scholarly journals Clinical Diagnostic Tests versus Medial Branch Blocks for Adults with Persisting Cervical Zygapophyseal Joint Pain: A Systematic Review and Meta-Analysis

2018 ◽  
Vol 70 (2) ◽  
pp. 179-187
Author(s):  
Kendra Usunier ◽  
Mark Hynes ◽  
James Michael Schuster ◽  
Annie Cornelio-Jin Suen ◽  
Jackie Sadi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Tests ◽  
Joint Pain ◽  
Meta Analysis ◽  
Medial Branch ◽  
Zygapophyseal Joint ◽  
Clinical Diagnostic

scholarly journals Overtesting and undertesting in primary care: a systematic review and meta-analysis

BMJ Open ◽  
2018 ◽  
Vol 8 (2) ◽  
pp. e018557 ◽  
Author(s):  
Jack W O’Sullivan ◽  
Ali Albasri ◽  
Brian D Nicholson ◽  
Rafael Perera ◽  
Jeffrey K Aronson ◽  
...  
Keyword(s):  
Systematic Review ◽  
Primary Care ◽  
Pulmonary Function ◽  
Diagnostic Test ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Pulmonary Function Tests ◽  
Upper Endoscopy ◽  
Eligibility Criteria ◽  
Function Tests

BackgroundHealth systems are currently subject to unprecedented financial strains. Inappropriate test use wastes finite health resources (overuse) and delays diagnoses and treatment (underuse). As most patient care is provided in primary care, it represents an ideal setting to mitigate waste.ObjectiveTo identify overuse and underuse of diagnostic tests in primary care.DesignSystematic review and meta-analysis.Data sources and eligibility criteriaWe searched MEDLINE and Embase from January 1999 to October 2017 for studies that measured the inappropriateness of any diagnostic test (measured against a national or international guideline) ordered for adult patients in primary care.ResultsWe included 357 171 patients from 63 studies in 15 countries. We extracted 103 measures of inappropriateness (41 underuse and 62 overuse) from included studies for 47 different diagnostic tests.The overall rate of inappropriate diagnostic test ordering varied substantially (0.2%–100%)%).17 tests were underused >50% of the time. Of these, echocardiography (n=4 measures) was consistently underused (between 54% and 89%, n=4). There was large variation in the rate of inappropriate underuse of pulmonary function tests (38%–78%, n=8).Eleven tests were inappropriately overused >50% of the time. Echocardiography was consistently overused (77%–92%), whereas inappropriate overuse of urinary cultures, upper endoscopy and colonoscopy varied widely, from 36% to 77% (n=3), 10%–54% (n=10) and 8%–52% (n=2), respectively.ConclusionsThere is marked variation in the appropriate use of diagnostic tests in primary care. Specifically, the use of echocardiography (both underuse and overuse) is consistently poor. There is substantial variation in the rate of inappropriate underuse of pulmonary function tests and the overuse of upper endoscopy, urinary cultures and colonoscopy.PROSPERO registration numberCRD42016048832.

scholarly journals High value of rapid diagnostic tests to diagnose malaria within children: A systematic review and meta-analysis

2020 ◽  
Vol 10 (1) ◽  
Author(s):  
Wenjun Zhu ◽  
XiaoXiao Ling ◽  
Wenru Shang ◽  
Yanqiu Du ◽  
Jinyu Liu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
Rapid Diagnostic Tests

scholarly journals The accuracy of diagnostic tests for GH deficiency in adults: a systematic review and meta-analysis

2011 ◽  
Vol 165 (6) ◽  
pp. 841-849 ◽  
Author(s):  
Ahmad Hazem ◽  
Mohamed B Elamin ◽  
German Malaga ◽  
Irina Bancos ◽  
Yolanda Prevost ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Diagnostic Tests ◽  
Methodological Quality ◽  
Gh Deficiency ◽  
Small Sample Size ◽  
Meta Analysis ◽  
Outcome Data ◽  
Small Sample ◽  
Supporting Evidence

ContextThe diagnostic accuracy of tests used to diagnose GH deficiency (GHD) in adults is unclear.ObjectiveWe conducted a systematic review and meta-analysis of studies that provided data on the available diagnostic tests.Data sourcesWe searched electronic databases (MEDLINE, EMBASE, Cochrane CENTRAL, Web of Sciences, and Scopus) through April 2011.Study selectionReview of reference lists and contact with experts identified additional candidate studies. Reviewers, working independently and in duplicate, determined study eligibility.Data extractionReviewers, working independently and in duplicate, determined the methodological quality of studies and collected descriptive, quality, and outcome data.Data synthesisTwenty-three studies provided diagnostic accuracy data; none provided patient outcome data. Studies had fair methodological quality, used several reference standards, and included over 1100 patients. Several tests based on direct or indirect stimulation of GH release were associated with good diagnostic accuracy, although most were assessed in one or two studies decreasing the strength of inference due to small sample size. Serum levels of GH or IGF1 had low diagnostic accuracy. Pooled sensitivity and specificity of the two most commonly used stimulation tests were found to be 95 and 89% for the insulin tolerance test and 73 and 81% for the GHRH+arginine test respectively. Meta-analytic estimates for accuracy were associated with substantial heterogeneity.ConclusionSeveral tests with reasonable diagnostic accuracy are available for the diagnosis of GHD in adults. The supporting evidence, however, is at high risk of bias (due to heterogeneity, methodological limitations, and imprecision).

scholarly journals The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research

PLoS ONE ◽  
2016 ◽  
Vol 11 (12) ◽  
pp. e0168613 ◽  
Author(s):  
Lisa A. Waddell ◽  
Judy Greig ◽  
Mariola Mascarenhas ◽  
Shannon Harding ◽  
Robbin Lindsay ◽  
...  
Keyword(s):  
Systematic Review ◽  
Lyme Disease ◽  
North American ◽  
Diagnostic Tests ◽  
Meta Analysis ◽  
American Research

scholarly journals Health workers’ compliance to rapid diagnostic tests (RDTs) to guide malaria treatment: a systematic review and meta-analysis

2016 ◽  
Vol 15 (1) ◽  
Author(s):  
Alinune N. Kabaghe ◽  
Benjamin J. Visser ◽  
Rene Spijker ◽  
Kamija S. Phiri ◽  
Martin P. Grobusch ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Tests ◽  
Health Workers ◽  
Meta Analysis ◽  
Rapid Diagnostic Tests ◽  
Malaria Treatment

Incidental findings in genetic research and clinical diagnostic tests: A systematic review

2012 ◽  
Vol 158A (12) ◽  
pp. 3159-3167 ◽  
Author(s):  
Leigh Jackson ◽  
Lesley Goldsmith ◽  
Anita O'Connor ◽  
Heather Skirton
Keyword(s):  
Systematic Review ◽  
Diagnostic Tests ◽  
Incidental Findings ◽  
Genetic Research ◽  
Clinical Diagnostic

scholarly journals Systematic Review of the Therapeutic Effectiveness of Cervical Facet Joint Interventions: An Update

2012 ◽  
Vol 6;15 (6;12) ◽  
pp. E839-E868 ◽  
Author(s):  
Frank J.E. Falco
Keyword(s):  
Systematic Review ◽  
Neck Pain ◽  
Joint Pain ◽  
Observational Studies ◽  
Facet Joint ◽  
Medial Branch ◽  
Radiofrequency Neurotomy ◽  
Facet Joint Interventions ◽  
Cervical Facet ◽  
Cervical Facet Joint

Background: The prevalence of chronic, recurrent neck pain is approximately 15% of the adult general population. Controlled studies have supported the existence of cervical facet or zygapophysial joint pain in 36% to 67% of these patients, when disc herniation, radiculitis, and discogenic are not pathognomic. However, these studies also have shown false-positive results in 27% to 63% of the patients with a single diagnostic block. There is also a paucity of literature investigating therapeutic interventions of cervical facet joint pain. Study Design: Systematic review of therapeutic cervical facet joint interventions. Objective: To determine and update the clinical utility of therapeutic cervical facet joint interventions in the management of chronic neck pain. Methods: The available literature for utility of facet joint interventions in therapeutic management of cervical facet joint pain was reviewed. The quality assessment and clinical relevance criteria utilized were the Cochrane Musculoskeletal Review Group criteria as utilized for interventional techniques for randomized trials and the criteria developed by the Newcastle-Ottawa Scale criteria for observational studies. The level of evidence was classified as good, fair, and limited or poor based on the quality of evidence developed by the U.S. Preventive Services Task Force (USPSTF). Data sources included relevant literature identified through searches of PubMed and EMBASE from 1966 to June 2012, and manual searches of the bibliographies of known primary and review articles. Outcome Measures: The primary outcome measure was pain relief (short-term relief = up to 6 months and long-term > 6 months). Secondary outcome measures were improvement in functional status, psychological status, return to work, and reduction in opioid intake. Results: In this systematic review, 32 manuscripts were considered for inclusion. For final analysis, 4 randomized trials and 6 observational studies met the inclusion criteria and were included in the evidence synthesis. Based on one randomized, sham-controlled, double-blind trial and 5 observational studies, the indicated evidence for cervical radiofrequency neurotomy is fair. Based on one randomized, double-blind, active-controlled trial and one prospective evaluation, the indicated evidence for cervical medial branch blocks is fair. Based on 2 randomized controlled trials, the evidence for cervical intraarticular injections is limited. Limitations: Paucity of the overall published literature and specifically lack of literature for intraarticular cervical facet joint injections. Conclusions: The indicated evidence for cervical radiofrequency neurotomy is fair. The indicated evidence for cervical medial branch blocks is fair. The indicated evidence for cervical intraarticular injections with local anesthetic and steroids is limited. Key words: Chronic neck pain, cervical facet or zygapophysial joint pain, cervical medial branch blocks, cervical radiofrequency neurotomy, cervical intraarticular facet joint injections

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