Reflectance confocal microscopy diagnostic accuracy for malignant melanoma in different clinical settings: systematic review and meta‐analysis

2020 ◽  
Vol 34 (10) ◽  
pp. 2268-2279 ◽  
Author(s):  
C. Pezzini ◽  
S. Kaleci ◽  
J. Chester ◽  
F. Farnetani ◽  
C. Longo ◽  
...  
Keyword(s):  
Systematic Review ◽  
Malignant Melanoma ◽  
Confocal Microscopy ◽  
Diagnostic Accuracy ◽  
Meta Analysis ◽  
Reflectance Confocal Microscopy ◽  
Clinical Settings

scholarly journals Standard echocardiography versus handheld echocardiography for the detection of subclinical rheumatic heart disease: a systematic review and meta-analysis of diagnostic accuracy

BMJ Open ◽  
2020 ◽  
Vol 10 (10) ◽  
pp. e038449
Author(s):  
Lisa Helen Telford ◽  
Leila Hussein Abdullahi ◽  
Eleanor Atieno Ochodo ◽  
Liesl Joanna Zuhlke ◽  
Mark Emmanuel Engel
Keyword(s):  
Systematic Review ◽  
Heart Disease ◽  
Diagnostic Accuracy ◽  
Receiver Operating Characteristic ◽  
Rheumatic Heart Disease ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Endemic Areas ◽  
Rheumatic Heart ◽  
Receiver Operating

ObjectiveTo summarise the accuracy of handheld echocardiography (HAND) which, if shown to be sufficiently similar to that of standard echocardiography (STAND), could usher in a new age of rheumatic heart disease (RHD) screening in endemic areas.DesignSystematic review and meta-analysis.Data sourcesPubMed, Scopus, EBSCOHost and ISI Web of Science were initially searched on 27 September 2017 and again on 3 March 2020 for studies published from 2012 onwards.Eligibility criteriaStudies assessing the accuracy of HAND compared with STAND when performed by an experienced cardiologist in conjunction with the 2012 World Heart Federation criteria among populations of children and adolescents living in endemic areas were included.Data extraction and synthesisTwo reviewers independently extracted data and assessed the methodological quality of included studies against review-specific Quality Assessment of Diagnostic Accuracy Studies (QUADAS)-2 criteria. A meta-analysis using the hierarchical summary receiver operating characteristic model was conducted to produce summary results of sensitivity and specificity. Forest plots and scatter plots in receiver operating characteristic space in combination with subgroup analyses were used to investigate heterogeneity. Publication bias was not investigated.ResultsSix studies (N=4208) were included in the analysis. For any RHD detection, the pooled results from six studies were as follows: sensitivity: 81.56% (95% CI 76.52% to 86.61%) and specificity: 89.75% (84.48% to 95.01%). Meta-analytical results from five of the six included studies were as follows: sensitivity: 91.06% (80.46% to 100%) and specificity: 91.96% (85.57% to 98.36%) for the detection of definite RHD only and sensitivity: 62.01% (31.80% to 92.22%) and specificity: 82.33% (65.15% to 99.52%) for the detection of borderline RHD only.ConclusionsHAND displayed good accuracy for detecting definite RHD only and modest accuracy for detecting any RHD but demonstrated poor accuracy for the detection of borderline RHD alone. Findings from this review provide some evidence for the potential of HAND to increase access to echocardiographic screening for RHD in resource-limited and remote settings; however, further research into feasibility and cost-effectiveness of wide-scale screening is still needed.PROSPERO registration numberCRD42016051261.

Sign in / Sign up

Export Citation Format

Share Document