluciclovine Positron Emission Tomography in Prostate Cancer: A Systematic Review and Diagnostic Meta-Analysis

Diagnostics ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. 304
Author(s):  
Giuseppina Biscontini ◽  
Cinzia Romagnolo ◽  
Chiara Cottignoli ◽  
Andrea Palucci ◽  
Fabio Massimo Fringuelli ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Computed Tomography ◽  
Positron Emission Tomography ◽  
Meta Analysis ◽  
False Negative ◽  
Final Analysis ◽  
Emission Tomography ◽  
True Negative ◽  
Positron Emission ◽  
Pet Ct

Background: to explore the diagnostic accuracy of 18F-Fluciclovine positron-emission tomography (PET) in prostate cancer (PCa), considering both primary staging prior to radical therapy, biochemical recurrence, and advanced setting. Methods: A systematic web search through Embase and Medline was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines. Studies performed from 2011 to 2020 were evaluated. The terms used were “PET” or “positron emission tomography” or “positron emission tomography/computed tomography” or “PET/CT” or “positron emission tomography-computed tomography” or “PET-CT” and “Fluciclovine” or “FACBC” and “prostatic neoplasms” or “prostate cancer” or “prostate carcinoma”. Only studies reporting about true positive (TP), true negative (TN), false positive (FP) and false negative (FN) findings of 18F-fluciclovine PET were considered eligible. Results: Fifteen out of 283 studies, and 697 patients, were included in the final analysis. The pooled sensitivity for 18F-Fluciclovine PET/CT for diagnosis of primary PCa was 0.83 (95% CI: 0.80–0.86), the specificity of 0.77 (95% CI: 0.74–0.80). The pooled sensitivity for preoperative LN staging was 0.57 (95% CI: 0.39–0.73) and specificity of 0.99 (95% CI: 0.94–1.00). The pooled sensitivity for the overall detection of recurrence in relapsed patients was 0.68 (95% CI: 0.63–0.73), and specificity of 0.68 (95% CI: 0.60–0.75). Conclusion: This meta-analysis showed promising results in term of sensitivity and specificity for 18F-Fluciclovine PET/CT to stage the primary lesion and in the assessment of nodal metastases, and for the detection of PCa locations in the recurrent setting. However, the limited number of studies and the broad heterogeneity in the selected cohorts and in different investigation protocols are limitation affecting the strength of these results.

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