ObjectiveTo systematically review the diagnostic value of FDG-PET, Aβ-PET and tau-PET for Alzheimer ’s disease (AD).MethodsPubMed, EMbase, The Cochrane Library, CNKI, WanFang Data, VIP and CBM databases were electronically searched to collect diagnostic tests of FDG-PET, Aβ-PET and tau-PET for AD from January 2000 to February 2020. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies; then, meta-analysis was performed by Meta-Disc 1.4 and Stata 14.0 software.ResultsA total of 31 studies involving 3 718 subjects were included. The results of meta-analysis showed that, using normal population as control, the sensitivity/specificity of FDG-PET and Aβ-PET in diagnosing AD were 0.853/0.734 and 0.824/0.771, respectively. Only 2 studies were included for tau-PET and meta-analysis was not performed.ConclusionsFDG-PET and Aβ-PET can provide good diagnostic accuracy for AD, and their diagnostic efficacy is similar. Due to limited quality and quantity of the included studies, more high quality studies are required to verify the above conclusions.
ObjectivesTo assess the accuracy of different types and magnetic field intensity of cardiac magnetic resonance for coronary artery disease.MethodsPubMed, The Cochrane Library, EMbase, WanFang Data, CNKI and CBM databases were searched to collect the studies on different types and magnetic field intensity of cardiac magnetic resonance for coronary artery disease from inception to May 15th, 2017. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Then, data were synthesized by using MetaDisc 1.4, RevMan 5.3 and Stata 12.0 softwares. The pooled sensitivity (Sen), pooled specificity (Spe), pooled positive likelihood ratio (+LR), pooled negative likelihood ratio (–LR), pooled diagnostic odds ratio (DOR) and the area under curve (AUC) of the summary receiver-operating characteristic curve (SROC) were used to assess the diagnostic value of different types and magnetic field intensity of cardiac magnetic resonance.ResultsTwenty diagnostic studies were included, which involved 1 357 patients. The results of meta-analysis showed that (1) based on patient: compared with the gold standard, the pooled Sen, Spe, +LR, –LR, DOR and the AUC of SROC, pre-test probability, post-test probability were (0.87, 95%CI 0.82 to 0.90), (0.88, 95%CI 0.82 to 0.92), (7.33, 95%CI 4.74 to 11.32), (0.15, 95%CI 0.11 to 0.20), (49.53, 95%CI 27.46 to 89.36), (0.93, 95%CI 0.91 to 0.95), 20.00% and 65.00%, respectively. (2) Based on blood vessels: the pooled Sen, Spe, +LR, –LR, DOR and the AUC of SROC, pre-test probability, post-test probability were (0.81, 95%CI 0.76 to 0.85), (0.87, 95%CI 0.81 to 0.91), (6.37, 95%CI 4.37 to 9.30), (0.22, 95%CI 0.17 to 0.27), (29.58, 95%CI 18.53 to 47.22), (0.89, 95%CI 0.86 to 0.92), 20.00% and 61.00%, respectively. (3) Subgroup analysis showed that there was no difference in AUROC of different types of cardiac magnetic resonance, but significant difference was found in AUROC of 1.5T and 3.0T magnetic field intensity.ConclusionsCurrent evidence shows that, compared with gold standard, cardiac magnetic resonance can be regarded as an effective and feasible method for preoperative staging of breast cancer.
With the development of artificial intelligence, machine learning has been widely used in diagnosis of diseases. It is crucial to conduct diagnostic test accuracy studies and evaluate the performance of models reasonably to improve the accuracy of diagnosis. For machine learning-based diagnostic test accuracy studies, this paper introduces the principles of study design in the aspects of target conditions, selection of participants, diagnostic tests, reference standards and ethics.
ObjectiveTo systematically review the value of intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas.
MethodsSuch databases as PubMed, EMbase, The Cochrane Library, CBM, CNKI, WanFang Data and VIP were electronically searched for the diagnostic test about intra-operative ultrasound in diagnosis of tumor residue after resection of intracranial gliomas by March 31st, 2013. Meanwhile, search engines such as Google, Baidu were also used for relevant search. According to the inclusion and exclusion criteria, the literature was screened and the data were extracted. The methodological quality was evaluated in accordance with the quality assessment tool for diagnostic accuracy studies (QUADAS) and then meta-analysis was conducted using Meta-DiSc 1.4 software.
ResultsA total of 10 studies involving 423 patients were included. The results of meta-analysis showed that the sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio (DOR) were 0.78 (95%CI 0.74 to 0.82), 0.90 (95%CI 0.88 to 0.90), 5.12 (95%CI 2.86 to 9.16), 0.29 (95%CI 0.21 to 0.39) and 25.00 95%CI (13.27 to 47.10), respectively; and the AUC was 0.89. In the subgroup analysis, for low grade intracranial gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.87 (95%CI 0.77 to 0.94), 0.88 (95%CI 0.78 to 0.94) and 28.93 (95%CI 7.46 to 112.14), respectively, and the AUC was 0.92. For high grade gliomas, the results of meta-analysis showed that the sensitivity, specificity and DOR were 0.80 (95%CI 0.72 to 0.87), 0.67 (95%CI 0.53 to 0.79) and 7.20 (95%CI 3.04 to 17.09), respectively, and the AUC was 0.80.
ConclusionIntra-operative ultrasound is useful for the diagnosis of tumor residue after resection of intracranial gliomas, especially for low grade gliomas.
ObjectiveTo systematically review the diagnostic value of ultrasound for breast cancer with axillary sentinel lymph nodes, so as to provide evidence for clinical decision-making.
MethodsWe searched the databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CBM, CNKI, WanFang Data and VIP for studies about ultrasound in the diagnosis of breast cancer with axillary sentinel lymph nodes till December 31st, 2013. According to the inclusion and exclusion criteria, literature was screened, data were extracted, and methodological quality of the included studies was evaluated. Meta-analysis was then conducted using Meta-Disc 1.4 software.
ResultsA total of 12 studies involving 2 188 cases were included. The pooled results of meta-analysis showed that sensitivity and specificity were 0.75 (95%CI 0.72 to 0.77) and 0.91 (95%CI 0.89 to 0.92), respectively; positive likelihood ratio and negative likelihood ratio were 6.54 (95%CI 4.68 to 8.89) and 0.22 (95%CI 0.15 to 0.33), respectively; diagnostic odds ratio was 33.59 (95%CI 17.87 to 63.12); and the AUC was 0.934 3.
ConclusionUltrasound is has relatively high value in diagnosis of breast cancer with axillary sentinel lymph nodes. However, due to the influence caused by the limited quality and various potential heterogeneity, more high quality RCTs with large sample size are needed to further verify the above conclusion.
ObjectiveTo systematically review the diagnostic value of anti-C1q antibodies for lupus nephritis (LN) in Chinese population.
MethodsWe electronically searched databases including PubMed, EMbase, CNKI, The Cochrane Library, VIP and WanFang Data for diagnostic accuracy studies of anti-C1q antibodies for LN in Chinese population from inception to 1st March, 2015. Two reviewers independently screened literature, extracted data and assessed the risk bias of included studies by QUADAS tool. Then, meta-analysis was performed by Meta-DiSc 1.4 software and Stata 11.0 software.
ResultsA total of 11 studies involving 1 084 systemic lupus erythematosus (SLE) patients were included. Among them, 474 patients were LN. The results of meta-analysis showed that:the pooled sensitivity, specificity, diagnostic odds ratio, positive likelihood ratio, and negative likelihood ratio of anti-C1q in the diagnosis of LN were 0.67 (95%CI 0.63 to 0.71), 0.69 (95%CI 0.65 to 0.74), 5.09 (95%CI 3.29 to 7.85), 2.18 (95%CI 1.75 to 2.72), and 0.48 (95%CI 0.39 to 0.60), respectively. The area under the curve (AUC) of SROC was 0.749 6 and the Q index value was 0.693 1. The average missed diagnosis rate was 33.0% and the misdiagnosis rate was 31.0%.
ConclusionCurrent evidence indicates that anti-C1q antibodies may have some value in the diagnosis of LN. Because of the high missed diagnosis rate and the misdiagnosis rate, it could not be used to diagnose LN alone, and it only could be used as an adjuvant diagnostic indicator for LN. Due to the limited quality and quantity of the included studies, more high quality studies are needed to verify the above conclusion.
ObjectiveTo evaluate the diagnostic accuracy and efficacy of X-ray for evaluating the tip position of umbilical venous catheterization (UVC). MethodsThe PubMed, Embase, Cochrane Library, CBM, CNKI, VIP and WanFang Data databases were electronically searched to collect diagnostic tests for UVC tip localisation from inception to 1 May 2023. Two reviewers independently screened the literature according to the inclusion and exclusion criteria, extracted the data and assessed the quality of the studies using the QUADAS-2 tool. Then, meta-analysis was performed by using Stata 16.0 software. Results Twelve articles involving 1 055 patients were included. The sensitivity and specificity of Negar Yazdani’s study were both 100%. The results of the meta-analysis (the remaining eleven articles, n=951) indicated a pooled sensitivity of 0.7 (95%CI 0.6 to 0.8), a pooled specificity of 0.8 (95%CI 0.7 to 0.9), a positive likelihood ratio of 4.0 (95%CI 2.0 to 8.1), a negative likelihood ratio of 0.4 (95%CI 0.2 to 0.6) and a diagnostic odds ratio of 11 (95%CI 3 to 36) with an area under the cumulative receiver operating characteristic curve of 0.8 (95%CI 0.8 to 0.9). A subgroup analysis was performed according to the different methods of judging X, the 8th–9th thoracic, the 9th–10th thoracic and combined judgement of the diaphragmatic plane + the vertebral body + the heart shadow. The sensitivities of the 3 groups were 0.8 (95%CI 0.5 to 0.9), 0.5 (95%CI 0.4 to 0.7) and 0.8 (95%CI 0.6 to 0.9); the specificities of the 3 groups were 0.8 (95%CI 0.6 to 0.9), 0.76 (95%CI 0.6 to 0.9) and 0.91 (95%CI 0.79 to 0.96). The areas under the cumulative receiver operating characteristic curve were 0.9 (95%CI 0.8 to 0.9), 0.7 (95%CI 0.6 to 0.7) and 0.92 (95%CI 0.89 to 0.94). ConclusionSome error is present when determining the catheter tip position by X-ray, in which the evaluation of the umbilical vein catheter tip position through a comprehensive evaluation of the diaphragmatic plane, the heart margin and the vertebral body is more powerful than the evaluation of the vertebral body alone.
ObjectiveTo systematically review the diagnostic value of FibroScan for the staging of liver fibrosis in chronic hepatitis B.
MethodsWe searched the PubMed, EMbase, Web of Knowledge, CBM, WanFang Data and CNKI databases for studies investigated the diagnostic value of FibroScan for hepatic fibrosis B from Jan. 1st, 2003 to Aug. 31st, 2013. Two reviewers independently screened literature according to the exclusion and inclusion criteria, extracted data and assessed methodological quality of included studies. Then, Stata 13.0 software was used to analyze the data.
ResultsA total of 15 studies involving 2 588 patients were included. The results of meta-analysis showed that:the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and the AUC of SROC were 0.77 (95%CI 0.69 to 0.83), 0.84 (95%CI 0.70 to 0.87), 3.8 (95%CI 2.6 to 5.6), 0.29 (95%CI 0.22 to 0.38), 13 (95%CI 8 to 21), 0.82 (95%CI 0.82 to 0.88) for hepatic fibrosis; and were 0.81 (95%CI 0.73 to 0.87), 0.89 (95%CI 0.86 to 0.92), 7.5 (95%CI 5.3 to 10.3), 0.21 (95%CI 0.14 to 0.31), 36 (95%CI 20 to 65), 0.93 (95%CI 0.90 to 0.95) for early hepatic cirrhosis, respectively.
ConclusionThe current evidence suggests that FibroScan is of good accuracy in the diagnosis of early hepatic fibrosis but not for hepatic cirrhosis in patient with chronic hepatitis B.
ObjectiveTo explore the diagnostic value of HLA-B27 for ankylosing spondylitis (AS) in Chinese population.
MethodsWe searched PubMed, EMbase, The Cochrane Library (Issue 8, 2015), CNKI, and WanFang data from inception to August 2015, to collect diagnostic studies about HLA-B27 for AS in Chinese population. Two reviewers independently screened literature, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed by using Stata12.0 software.
ResultsA total of 16 studies involving 3137 AS and 5617 suspect patients were finally included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, -LR and DOR were 0.91(95%CI 0.89 to 0.93), 0.94(95%CI 0.91 to 0.96), 14.90(95%CI 9.60 to 23.10), 0.09(95%CI 0.08 to 0.12) and 157.00(95%CI 90.00 to 275.00), respectively. The AUC of SROC was 0.98(95%CI 0.93 to 0.97).
ConclusionsHLA-B27 detection is of great diagnostic value for AS in Chinese population. However, due to the limited quality and quantity of the included studies, more long-term follow-up prospective studies are needed to verify the above conclusion.
