scholarly journals A unification of models for meta-analysis of diagnostic accuracy studies without a gold standard

Biometrics ◽  
2014 ◽  
Vol 71 (2) ◽  
pp. 538-547 ◽  
Author(s):  
Yulun Liu ◽  
Yong Chen ◽  
Haitao Chu
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Meta Analysis ◽  
Without A Gold Standard

scholarly journals Diagnostic Accuracy of Ambulatory Devices in Detecting Atrial Fibrillation: Systematic Review and Meta-analysis

10.2196/26167 ◽  
2021 ◽  
Vol 9 (4) ◽  
pp. e26167
Author(s):  
Tien Yun Yang ◽  
Li Huang ◽  
Shwetambara Malwade ◽  
Chien-Yi Hsu ◽  
Yang Ching Chen
Keyword(s):  
Atrial Fibrillation ◽  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Systematic Reviews ◽  
Subgroup Analysis ◽  
Gold Standard ◽  
Meta Analysis ◽  
Automatic Interpretation ◽  
Sensitivity Specificity

Background Atrial fibrillation (AF) is the most common cardiac arrhythmia worldwide. Early diagnosis of AF is crucial for preventing AF-related morbidity, mortality, and economic burden, yet the detection of the disease remains challenging. The 12-lead electrocardiogram (ECG) is the gold standard for the diagnosis of AF. Because of technological advances, ambulatory devices may serve as convenient screening tools for AF. Objective The objective of this review was to investigate the diagnostic accuracy of 2 relatively new technologies used in ambulatory devices, non-12-lead ECG and photoplethysmography (PPG), in detecting AF. We performed a meta-analysis to evaluate the diagnostic accuracy of non-12-lead ECG and PPG compared to the reference standard, 12-lead ECG. We also conducted a subgroup analysis to assess the impact of study design and participant recruitment on diagnostic accuracy. Methods This systematic review and meta-analysis was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. MEDLINE and EMBASE were systematically searched for articles published from January 1, 2015 to January 23, 2021. A bivariate model was used to pool estimates of sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and area under the summary receiver operating curve (SROC) as the main diagnostic measures. Study quality was evaluated using the quality assessment of diagnostic accuracy studies (QUADAS-2) tool. Results Our search resulted in 16 studies using either non-12-lead ECG or PPG for detecting AF, comprising 3217 participants and 7623 assessments. The pooled estimates of sensitivity, specificity, PLR, NLR, and diagnostic odds ratio for the detection of AF were 89.7% (95% CI 83.2%-93.9%), 95.7% (95% CI 92.0%-97.7%), 20.64 (95% CI 10.10-42.15), 0.11 (95% CI 0.06-0.19), and 224.75 (95% CI 70.10-720.56), respectively, for the automatic interpretation of non-12-lead ECG measurements and 94.7% (95% CI 93.3%-95.8%), 97.6% (95% CI 94.5%-99.0%), 35.51 (95% CI 18.19-69.31), 0.05 (95% CI 0.04-0.07), and 730.79 (95% CI 309.33-1726.49), respectively, for the automatic interpretation of PPG measurements. Conclusions Both non-12-lead ECG and PPG offered high diagnostic accuracies for AF. Detection employing automatic analysis techniques may serve as a useful preliminary screening tool before administering a gold standard test, which generally requires competent physician analyses. Subgroup analysis indicated variations of sensitivity and specificity between studies that recruited low-risk and high-risk populations, warranting future validity tests in the general population. Trial Registration PROSPERO International Prospective Register of Systematic Reviews CRD42020179937; https://www.crd.york.ac.uk/prospero/display_record.php?RecordID=179937

scholarly journals Diagnostic Accuracy of Transthoracic Echocardiography and Transesophageal Echocardiography for Ruptured Chordae Tendineae: A Meta-Analysis

2020 ◽  
Author(s):  
Lisi Liao ◽  
Fa-jin DONG ◽  
Jie-ying ZENG ◽  
Bo-bo SHI ◽  
Xiao-fang ZHONG ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Transesophageal Echocardiography ◽  
Transthoracic Echocardiography ◽  
Gold Standard ◽  
Meta Analysis ◽  
Inclusion Criteria ◽  
Chordae Tendineae ◽  
Prior Probabilities ◽  
Highly Sensitive ◽  
Better Than

Abstract Background Echocardiography is significant for the diagnosis of ruptured chordae tendineae (RCT) for which transesophageal echocardiography (TEE) is always better than transthoracic echocardiography (TTE), but the diagnostic accuracy of TTE still remains confusing. Methods A meta-analysis of included papers was performed to evaluate the diagnostic accuracy of TTE and TEE, with surgical findings of RCT as the gold standard of patients with suspected RCT. Results The literature search yielded 862 papers, 6 met the inclusion criteria, included 505 patients, for detecting RCT, the sensitivity and specificity of TTE were 48% (95% CI: 35–62%) and 98% (95% CI: 89–100%), and those of TEE were 99% (95% CI: 64–100%) and 94% (95% CI: 87–98%), respectively. The summary + LR, -LR of TTE were 22.40 (95%CI: 4.89–102.62), 0.53(95%CI:0. 41–0.68), respectively. The summary + LR, -LR of TEE were 17.62(95%CI: 7.16–43.39), 0.02(95%CI:0. 00-0.57), respectively. For TTE, the area under SROC was 84% (95%CI:92%-96%),and that of TEE is 98%. The pooled + LR and -LR were calculated by setting the prior probabilities of 20% in both TTE and TEE. Conclusions TTE is not highly sensitive for the detection of RCT but is highly specific, so there is a potential of missing diagnosis, and subsequent TEE is almost required in highly suspected patients.

scholarly journals Estimating diagnostic accuracy of tests for latent tuberculosis infection without a gold standard among healthcare workers

2009 ◽  
Vol 14 (43) ◽  
Author(s):  
E Girardi ◽  
C Angeletti ◽  
V Puro ◽  
R Sorrentino ◽  
N Magnavita ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Gold Standard ◽  
Healthcare Workers ◽  
Latent Tuberculosis Infection ◽  
Latent Tuberculosis ◽  
Tuberculosis Infection ◽  
Binary File ◽  
Without A Gold Standard

Binary file ES_Abstracts_Final_ECDC.txt matches

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