scholarly journals SARC-F Is Inaccurate to Identify Geriatric Rehabilitation Inpatients at Risk for Sarcopenia: RESORT

Gerontology ◽  
2021 ◽  
pp. 1-9
Author(s):  
Lenore Dedeyne ◽  
Esmee M. Reijnierse ◽  
Jacob Pacifico ◽  
Jacqueline E. Kay ◽  
Patricia Maggs ◽  
...  
Keyword(s):  
At Risk ◽  
Diagnostic Accuracy ◽  
Working Group ◽  
Handgrip Strength ◽  
Area Under The Curve ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Geriatric Rehabilitation ◽  
European Working ◽  
Sensitivity Specificity

<b><i>Introduction:</i></b> Sarcopenia is highly prevalent in geriatric rehabilitation inpatients; screening using the Strength, Assistance in walking, Rise from a chair, Climb stairs, Falls history questionnaire (SARC-F) has been recommended. This study assessed the diagnostic accuracy of the SARC-F in identifying sarcopenia according to the European Working Group on Sarcopenia in Older People (EWGSOP), EWGSOP2, and Asian Working Group for Sarcopenia (AWGS) definitions in geriatric rehabilitation inpatients. <b><i>Methods:</i></b> REStOring health of acutely unwell adulTs (RESORT) is an observational, longitudinal cohort of geriatric rehabilitation inpatients. The SARC-F was completed for 2 time-points, status at preadmission (1 month before admission) and at admission; a score ≥4 was considered at risk for sarcopenia. Muscle mass (bioelectrical impedance analysis), handgrip strength (handheld dynamometry), and gait speed (4-m walk test) were measured at admission. Diagnostic accuracy was determined by sensitivity, specificity, and area under the curve (AUC). <b><i>Results:</i></b> The sarcopenia prevalence (<i>n</i> = 290, median age 84.0 years [IQR 79.0–89.0], 56.9% female) was 40.3% (EWGSOP1), 25.4% (EWGSOP2), and 38.8% (AWGS). For preadmission and admission status, respectively, the SARC-F identified 67.9 and 82.1% (EWGSOP), 66.0 and 81.0% (EWGSOP2), and 67.5 and 81.6% (AWGS) inpatients at risk for sarcopenia. The SARC-F showed fair sensitivity (67–74%), poor specificity (32–37%), and poor AUC (0.411–0.474) to identify inpatients at risk for sarcopenia at preadmission status, and fair-good sensitivity (79–84%), poor specificity (17–20%), and poor AUC (0.401–0.432) to identify inpatients at risk for sarcopenia at admission, according to EWGSOP, EWGSOP2, and AWGS definitions. <b><i>Conclusion:</i></b> The SARC-F showed poor diagnostic accuracy in identifying sarcopenia in geriatric rehabilitation inpatients. Assessment of sarcopenia is recommended without screening.

scholarly journals COMPARISON OF CURRENT SARCOPENIA CLASSIFICATION CRITERIA IN OLDER NEW ENGLAND WOMEN

2017 ◽  
pp. 1-5
Author(s):  
S.G. Slezak ◽  
K.B Mahoney ◽  
E.N. Renna ◽  
I.E. Lofgren ◽  
F. Xu ◽  
...  
Keyword(s):  
Working Group ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Classification Criteria ◽  
Community Dwelling ◽  
Self Report ◽  
Cross Sectional ◽  
European Working ◽  
Significant Difference ◽  
Distribution Frequency

Objectives: To evaluate the prevalence of sarcopenia in a sample of older, sedentary women using criteria from the European Working Group on Sarcopenia in Older People (EWGSOP), the International Working Group (IWG), and the Foundation for the National Institutes of Health Sarcopenia Project (FNIHSP). Design: Cross-sectional analysis. Setting and Participants: Community-dwelling women (n = 61) aged 71.9 ± 4.6 years (mean±SD) with a BMI 27.3 ± 6.0 kg/m2 who by self-report were healthy and did not exercise were recruited and evaluated for sarcopenia. Measurements: Height, weight, grip strength, gait speed, and appendicular lean mass (via segmental multi-frequency bioelectrical impedance analysis: SMF-BIA) were measured. Prevalence was reported using descriptive statistics and a Fisher’s exact test was used to analyze the distribution frequency of sarcopenia classification by different criteria. Results: In this sample 14.8% met EWGSOP criteria, 6.6% met FNIHSP criteria, and 3.3% met IWG criteria. There was a borderline significant difference in distribution frequency between EWGSOP and IWG classification criteria (p=0.053). Conclusion: The variation in sarcopenia prevalence depending on the diagnostic criteria used is consistent with previous research and there are borderline significant differences between classification criteria in this population. These data suggest the need for additional examination to determine current cut points for ALM measured by SMF-BIA, as well as which established definition of sarcopenia is appropriate for this population.

scholarly journals POS0518 DIAGNOSTIC VALUE OF MUSCLE STRENGTH TESTS FOR THE DIAGNOSIS OF SARCOPENIA IN RHEUMATOID ARTHRITIS PATIENTS

2021 ◽  
Vol 80 (Suppl 1) ◽  
pp. 493.1-493
Author(s):  
O. Dobrovolskaya ◽  
A. Efremova ◽  
N. Toroptsova ◽  
O. Nikitinskaya ◽  
A. Feklistov
Keyword(s):  
Rheumatoid Arthritis ◽  
Muscle Strength ◽  
Diagnostic Accuracy ◽  
Muscle Mass ◽  
Handgrip Strength ◽  
Diagnostic Value ◽  
Predictive Values ◽  
European Working ◽  
Strength Tests ◽  
Sensitivity Specificity

Background:Motor disorders in patients with rheumatoid arthritis (RA) may be associated with sarcopenia (SP). The frequency of secondary SP in RA patients reaches 17 - 37% [1, 2]. Currently, in patients with RA muscle strength is evaluated by methods proposed in geriatric practice [3].Objectives:To determine the sensitivity, specificity, diagnostic accuracy, positive and negative predictive value of handgrip strength (HS) and chair stand test (5-times sit-to-stand, CST) for the diagnosis of sarcopenia (SP) in women with rheumatoid arthritis (RA).Methods:87 women (aged 40-75 years) with RA were enrolled in the study. We did not include patients with aseptic bone necrosis, femoral and knee endoprostheses and comorbidity that negatively affected on the bone tissue. All patients underwent handgrip strength by mechanical dynamometer and CST. Handgrip strength less than 16 kg and CST more than 15 seconds were the criteria for probable SP. Assessment of muscle mass was carried out by dual-energy x-ray absorptiometry («Discovery A» Hologic, USA). Reduced muscle mass was determined as a decrease in appendicular muscle mass (AMM) < 15 kg or appendicular mass index (AMI) < 5.5 kg/m2. Confirmed SP was diagnosed when there was a combination of low muscle strength and reduced muscle mass. For both tests of muscle strength assessment, the sensitivity, specificity, diagnostic accuracy of the method, as well as their positive and negative predictor value for the diagnosis of SP were calculated.Results:Low handgrip strength and 5-times CST more than 15 seconds were found in 63 (72%) and 54 (62%) women, respectively. Among them only 20 (23%) patients had low AMM or AMI, so in these women SP was confirmed. For the handgrip strength the sensitivity of the method was 95%, and the specificity - only 34%, the diagnostic accuracy was 48%. The positive prognostic value of this test was 30%, and the negative value - 96%. The sensitivity, specificity and diagnostic accuracy of the CST were significantly lower than the handgrip strength and amounted to 50%, 21% and 28%, respectively. The prognostic value of this test, both positive (16%) and negative (58%), was also significantly lower than the assessment of handgrip strength in RA patients.We evaluated the diagnostic value of combination of two tests to identify individuals with probable SP: the sensitivity, specificity and diagnostic accuracy were 65%, 30% and 39%, respectively. Negative and positive predictive values were 71% and 24%, respectively, for combination of 2 tests, which was better than using only CST, but worse than using only hand dynamometry.Conclusion:Muscle strength tests proposed by the European Working Group on Sarcopenia in Older People have a low specificity, diagnostic accuracy and positive predictive values for detecting SP in RA patients, which requires the development of other methods of the first step of diagnosis of SP in RA patients.References:[1]Torii M, Hashimoto M, Hanai A, et al. Prevalence and factors associated with sarcopenia in patients with rheumatoid arthritis. Modern Rheumatology, 2018;29(4):589-595. doi:10.1080/14397595.2018.1510565[2]Vlietstra L, Stebbings S, Meredith-Jones K et al. Sarcopenia in osteoarthritis and rheumatoid arthritis: The association with self-reported fatigue, physical function and obesity. PLoS ONE, 2019;14(6):e0217462. doi:10.1371/journal.pone.0217462[3]Cruz-Jentoft AJ, Bahat G, Bauer J, et al. Writing Group for the European Working Group on Sarcopenia in Older People 2 (EWGSOP2), and the Extended Group for EWGSOP2. Sarcopenia: revised European consensus on definition and diagnosis. Age Ageing. 2019;48(1):16-31. doi:10.1093/ageing/afy169Disclosure of Interests:None declared

scholarly journals The Potential Diagnostic Accuracy of Circulating MicroRNAs for Leukemia: A Meta-Analysis

2021 ◽  
Vol 20 ◽  
pp. 153303382110119
Author(s):  
Wen-Ting Zhang ◽  
Guo-Xun Zhang ◽  
Shuai-Shuai Gao
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Subgroup Analysis ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Circulating Micrornas ◽  
Sensitivity Specificity

Background: Leukemia is a common malignant disease in the human blood system. Many researchers have proposed circulating microRNAs as biomarkers for the diagnosis of leukemia. We conducted a meta-analysis to evaluate the diagnostic accuracy of circulating miRNAs in the diagnosis of leukemia. Methods: A comprehensive literature search (updated to October 13, 2020) in PubMed, EMBASE, Web of Science, Cochrane Library, Wanfang database and China National Knowledge Infrastructure (CNKI) was performed to identify eligible studies. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the curve (AUC) for diagnosing leukemia were pooled for both overall and subgroup analysis. The meta-regression and subgroup analysis were performed to explore heterogeneity and Deeks’ funnel plot was used to assess publication bias. Results: 49 studies from 22 publications with a total of 3,489 leukemia patients and 2,756 healthy controls were included in this meta-analysis. The overall sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio and area under the curve were 0.83, 0.92, 10.8, 0.18, 59 and 0.94, respectively. Subgroup analysis shows that the microRNA clusters of plasma type could carry out a better diagnostic accuracy of leukemia patients. In addition, publication bias was not found. Conclusions: Circulating microRNAs can be used as a promising noninvasive biomarker in the early diagnosis of leukemia.

scholarly journals Muscle quantity and function measurements are acceptable to older adults during and post- hospitalisation: results of a questionnaire-based study

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Carly Welch ◽  
Carolyn Greig ◽  
Tahir Masud ◽  
Thomas A. Jackson
Keyword(s):  
Older Adults ◽  
Gait Speed ◽  
Bacterial Infections ◽  
Handgrip Strength ◽  
General Medicine ◽  
Research Participation ◽  
Bioelectrical Impedance ◽  
Impedance Analysis ◽  
Queen Elizabeth Hospital ◽  
Elective Colorectal Surgery

Abstract Background To evaluate the acceptability of handgrip strength, gait speed, quadriceps ultrasound, and Bioelectrical Impedance Analysis (BIA) to older adults conducted during and following hospitalisation. Methods Questionnaire-based study conducted upon completion of prospective cohort study, with follow-up in either Queen Elizabeth Hospital Birmingham (QEHB), UK, or participant’s own home following recent admission to QEHB. Outcome measures were acceptability as defined by total multi-domain score for each test (maximum score 35), and by frailty status. Results Forty adults aged 70 years and older admitted for emergency abdominal surgery, elective colorectal surgery, or acute bacterial infections (general medicine) participated. Handgrip strength (median 33, IQR 30–35; p = 0.001), gait speed (median 32, IQR 30–35; p = 0.002), ultrasound quadriceps (median 33, IQR 31–35; p = 0.001), and BIA (median 33.5, IQR 31–35; p = 0.001) were considered highly acceptable. Participants responded positively that they enjoyed participating in these tests, and considered these tests of importance. There was no difference in scores between tests (p = 0.166). Individual total test scores did not differ between patients with and without frailty. Qualitative data are also presented on drivers for research participation. Conclusions Handgrip strength, gait speed, ultrasound quadriceps, and BIA are acceptable tests to older adults during and following hospitalisation. Our results may serve as standards when evaluating acceptability of other tests. Trial registration Prospectively registered February 2019: https://clinicaltrials.gov/ct2/show/NCT03858192

scholarly journals Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis

2019 ◽  
Vol 179 (1) ◽  
pp. 29-38 ◽  
Author(s):  
Hanneke E. M. van der Hoek-Snieders ◽  
Antonius J. M. L. van den Heuvel ◽  
Harmieke van Os-Medendorp ◽  
Digna M. A. Kamalski
Keyword(s):  
At Risk ◽  
Diagnostic Accuracy ◽  
Cleft Palate ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Fetal Mri ◽  
Diagnostic Study ◽  
Index Test ◽  
Orofacial Clefts ◽  
Prenatal Detection

AbstractThis systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (reference test) in fetuses at risk for orofacial clefts. Methodological quality was assessed using the QUADAS-2. A meta-analysis was performed with a random-effects model, calculating the pooled sensitivity, specificity, and area under the curve. The search resulted in eight studies (334 fetuses) to be included: four prospective and four retrospective studies. The applicability concern was low. There was, however, a risk of selection and information bias. All studies showed that MRI well predicted the chance of cleft palate. The sensitivity results were homogeneous, but heterogeneity was assumed regarding the specificity estimate (Cochrane’s Q test: p = 0.00). The pooled sensitivity was 0.97 (95% CI 0.93–0.99); the pooled specificity was 0.94 (0.89–0.97). The area under the curve was 0.98 (95% CI 0.98–0.99).Conclusion: This meta-analysis shows that MRI has an excellent sensitivity and good to excellent specificity for diagnosing cleft palate in fetuses at risk for orofacial clefts. Future research should assess applicability for clinical care.What is Known:• Using ultrasound for prenatal detection of cleft palate leads to misdiagnosis frequently.• MRI could potentially improve the prenatal detection rate of cleft palate.What is New:• Eight studies describe the diagnostic accuracy of MRI for detecting cleft palate.• Combined results show excellent sensitivity and good to excellent specificity.

scholarly journals The role of red cell distribution width in the differential diagnosis of iron deficiency anemia and non-transfusion dependent thalassemia patients

2018 ◽  
Vol 10 (3) ◽  
Author(s):  
Pokpong Piriyakhuntorn ◽  
Adisak Tantiworawit ◽  
Thanawat Rattanathammethee ◽  
Chatree Chai-Adisaksopha ◽  
Ekarat Rattarittamrong ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Area Under The Curve ◽  
Microcytic Anemia ◽  
Deficiency Anemia ◽  
Operating Characteristics ◽  
Training Set ◽  
Distribution Width ◽  
Validation Set ◽  
Sensitivity Specificity

This study aims to find the cut-off value and diagnostic accuracy of the use of RDW as initial investigation in enabling the differentiation between IDA and NTDT patients. Patients with microcytic anemia were enrolled in the training set and used to plot a receiving operating characteristics (ROC) curve to obtain the cut-off value of RDW. A second set of patients were included in the validation set and used to analyze the diagnostic accuracy. We recruited 94 IDA and 64 NTDT patients into the training set. The area under the curve of the ROC in the training set was 0.803. The best cut-off value of RDW in the diagnosis of NTDT was 21.0% with a sensitivity and specificity of 81.3% and 55.3% respectively. In the validation set, there were 34 IDA and 58 NTDT patients using the cut-off value of >21.0% to validate. The sensitivity, specificity, positive predictive value and negative predictive value were 84.5%, 70.6%, 83.1% and 72.7% respectively. We can therefore conclude that RDW >21.0% is useful in differentiating between IDA and NTDT patients with high diagnostic accuracy

scholarly journals The diagnostic utility of the “Thwaites’ system” and “lancet consensus scoring system” in tuberculous vs. non-tuberculous subacute and chronic meningitis: multicenter analysis of 395 adult patients

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Tarek Sulaiman ◽  
Sai Medi ◽  
Hakan Erdem ◽  
Seniha Senbayrak ◽  
Derya Ozturk-Engin ◽  
...  
Keyword(s):  
Bacterial Meningitis ◽  
Diagnostic Accuracy ◽  
Scoring System ◽  
Area Under The Curve ◽  
Receiver Operating Curve ◽  
Chronic Meningitis ◽  
Multicenter Analysis ◽  
Consensus Scoring ◽  
Sensitivity Specificity ◽  
Management Challenge

Abstract Background Tuberculous meningitis (TBM) represents a diagnostic and management challenge to clinicians. The “Thwaites’ system” and “Lancet consensus scoring system” are utilized to differentiate TBM from bacterial meningitis but their utility in subacute and chronic meningitis where TBM is an important consideration is unknown. Methods A multicenter retrospective study of adults with subacute and chronic meningitis, defined by symptoms greater than 5 days and less than 30 days for subacute meningitis (SAM) and greater than 30 days for chronic meningitis (CM). The “Thwaites’ system” and “Lancet consensus scoring system” scores and the diagnostic accuracy by sensitivity, specificity, and area under the curve of receiver operating curve (AUC-ROC) were calculated. The “Thwaites’ system” and “Lancet consensus scoring system” suggest a high probability of TBM with scores ≤4, and with scores of ≥12, respectively. Results A total of 395 patients were identified; 313 (79.2%) had subacute and 82 (20.8%) with chronic meningitis. Patients with chronic meningitis were more likely caused by tuberculosis and had higher rates of HIV infection (P < 0.001). A total of 162 patients with TBM and 233 patients with non-TBM had unknown (140, 60.1%), fungal (41, 17.6%), viral (29, 12.4%), miscellaneous (16, 6.7%), and bacterial (7, 3.0%) etiologies. TMB patients were older and presented with lower Glasgow coma scores, lower CSF glucose and higher CSF protein (P < 0.001). Both criteria were able to distinguish TBM from bacterial meningitis; only the Lancet score was able to differentiate TBM from fungal, viral, and unknown etiologies even though significant overlap occurred between the etiologies (P < .001). Both criteria showed poor diagnostic accuracy to distinguish TBM from non-TBM etiologies (AUC-ROC was <. 5), but Lancet consensus scoring system was fair in diagnosing TBM (AUC-ROC was .738), sensitivity of 50%, and specificity of 89.3%. Conclusion Both criteria can be helpful in distinguishing TBM from bacterial meningitis, but only the Lancet consensus scoring system can help differentiate TBM from meningitis caused by fungal, viral and unknown etiologies even though significant overlap occurs and the overall diagnostic accuracy of both criteria were either poor or fair.

scholarly journals Comparison of revised EWGSOP2 criteria of sarcopenia in patients with cancer using different parameters of muscle mass

PLoS ONE ◽  
2021 ◽  
Vol 16 (9) ◽  
pp. e0257446
Author(s):  
Ana Paula Trussardi Fayh ◽  
Iasmin Matias de Sousa
Keyword(s):  
Cancer Patients ◽  
Muscle Mass ◽  
Handgrip Strength ◽  
Lumbar Vertebra ◽  
Cross Sectional Study ◽  
Diagnostic Methods ◽  
Cross Sectional ◽  
Kappa Test ◽  
European Working ◽  
Sensitivity Specificity

Calf circumference (CC) has been established as a marker of muscle mass (MM) with good performance for predicting survival in individuals with cancer. The study aims to determine the prevalence of sarcopenia according to the European Working Group on Sarcopenia in Older People 2 (EWGSOP2) criteria and to evaluate the accuracy of sarcopenia using low CC relative to MM assessment by computed tomography (CT) at third lumbar vertebra level (L3) as a reference. Cross-sectional study with cancer patients aged ≥ 60 years. Data included socio-demographic, clinical and anthropometric variables. MM was assessed by CC and by CT images at the L3. Sarcopenia was diagnosed according to the EWGSOP2 criteria: a) low handgrip strength (HGS) + reduced MM evaluated by CT; and b) low HGS + low CC. Pearson’s correlation, accuracy, sensitivity, specificity, positive predictive and negative predictive value were analyzed. A total of 108 patients were evaluated, age of 70.6 ± 7.4 years (mean ± standard deviation). The prevalence of sarcopenia was of 24.1% (low MM) and 25.9% (low CC). The Kappa test showed a substantial agreement (K = 0.704), 81% sensitivity, and 92% specificity. Although the EWGSOP2 advises that we should use CC measures in the algorithm for sarcopenia when no other MM diagnostic methods are available, the findings allow the use of CC instead of MM by CT in cancer patients.

scholarly journals Diagnostic value of endobronchial ultrasound elastography for differentiating benign and malignant hilar and mediastinal lymph nodes: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Jiangfeng Wu ◽  
Yue Sun ◽  
Yunlai Wang ◽  
Lijing Ge ◽  
Yun Jin ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Value ◽  
Endobronchial Ultrasound ◽  
Mediastinal Lymph Nodes ◽  
Sensitivity Specificity

Aims: In the present study, a meta-analysis was performed to evaluate the diagnostic value of endobronchial ultrasound (EBUS) elastography for differentiating benign and malignant hilar and mediastinal lymph nodes (LNs). Material and methods: A comprehensive literature search was carried out through PubMed, Embase, and Cochrane Library. Two authors screened the papers and extracted the data independently and any discrepancies were resolved by discussion. The methodolog-ical quality of each included study was assessed by the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and area under the curve were calculated to evaluate the value of EBUS elastography for hilar and mediastinal LNs. Results: Seventeen studies with the number of 2307 LNs were included. There was significant heterogeneity across the included studies. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and diagnostic odds ratio for the diagnosis of hilar and mediastinal LNs by EBUS elastography were 0.90 (95% confidence interval [CI], 0.84-0.94), 0.78 (95% CI, 0.74-0.81), 4.1 (95% CI, 3.4-4.9), 0.12 (95% CI, 0.07-0.21) and 33 (95% CI, 17-64), respectively. Furthermore, area under the curve was calculated to be 0.86 (95% CI, 0.82-0.88). Conclusion: EBUS elastography is a valuable technology in the differentiation of benign and malignant hilar and mediastinal LNs and could provide supplementary diagnostic information during endobronchial ultrasound-guided transbronchial needle aspiration. The combination of EBUS elastography and B-mode EBUS could improve the diagnostic accuracy for hilar and mediastinal LNs.

scholarly journals Diagnostic accuracy of Doppler ultrasound, CT and MRI in Budd Chiari syndrome: systematic review and meta-analysis

2020 ◽  
Vol 93 (1109) ◽  
pp. 20190847 ◽  
Author(s):  
Pankaj Gupta ◽  
Varun Bansal ◽  
Praveen Kumar-M ◽  
Saroj K Sinha ◽  
Jayanta Samanta ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Doppler Ultrasound ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Budd Chiari Syndrome ◽  
Chiari Syndrome ◽  
Sensitivity Specificity ◽  
Ct And Mri

Objective: To evaluate the sensitivity, specificity, and diagnostic odds ratio (DOR) of Doppler ultrasound, CT, and MRI in the diagnosis of Budd Chiari syndrome (BCS). Methods: We performed a literature search in PubMed, Embase, and Scopus to identify articles reporting the diagnostic accuracy of Doppler ultrasound, CT, and MRI (either alone or in combination) for BCS using catheter venography or surgery as the reference standard. The quality of the included articles was assessed by using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. Results: 11 studies were found eligible for inclusion. Pooled sensitivities and specificities of Doppler ultrasound were 89% [95% confidence interval (CI), 81–94%, I2 = 24.7%] and 68% (95% CI, 3–99%, I2 = 95.2%), respectively. Regarding CT, the pooled sensitivities and specificities were 89% (95% CI, 77–95%, I2 = 78.6%) and 72% (95% CI, 21–96%, I2 = 91.4%), respectively. The pooled sensitivities and specificities of MRI were 93% (95% CI, 89–96%, I2 = 10.6%) and 55% (95% CI, 5–96%, I2 = 87.6%), respectively. The pooled DOR for Doppler ultrasound, CT, and MRI were 10.19 (95% CI: 1.5, 69.2), 14.57 (95% CI: 1.13, 187.37), and 20.42 (95% CI: 1.78, 234.65), respectively. The higher DOR of MRI than that of Doppler ultrasound and CT shows the better discriminatory power. The area under the curve for MRI was 90.8% compared with 88.4% for CT and 86.6% for Doppler ultrasound. Conclusion: Doppler ultrasound, CT and MRI had high overall diagnostic accuracy for diagnosis of BCS, but substantial heterogeneity was found. Prospective studies are needed to investigate diagnostic performance of these imaging modalities. Advances in knowledge: MRI and CT have the highest meta-analytic sensitivity and specificity, respectively for the diagnosis of BCS. Also, MRI has the highest area under curve for the diagnosis of BCS.

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