• Bovine tuberculosis
• Meta-analysis
• Molecular diagnostics
• Mycobacterium bovis
• Systematic review

• Mycobacterium bovis/isolation & purification
• Animals
• Cattle
• Tuberculosis, Bovine/diagnosis
• Tuberculosis, Bovine/microbiology
• Molecular Diagnostic Techniques/veterinary
• Molecular Diagnostic Techniques/methods
• Sensitivity and Specificity
• Nucleic Acid Amplification Techniques/veterinary
• Nucleic Acid Amplification Techniques/methods

• COVID-19
• computed tomography
• cross-disciplinary methods
• novel coronavirus
• nucleic acid detection
• real world

The 2019 novel coronavirus (COVID-19) pandemic remains rampant in many countries/regions. Improving the positive detection rate of COVID-19 infection is an important measure for control and prevention of this pandemic. This meta-analysis aims to systematically summarize the current characteristics of the auxiliary screening methods by serology for COVID-19 infection in real world.

Web of Science, Cochrane Library, Embase, PubMed, CNKI, and Wangfang databases were searched for relevant articles published prior to May 1^st, 2022. Data on specificity, sensitivity, positive/negative likelihood ratio, area under curve (AUC), and diagnostic odds ratio (dOR) were calculated purposefully.

Sixty-two studies were included with 35,775 participants in the meta-analysis. Among these studies, the pooled estimates for area under the summary receiver operator characteristic of IgG and IgM to predicting COVID-19 diagnosis were 0.974 and 0.928, respectively. The IgG dOR was 209.78 (95% CI: 106.12 to 414.67). The IgM dOR was 78.17 (95% CI: 36.76 to 166.25).

Our findings support serum-specific antibody detection may be the main auxiliary screening methods for COVID-19 infection in real world.

• COVID-19/diagnosis
• COVID-19/epidemiology
• COVID-19 Testing
• Humans
• Immunoglobulin G
• Immunoglobulin M
• Sensitivity and Specificity

• diabetes mellitus
• diagnosis
• diagnostic accuracy
• glycated albumin
• meta-analysis

Older individuals sustaining low-energy falls (LEF) and presenting to the emergency department (ED) demand straightforward diagnostic measures for injury detection. Plain radiography (XR) series for diagnosis of fall-related injuries are standard of care, but frequently subsequent CT examination is required for diagnostic assurance. A systematic database search of diagnostic accuracy of XR for detection of fractures in older LEF patients was performed.

We searched PubMed, Embase, Cochrane Library, WHO International Clinical Trial Platform, and Clinical trials.gov databases from inception to January 2020 for studies including older patients (≥65 years) with LEF and obtaining CT examination and XR of the skeleton in an ED setting.

From 8944 references screened, 11 studies met the criteria for inclusion. Performance of XR for detection of fractures of the pelvic ring and hip was analyzed in nine studies, two studies investigated XR performance to detect rib fractures, and two studies compared diagnostic accuracy of thoracolumbar spine XR. Sensitivity estimates ranged from 10% to 58% and specificity estimates from 55% to 100%. Clinical and statistical heterogeneity was significant among included studies, with an overall considerable risk of bias.

High-quality evidence on accurate imaging strategies in older patients with LEF is lacking to date. XR is missing a reasonable amount of fractures of the pelvic ring, rib cage, and thoracic and lumbar spine. However, the utility of first-line CT imaging and the benefit of diagnosing every fracture is unknown, demanding high-quality prospective trials considering patient-oriented outcome as well.

• accidental falls
• emergency department
• geriatrics

• Accuracy
• Breast cancer
• Contrast-enhanced spectral mammography
• Meta-analysis

• DNA methylation
• WIF1
• colorectal cancer
• diagnostic value
• meta-analysis

• Bovine tuberculosis
• Diagnostic tests
• Performance
• Sensitivity
• Specificity
• Systematic review

• Computed tomography-guided percutaneous transthoracic needle biopsy (CT-PTNB)
• diagnosis
• meta-analysis
• peripheral pulmonary lesions
• radial probe endobronchial ultrasound-guided transbronchial lung biopsy (r-EBUS-TBLB)

• QUALITATIVE RESEARCH
• guideline development
• in depth interviews
• medical education
• medical tests
• test accuracy

• Diffusion of Innovation
• Europe
• Evidence-Based Medicine
• Female
• Guideline Adherence
• Humans
• Interviews as Topic
• Male
• Medical Staff, Hospital
• Practice Guidelines as Topic
• Program Development/methods
• Qualitative Research

• Adolescent
• Adult
• Aged
• Aged, 80 and over
• Biomarkers, Tumor/blood
• Carcinoma, Pancreatic Ductal/blood
• Carcinoma, Pancreatic Ductal/diagnosis
• Cytokines/blood
• Humans
• Middle Aged
• Pancreatic Neoplasms/blood
• Pancreatic Neoplasms/diagnosis
• Predictive Value of Tests
• Prognosis
• Quality Assurance, Health Care
• Risk Factors
• Severity of Illness Index
• Young Adult

• Exhaled nitric oxide
• asthma
• diagnosis
• eNO
• meta-analysis

AIM: To evaluate the utility of carbohydrate antigen 19-9 (CA19-9) for differential diagnosis of pancreatic carcinoma and chronic pancreatitis.

METHODS: We searched the literature for studies reporting the sensitivity, specificity, and other accuracy measures of serum CA19-9 levels for differentiating pancreatic carcinoma and chronic pancreatitis. Pooled analysis was performed using random-effects models, and receiver operating characteristic (ROC) curves were generated. Study quality was assessed using Standards for Reporting Diagnostic Accuracy and Quality Assessment for Studies of Diagnostic Accuracy tools.

RESULTS: A total of 34 studies involving 3125 patients with pancreatic carcinoma and 2061 patients with chronic pancreatitis were included. Pooled analysis of the ability of CA19-9 level to differentiate pancreatic carcinoma and chronic pancreatitis showed the following effect estimates: sensitivity, 0.81 (95%CI: 0.80-0.83); specificity, 0.81 (95%CI: 0.79-0.82); positive likelihood ratio, 4.08 (95%CI: 3.39-4.91); negative likelihood ratio, 0.24 (95%CI: 0.21-0.28); and diagnostic odds ratio, 19.31 (95%CI: 14.40-25.90). The area under the ROC curve was 0.88. No significant publication bias was detected.

CONCLUSION: Elevated CA19-9 by itself is insufficient for differentiating pancreatic carcinoma and chronic pancreatitis, however, it increases suspicion of pancreatic carcinoma and may complement other clinical findings to improve diagnostic accuracy.

• Pancreatic carcinoma
• Chronic pancreatitis
• Carbohydrate antigen
• Diagnosis
• Meta-analysis

• Area Under Curve
• Biomarkers, Tumor/blood
• CA-19-9 Antigen/blood
• Carcinoma/blood
• Carcinoma/diagnosis
• Diagnosis, Differential
• Humans
• Odds Ratio
• Pancreatic Neoplasms/blood
• Pancreatic Neoplasms/diagnosis
• Pancreatitis, Chronic/blood
• Pancreatitis, Chronic/diagnosis
• Predictive Value of Tests
• Prognosis
• ROC Curve
• Up-Regulation

AIM: To evaluate the diagnostic accuracy of magnetic resonance cholangiopancreatography (MRCP) in patients with choledocholithiasis.

METHODS: We systematically searched MEDLINE, EMBASE, Web of Science, and Cochrane databases for studies reporting on the sensitivity, specificity and other accuracy measures of diagnostic effectiveness of MRCP for detection of common bile duct (CBD) stones. Pooled analysis was performed using random effects models, and receiver operating characteristic curves were generated to summarize overall test performance. Two reviewers independently assessed the methodological quality of studies using standards for reporting diagnostic accuracy and quality assessment for studies of diagnostic accuracy tools.

RESULTS: A total of 25 studies involving 2310 patients with suspected choledocholithiasis and 738 patients with CBD stones met the inclusion criteria. The average inter-rater agreement on the methodological quality checklists was 0.96. Pooled analysis of the ability of MRCP to detect CBD stones showed the following effect estimates: sensitivity, 0.90 (95%CI: 0.88-0.92, χ² = 65.80; P < 0.001); specificity, 0.95 (95%CI: 0.93-1.0, χ² = 110.51; P < 0.001); positive likelihood ratio, 13.28 (95%CI: 8.85-19.94, χ² = 78.95; P < 0.001); negative likelihood ratio, 0.13 (95%CI: 0.09-0.18, χ² = 6.27; P < 0.001); and diagnostic odds ratio, 143.82 (95%CI: 82.42-250.95, χ² = 44.19; P < 0.001). The area under the receiver operating characteristic curve was 0.97. Significant publication bias was not detected (P = 0.266).

CONCLUSION: MRCP has high diagnostic accuracy for the detection of choledocholithiasis. MRCP should be the method of choice for suspected cases of CBD stones.

• Choledocholithiasis
• Diagnosis
• Magnetic resonance cholangiopancreatography
• Common bile duct
• Meta-analysis

• Area Under Curve
• Chi-Square Distribution
• Cholangiopancreatography, Magnetic Resonance
• Choledocholithiasis/diagnosis
• Choledocholithiasis/pathology
• Choledocholithiasis/therapy
• Common Bile Duct/pathology
• Humans
• Odds Ratio
• Predictive Value of Tests
• Prognosis
• ROC Curve
• Severity of Illness Index

Malignant pleural effusion (MPE) is one of the most common pleura-associated conditions observed in clinical practice. The development of MPE usually defines advanced cancer with a poor prognosis. Carbohydrate antigen 15-3 (CA 15-3), as an effective pleural fluid biomarker, has been an object of ongoing research in the detection of MPE. The aim of this meta-analysis was to establish the overall diagnostic accuracy of the measurement of pleural CA 15-3 for diagnosing MPE. The databases Medline (using PubMed as the search engine), Embase, Ovid, Web of Science and Cochrane database (up to December 2013) were searched to identify relevant studies. No lower date limit was applied. All literature published in English was reviewed. Sensitivity, specificity, likelihood ratio and diagnostic odds ratio (DOR) were pooled using a random-effect model. Summary receiver operating characteristic (SROC) curve analysis was conducted to evaluate the overall diagnostic value. The methodological quality was assessed in line with the Quality Assessment for Studies of Diagnostic Accuracy statement. Twenty-one studies with a total of 2,861 cases were included in present meta-analysis. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and DOR of CA 15-3 in the diagnosis of MPE were 0.58 [95% confidence interval (CI), 0.56–0.61], 0.91 (95% CI, 0.90–0.93), 8.93 (95% CI, 4.45–17.93), 0.46 (95% CI, 0.37–0.56) and 24.89 (95% CI, 10.39–59.63), respectively. In addition, the area under the curve (AUC) was 0.84. In conclusion, due to the significantly high specificity of pleural CA 15-3 in detecting MPE, it may play a pivotal role in screening to identify patients who may benefit from further invasive pathologic examination, particularly in those presenting clinical manifestations of MPE but with negative cytological findings of the pleural fluid. However, ruling out MPE by testing CA15-3 alone is not recommended due to its limited sensitivity, and it is recommended that the results of CA15-3 assays are interpreted in parallel with conventional test results and other clinical findings.

• CA 15-3
• diagnosis
• malignant pleural effusion
• meta-analysis

• Biomarkers/blood
• Colorectal Neoplasms/blood
• Colorectal Neoplasms/diagnosis
• Data Mining
• Humans
• Likelihood Functions
• Odds Ratio
• Prognosis
• Reproducibility of Results
• Sensitivity and Specificity

• Diagnosis
• Musculoskeletal
• QUADAS
• Rasch analysis
• Study quality
• Systematic review

• Lung ultrasound
• diagnosis
• meta-analysis
• pneumonia

AIM: To investigate the clinical usefulness of interferon-gamma release assays (IGRAs) in the differential diagnosis of intestinal tuberculosis (ITB) from Crohn’s disease (CD) by meta-analysis.

METHODS: A systematic search of English language studies was performed. We searched the following databases: Medline, Embase, Web of Science and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IGRAs in the differential diagnosis of ITB from CD were pooled and analyzed using random-effects models. Receiver operating characteristic curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.

RESULTS: Five studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.95. Analysis of IGRAs for the differential diagnosis of ITB from CD produced summary estimates as follows: sensitivity, 0.74 (95%CI: 0.68-0.80); specificity, 0.87 (95%CI: 0.82-0.90); positive likelihood ratio, 5.98 (95%CI: 3.79-9.43); negative likelihood ratio, 0.28 (95%CI: 0.18-0.43); and diagnostic odds ratio, 26.21 (95%CI: 14.15-48.57). The area under the curve was 0.92. The evaluation of publication bias was not significant (P = 0.235).

CONCLUSION: Although IGRAs are not sensitive enough, they provide good specificity for the accurate diagnosis of ITB, which may be helpful in the differential diagnosis of ITB from CD.

• Intestinal tuberculosis
• Crohn’s disease
• Interferon-gamma
• Meta-analysis

• Area Under Curve
• Chi-Square Distribution
• Crohn Disease/diagnosis
• Crohn Disease/immunology
• Diagnosis, Differential
• Humans
• Interferon-gamma Release Tests
• Intestinal Diseases/diagnosis
• Intestinal Diseases/immunology
• Intestinal Diseases/microbiology
• Odds Ratio
• Predictive Value of Tests
• ROC Curve
• Tuberculosis, Gastrointestinal/diagnosis
• Tuberculosis, Gastrointestinal/immunology
• Tuberculosis, Gastrointestinal/microbiology

AIM: To investigate the performance and diagnostic accuracy of interferon-gamma (IFN-γ) for tuberculous peritonitis (TBP) by meta-analysis.

METHODS: A systematic search of English language studies was performed. We searched the following electronic databases: MEDLINE, EMBASE, Web of Science, BIOSIS, LILACS and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IFN-γ concentration in the diagnosis of peritoneal effusion were pooled using random-effects models. Receiver operating characteristic (ROC) curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.

RESULTS: Six studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92. Analysis of IFN-γ level for TBP diagnosis yielded a summary estimate: sensitivity, 0.93 (95%CI, 0.87-0.97); specificity, 0.99 (95%CI, 0.97-1.00); positive likelihood ratio (PLR), 41.49 (95%CI, 18.80-91.55); negative likelihood ratio (NLR), 0.11 (95%CI, 0.06-0.19); and diagnostic odds ratio (DOR), 678.02 (95%CI, 209.91-2190.09). χ² values of the sensitivity, specificity, PLR, NLR and DOR were 5.66 (P = 0.3407), 6.37 (P = 0.2715), 1.38 (P = 0.9265), 5.46 (P = 0.3621) and 1.42 (P = 0.9220), respectively. The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97. The area under the curve was 0.99. The evaluation of publication bias was not significant (P = 0.922).

CONCLUSION: IFN-γ may be a sensitive and specific marker for the accurate diagnosis of TBP. The level of IFN-γ may contribute to the accurate differentiation of tuberculosis (TB) ascites from non-TB ascites.

• Tuberculosis
• Tuberculous peritonitis
• Interferon-gamma
• Diagnosis
• Meta-analysis

• Area Under Curve
• Ascitic Fluid/immunology
• Ascitic Fluid/microbiology
• Biomarkers/analysis
• Humans
• Interferon-gamma/analysis
• Mycobacterium tuberculosis/immunology
• Observer Variation
• Peritonitis, Tuberculous/diagnosis
• Peritonitis, Tuberculous/drug therapy
• Peritonitis, Tuberculous/immunology
• Peritonitis, Tuberculous/microbiology
• Predictive Value of Tests
• Prognosis
• ROC Curve
• Reproducibility of Results

• Cytokines
• Interlukin-6
• Meta-analysis
• Neonate
• Sepsis

Obstetrics and gynaecology have seen rapid growth in the development of new tests with research on these tests presented as diagnostic accuracy studies. To avoid errors in judgement it is important that the methodology of these studies is such that bias is minimised. Our objective was to determine the methodological quality of test accuracy studies in obstetrics and gynaecology using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS) checklist and to assess sources of bias.

A prospective protocol was developed to assess the impact of QUADAS on ten systematic reviews performed over the period 2004-2007.We investigated whether there was an improvement in study quality since the introduction of QUADAS, whether a correlation existed between study sample size, country of origin of study and its quality. We also investigated whether there was a correlation between reporting and methodological quality and by the use of meta-regression analyses explored for items of quality that were associated with bias.

A total of 300 studies were included. The overall quality of included studies was poor (> 50% compliance with 57.1% of quality items). However, the mean compliance with QUADAS showed an improvement post-publication of QUADAS (54.9% versus 61.4% p = 0.002). There was no correlation with study sample size. Gynaecology studies published from the United States of America showed higher quality (USA versus Western Europe p = 0.002; USA versus Asia p = 0.004). Meta-regression analysis showed that no individual quality item had a significant impact on accuracy. There was an association between reporting and methodological quality (r = 0.51 p < 0.0001 for obstetrics and r = 0.56 p < 0.0001 for gynaecology).

A combination of poor methodological quality and poor reporting affects the inferences that can be drawn from test accuracy studies. Further compliance with quality checklists is required to ensure that bias is minimised.

Most current guidelines recommend two serological tests to diagnose chronic Chagas disease. When serological tests are persistently inconclusive, some guidelines recommend molecular tests. The aim of this investigation was to review chronic Chagas disease diagnosis literature and to summarize results of ELISA and PCR performance.

A systematic review was conducted searching remote databases (MEDLINE, LILACS, EMBASE, SCOPUS and ISIWeb) and full texts bibliography for relevant abstracts. In addition, manufacturers of commercial tests were contacted. Original investigations were eligible if they estimated sensitivity and specificity, or reliability -or if their calculation was possible - of ELISA or PCR tests, for chronic Chagas disease.

Heterogeneity was high within each test (ELISA and PCR) and threshold effect was detected only in a particular subgroup. Reference standard blinding partially explained heterogeneity in ELISA studies, and pooled sensitivity and specificity were 97.7% [96.7%-98.5%] and 96.3% [94.6%-97.6%] respectively. Commercial ELISA with recombinant antigens studied in phase three investigations partially explained heterogeneity, and pooled sensitivity and specificity were 99.3% [97.9%-99.9%] and 97.5% [88.5%-99.5%] respectively. ELISA's reliability was seldom studied but was considered acceptable. PCR heterogeneity was not explained, but a threshold effect was detected in three groups created by using guanidine and boiling the sample before DNA extraction. PCR sensitivity is likely to be between 50% and 90%, while its specificity is close to 100%. PCR reliability was never studied.

Both conventional and recombinant based ELISA give useful information, however there are commercial tests without technical reports and therefore were not included in this review. Physicians need to have access to technical reports to understand if these serological tests are similar to those included in this review and therefore correctly order and interpret test results. Currently, PCR should not be used in clinical practice for chronic Chagas disease diagnosis and there is no PCR test commercially available for this purpose. Tests limitations and directions for future research are discussed.

• mild dementia
• screening instruments
• secondary care
• validation studies
• quality assessment of diagnostic accuracy studies

• Cognition Disorders/diagnosis
• Dementia/diagnosis
• Diagnostic Techniques, Neurological/instrumentation
• Diagnostic Techniques, Neurological/standards
• Humans
• Mass Screening/methods
• Meta-Analysis as Topic
• Neuropsychological Tests/standards
• Neuropsychological Tests/statistics & numerical data
• Quality Assurance, Health Care
• Reference Standards
• Review Literature as Topic
• Surveys and Questionnaires
• Validation Studies as Topic

• Communicable Disease Control
• Diagnostic Tests, Routine/standards
• HIV Infections/diagnosis
• Humans
• Malaria/diagnosis
• Peer Review, Research/standards
• Periodicals as Topic/standards
• Quality Control
• Reproducibility of Results
• Research Design/standards
• Tuberculosis/diagnosis

• MOP-89918 Canadian Institutes of Health Research

• Colectomy/methods
• Colonic Neoplasms/diagnosis
• Colonic Neoplasms/secondary
• Colonic Neoplasms/surgery
• Humans
• Lymphatic Metastasis
• Neoplasm Staging/methods
• Sentinel Lymph Node Biopsy/methods