ObjectiveTo systematic review the diagnostic value of magnetic resonance (MR) for pulmonary embolism (PE).MethodsWe electronically searched databases including EMbase, PubMed, The Cochrane Library, WanFang Data and CNKI from inception to November 2016, to collect the diagnostic studies about MR in the diagnosis of PE. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the risk of bias of included studies, and then meta-analysis was conducted using Stata 12.0 software.ResultsA total of 14 studies involving 1 042 patients were included. The pooled Sen, Spe, +LR, –LR and DOR were 0.90 (95%CI 0.83 to 0.94), 0.95 (95%CI 0.90 to 0.98), 19.8 (95%CI 8.5 to 46.1), 0.10 (95%CI 0.06 to 0.18), 189 (95%CI 69 to 521), respectively. The AUC of SROC were 0.97 (95%CI 0.95 to 0.98).ConclusionMR has a good diagnosis value for PE which can be regarded as an effective and feasible method for suspected PE patients, especially for those who has contraindication of computed tomographic pulmonary angiography.
ObjectiveTo systematically review the value of mass screening of serum pepsinogen test for Asian population with high-risk gastric carcinoma. MethodsWe electronically searched databases including PubMed, EMbase, The Cochrane Library (Issue 12, 2013), CNKI, WanFang Data, VIP and CBM for diagnostic tests on serum pepsinogen test versus with pathological biopsy/X-ray examination (gold standard) between January 2004 and January 2014. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed methodological quality of included studies. Then meta-analysis was conducted using Meta-DiSc software (version 1.4). ResultsA total of 15 studies involving 180 934 subjects were included. ROC curve showed "shoulder-arm shape" distribution. The results of Spearman correlation analysis suggested a significance of the threshold effect (P=0.001). The results of meta-analysis showed that, the area under curve (AUC) was 0.74. ConclusionSerum pepsinogen has good value in the screening of gastric carcinoma among Asian permanent residents. Due to limited quality of studies, the above conclusion should be verified by conducting more high quality studies.
Objective To evaluate the quality of studies assessing the value of serum hyaluronic acid in the diagnosis of liver fibrosis, to analyze the sources of bias and variation, and to estimate the accuracy of serum hyaluronic acid in diagnosing early liver cirrhosis and liver fibrosis in patients with chronic viral hepatitis.Methods We searched MEDLINE (1966 to June 2006), EMbase (1974 to June 2006), CBMdisc (1978 to April 2005), CNKI (2005 to June 2006) and VIP (2005 to June 2006) for studies assessing the diagnostic value of serum hyaluronic acid for liver fibrosis in patients with chronic viral hepatitis. We checked the references in the reports of included studies. QUADAS items were used for quality assessment. Meta-disc software was used to analyze sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic test odds ratio for the pooled analysis and heterogeneity test. DPS2005 software was used to draw SROC curves for those without heterogeneity. Results In total 24 studies were included: 12 published in Chinese and 12 published in English. Results of the pooled analysis showed that, as for radioimmunoassay (RIA), the pooled LR+ of the studies involving the diagnosis of liver cirrhosis and the differentiation of absent/present liver fibrosis were 7.029 and 3.608; and the pooled LR- were 0.198 and 0.319, respectively. As for enzyme-linked immunosorbent assay (ELISA), the pooled LR+ of the studies involving the diagnosis of liver cirrhosis, the differentiation of mild/severe and absent/present liver fibrosis were 6.093, 9.806 and 4.308; and the pooled LR- were 0.354, 0.347 and 0.563, respectively. Conclusion The biases identified from the 24 studies are mainly due to reference standard review bias. By both RIA and ELISA methods, serum hyaluronic acid has a sound value in diagnosing live cirrhosis. Its value in differentiating absent/present liver fibrosis is also acceptable. However, its value in differentiating mild/severe liver fibrosis needs to be further studied.
目的 探讨诱导痰、痰、血清中的白介素(IL)-4、-6、-8在慢性支气管炎急性期的浓度阈值，确定其诊断意义，了解三种白介素在三种标本中的不同浓度对诊断慢性支气管炎急性期的意义。 方法 2001年1月-8月对77例慢性反复咳嗽患者按全国慢性支气管炎诊断标准确诊慢性支气管炎急性期48例，非慢性支气管炎29例，进行IL-4、-6、-8的诱导痰、痰、血清检测。采用受试者工作特征曲线(ROC曲线)鉴定三种白介素对三种标本的诊断价值。 结果 ①三种标本的三种白介素的诊断比值比(DOR)均＞3，95%可信区间的下限均＞1。②ROC曲线下面积显示：诱导痰及痰中IL-4、-8之间无差别(P＞0.05)，IL-4和IL-8分别与IL-6之间有统计学意义(P＜0.05)；血清中IL-4、-6、-8检测结果无差异(P＞0.05)。IL-4、-8的诱导痰及痰与血清有统计学意义(P＜0.05)，IL-6的诱导痰、痰、血清之间无差异(P＞0.05)。 结论 诱导痰及痰中的IL-4、-8诊断价值较好，可用于慢性支气管炎急性期的诊断。
Objective To systematically review the diagnostic accuracy of 18F-FDG PET dual time point scan in identifying benign and malignant lung lesions, in order to necessity and clinical value of dual time point scan. Methods We electronically searched PubMed, EMbase, The Cochrane Library, WanFang Data, CNKI and CBM for diagnostic tests on 18F-FDG PET dual time point scan vs. surgery or needle biopsy (gold standard) from January 1990 to November 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then statistical analysis was performed to calculate pooled effect sizes of sensitivity (SEN) and specificity (SPE), and area under the curve (AUC) of summary receiver operating characteristics (SROC), followed by sensitive analysis and subgroup analysis. Results A total of 19 domestic and foreign studies were totally included, involving 1 225 lesions. The results of meta-analysis showed SEN 0.82 (95%CI 0.79 to 0.85) and SPE 0.74 (95%CI 0.71 to 0.78) regarding 18F-FDG PET dual time point scan in identifying benign and malignant lung lesions. The results of sensitive analysis showed that: a) after eliminating studies in which tuberculosis in the benign lesions accounted for more than 50%, it showed pooled SEN 0.81 (95%CI 0.77 to 0.84), pooled SPE 0.76 (95%CI 0.72 to 0.80), and AUC 0.850 3; b) after eliminating studies in which sample size was less than 50 cases, it showed pooled SEN 0.78 (95%CI 0.74 to 0.82), pooled SPE 0.78 (95%CI 0.74 to 0.82), and AUC 0.814 1; and c) after eliminating studies in which iSUV was more than 2.5, it showed pooled SEN 0.67 (95%CI 0.55 to 0.78), pooled SPE 0.66 (95%CI 0.54 to 0.77), and AUC 0.779 8. Conclusion 18F-FDG PET dual time point scan has intermediate value in identifying benign and malignant lung lesions, which is almost as good as single time point scan, so it’s unnecessary to apply it as a clinical routine test.
Objective To evaluate the diagnostic value of soluble triggering receptor expressed on myeloid cells-1 (sTREM-1) for sepsis. Methods Such databases as The Cochrane Library (Issue 4, 2012), PubMed, EMbase, CBM, CNKI, VIP and WanFang Data were searched to collect the diagnostic tests on sTREM-1 for sepsis published before April 2012. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted the data, and assessed the methodological quality. Then, Meta-Disc software (Version 1.5) was used to conduct analyses, draw the summary receiver operating characteristic (SROC) curve, and calculate the area under curve and Q index. Results A total of 11 studies involving 1 615 patients were included. The value of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, area under of SROC curve, and Q index were 69%, 71%, 3.7, 0.34, 14.73, 0.875, and 0.805, respectively. Conclusion This meta-analysis shows that sTREM-1 as a single indicator has moderate accuracy for early diagnosing sepsis. It should be combined with other diagnostic indicators to further improve the sensitivity and accuracy in diagnosing sepsis.
ObjectiveTo systematically review the value of contrast-enhanced ultrasound in diagnosis of benign and malignant renal tumors. MethodsSuch databases as PubMed, EMbase, The Cochrane Library (Issue 9, 2013), CBM, CNKI, WanFang Data and VIP were searched by Sep 31st, 2013. Two reviewers independently screened literature according to the inclusion and exclusion criteria, extracted data, and assessed the methodological quality of included studies. Then meta-analysis was performed using Meta-Disc 1.4 software. ResultsSeven studies involving 462 patients were finally included. ROC curve showed shoulder-arm shape. The results of Spearman suggested significance of the threshold effect. The results of meta-analysis showed that, the area under curve (AUC) was 0.98. ConclusionContrast-enhanced ultrasound can improve diagnostic accuracy, which is of important value in the diagnosis and differential diagnosis of benign and malignant renal tumors. Due to limited quality and quantity of the included studies, the abovementioned conclusion still needs to be verified by conducting more high quality studies.
Objective To evaluate the diagnostic value of vascular endothelial growth factor (VEGF)-D detection for the diagnosis of lymphangioleiomyomatosis (LAM) by Meta-analysis. Methods Literatures published before August 2017 were retrieved from PubMed, Embase, China Biology Medicine database, China National Knowledge Internet, Wangfang, and VIP database to retrieve the study about VEGF-D detection for LAM. The studies were screened according to the inclusive and exclusive criteria, the data were extracted, the quality was assessed and the Meta-analysis was performed with related statistical software. Results Six primary studies were included and 521 patients met the inclusion criterion. The Meta-analysis showed the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio of 0.75 [95% confidence interval (CI) (0.70, 0.79)], 0.95 [95%CI (0.91, 0.98)], 16.20 [95%CI (8.70, 30.19)], 0.20 [95%CI (0.10, 0.40)] and 89.49 [95%CI (38.46, 208.22)], respectively. The area under the curve was 0.953 9. Conclusions VEGF-D detection showes a good diagnostic value for LAM. A positive result is more clinical meaningful compared with a negative result, helping for the confirmation of the disease.
ObjectivesTo systematically review clinical values of multi-slice spiral computed tomography angiography (MSCTA) in diagnosis of chest pain triple (CPT).MethodsPubMed, EMbase, The Cochrane Library, Web of Science, CNKI, CBM, VIP and WanFang Data databases were searched to collect diagnostic tests on CPT diagnosed by MSCTA from inception to October 2017. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was performed by Stata 12.0 software. The pooled weighted Sen, Spe, +LR, -LR, and the DOR were calculated, SROC and AUC were drawn.ResultsA total of 11 diagnostic studies were included. The results of meta-analysis showed that the pooled Sen, Spe, +LR, -LR, DOR and AUC of MSCTA for diagnosing CPT were 0.95 (95%CI 0.91 to 0.98), 0.97 (95%CI 0.94 to 0.98), 31.24 (95%CI 15.63 to 62.43), 0.05 (95%CI 0.02 to 0.10), 659.04 (95%CI 236.73 to 1 834.71) and 0.99 (95%CI 0.98 to 1.00), respectively.ConclusionsMSCTA has high sensibility and specificity for diagnosing CPT. Due to limited quantity and quality of the included studies, more high-quality studies are required to verify the above conclusion.