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Samsunder N, Sivro A, Hassan-Moosa R, Lewis L, Kara Z, Baxter C, Karim QA, Karim SA, Kharsany ABM, Naidoo K, Ngcapu S. Evaluating diagnostic accuracy of an RT-PCR test for the detection of SARS-CoV-2 in saliva. Diagn Progn Res 2024; 8:9. [PMID: 39044271 PMCID: PMC11267770 DOI: 10.1186/s41512-024-00176-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/24/2023] [Accepted: 07/01/2024] [Indexed: 07/25/2024] Open
Abstract
BACKGROUND AND OBJECTIVE Saliva has been proposed as a potential more convenient, cost-effective, and easier sample for diagnosing SARS-CoV-2 infections, but there is limited knowledge of the impact of saliva volumes and stages of infection on its sensitivity and specificity. METHODS In this study, we assessed the performance of SARS-CoV-2 testing in 171 saliva samples from 52 mostly mildly symptomatic patients (aged 18 to 70 years) with a positive reference standard result at screening. The samples were collected at different volumes (50, 100, 300, and 500 µl of saliva) and at different stages of the disease (at enrollment, day 7, 14, and 28 post SARS-CoV-2 diagnosis). Imperfect nasopharyngeal (NP) swab nucleic acid amplification testing was used as a reference. We used a logistic regression with generalized estimating equations to estimate sensitivity, specificity, PPV, and NPV, accounting for the correlation between repeated observations. RESULTS The sensitivity and specificity values were consistent across saliva volumes. The sensitivity of saliva samples ranged from 70.2% (95% CI, 49.3-85.0%) for 100 μl to 81.0% (95% CI, 51.9-94.4%) for 300 μl of saliva collected. The specificity values ranged between 75.8% (95% CI, 55.0-88.9%) for 50 μl and 78.8% (95% CI, 63.2-88.9%) for 100 μl saliva compared to NP swab samples. The overall percentage of positive results in NP swabs and saliva specimens remained comparable throughout the study visits. We observed no significant difference in cycle number values between saliva and NP swab specimens, irrespective of saliva volume tested. CONCLUSIONS The saliva collection offers a promising approach for population-based testing.
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Affiliation(s)
- Natasha Samsunder
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
| | - Aida Sivro
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
- JC Wilt Infectious Disease Research Centre, National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, MB, Canada
- Department of Medical Microbiology and Infectious Diseases, University of Manitoba, Winnipeg, MB, Canada
| | - Razia Hassan-Moosa
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- SAMRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Lara Lewis
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
| | - Zahra Kara
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
| | - Cheryl Baxter
- Centre for Epidemic Response and Innovation (CERI), Stellenbosch University, Stellenbosch, South Africa
| | - Quarraisha Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Salim Abdool Karim
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- Department of Epidemiology, Columbia University, New York, NY, USA
| | - Ayesha B M Kharsany
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa
| | - Kogieleum Naidoo
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa
- SAMRC-CAPRISA HIV-TB Pathogenesis and Treatment Research Unit, Doris Duke Medical Research Institute, University of KwaZulu-Natal, Durban, South Africa
| | - Sinaye Ngcapu
- Centre for the AIDS Programme of Research in South Africa (CAPRISA), 719 Umbilo Road, Durban, 4001, South Africa.
- Department of Medical Microbiology, University of KwaZulu-Natal, Durban, South Africa.
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Dubois C, Dawit H, Korevaar DA, Vali Y, Al Sibaaie A, Frank RA, McInnes MDF, Hyde C, Bossuyt PM, Cohen JF. Evaluation of adherence to STARD for abstracts in a diverse sample of diagnostic accuracy abstracts published in 2012 and 2019 reveals suboptimal reporting practices. J Clin Epidemiol 2024; 173:111459. [PMID: 39004321 DOI: 10.1016/j.jclinepi.2024.111459] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2024] [Revised: 06/18/2024] [Accepted: 07/07/2024] [Indexed: 07/16/2024]
Abstract
OBJECTIVES To evaluate the completeness of reporting in a sample of abstracts on diagnostic accuracy studies before and after the release of Standards for Reporting of Diagnostic Accuracy Studies (STARD) for abstracts in 2017. METHODS We included 278 diagnostic accuracy abstracts published in 2012 (N = 138) and 2019 (N = 140) and indexed in EMBASE. We analyzed their adherence to 10 items of the 11-item STARD for abstracts checklist, and we explored variability in reporting across abstract characteristics using multivariable Poisson modeling. RESULTS Most of the 278 abstracts (75%) were published in discipline-specific journals, with a median impact factor of 2.9 (IQR: 1.9-3.7). The majority (41%) of abstracts reported on imaging tests. Overall, a mean of 5.4/10 (SD: 1.4) STARD for abstracts items was reported (range: 1.2-9.7). Items reported in less than one-third of abstracts included 'eligible patient demographics' (24%), 'setting of recruitment' (30%), 'method of enrollment' (18%), 'estimates of precision for accuracy measures' (26%), and 'protocol registration details' (4%). We observed substantial variability in reporting across several abstract characteristics, with higher adherence associated with the use of a structured abstract, no journal limit for abstract word count, abstract word count above the median, one-gate enrollment design, and prospective data collection. There was no evidence of increase in the number of reported items between 2012 and 2019 (5.2 vs 5.5 items; adjusted reporting ratio: 1.04 [95% CI: 0.98-1.10]). CONCLUSION This sample of diagnostic accuracy abstracts revealed suboptimal reporting practices without improvement between 2012 and 2019. The test evaluation field could benefit from targeted knowledge translation strategies to improve completeness of reporting in abstracts.
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Affiliation(s)
- Constance Dubois
- Center of Research in Epidemiology and Statistics (CRESS), INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université Paris Cité, Paris, France
| | - Haben Dawit
- Temerty Faculty of Medicine, University of Toronto, Toronto, Canada; Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Centers, Amsterdam, The Netherlands
| | - Yasaman Vali
- Department of Epidemiology and Data Science, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Alma Al Sibaaie
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France
| | - Robert A Frank
- Division of Abdominal Imaging and Intervention, Department of Radiology, Harvard Medical School, Brigham and Women's Hospital, Boston, MA, USA
| | - Matthew D F McInnes
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Canada
| | - Chris Hyde
- Exeter Test Group, College House, University of Exeter, Exeter, UK
| | - Patrick M Bossuyt
- Department of Epidemiology and Data Science, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, The Netherlands
| | - Jérémie F Cohen
- Center of Research in Epidemiology and Statistics (CRESS), INSERM, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Université Paris Cité, Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Université Paris Cité, Paris, France.
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van der Pol CB, Costa AF, Lam E, Dawit H, Bashir MR, McInnes MDF. Best Practice for MRI Diagnostic Accuracy Research With Lessons and Examples from the LI-RADS Individual Participant Data Group. J Magn Reson Imaging 2024; 60:21-28. [PMID: 37818955 DOI: 10.1002/jmri.29049] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2023] [Revised: 09/26/2023] [Accepted: 09/27/2023] [Indexed: 10/13/2023] Open
Abstract
Medical imaging diagnostic test accuracy research is strengthened by adhering to best practices for study design, data collection, data documentation, and study reporting. In this review, key elements of such research are discussed, and specific recommendations provided for optimizing diagnostic accuracy study execution to improve uniformity, minimize common sources of bias and avoid potential pitfalls. Examples are provided regarding study methodology and data collection practices based on insights gained by the liver imaging reporting and data system (LI-RADS) individual participant data group, who have evaluated raw data from numerous MRI diagnostic accuracy studies for risk of bias and data integrity. The goal of this review is to outline strategies for investigators to improve research practices, and to help reviewers and readers better contextualize a study's findings while understanding its limitations. LEVEL OF EVIDENCE: 5 TECHNICAL EFFICACY: Stage 3.
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Affiliation(s)
- Christian B van der Pol
- Department of Diagnostic Imaging, Juravinski Hospital and Cancer Centre, Hamilton Health Sciences, Hamilton, Ontario, Canada
- McMaster University, Hamilton, Ontario, Canada
| | - Andreu F Costa
- Department of Diagnostic Radiology, Queen Elizabeth II Health Sciences Centre and Dalhousie University, Halifax, Nova Scotia, Canada
| | - Eric Lam
- Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
| | - Haben Dawit
- Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
- Temerty Faculty of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Mustafa R Bashir
- Departments of Radiology and Medicine, Duke University Medical Center, Durham, North Carolina, USA
- Center for Advanced Magnetic Resonance Development, Duke University Medical Center, Durham, North Carolina, USA
- Department of Radiology, University of North Carolina, Chapel Hill, North Carolina, USA
| | - Matthew D F McInnes
- Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, Ontario, Canada
- Rm c-159 Departments of Radiology and Epidemiology, The Ottawa Hospital-Civic Campus, Ottawa, Ontario, Canada
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Thomas LC, Holliday E, Attia JR, Levi C. Development of a diagnostic support tool for predicting cervical arterial dissection in primary care. J Man Manip Ther 2024; 32:173-181. [PMID: 37651397 PMCID: PMC10956904 DOI: 10.1080/10669817.2023.2250164] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2023] [Accepted: 08/14/2023] [Indexed: 09/02/2023] Open
Abstract
OBJECTIVES Cervical arterial dissection (CAD) is an important cause of stroke in young people which may be missed because early features may mimic migraine or a musculoskeletal presentation. The study aimed to develop a diagnostic support tool for early identification of CAD. DESIGN Retrospective observational study. SETTING Tertiary hospital. PARTICIPANTS Radiologically confirmed CAD cases (n = 37), non-CAD stroke cases (n = 20), and healthy controls (n = 100). MAIN OUTCOME MEASURES The presence of CAD is confirmed with imaging. Predictive variables included risk factors and clinical characteristics of CAD. Variables with a p-value <0.2 included in a multivariable model. Predictive utility of the model is assessed by calculating area underthe ROC curve (AUC). RESULTS The model including four variables: age 40-55 years (vs < 40), trauma, recent onset headache, and > 2 neurological features, demonstrated excellent discrimination: AUC of 0.953 (95% CI: 0.916, 0.987). A predictive scoring system (total score/7) identified an optimal threshold of ≥ 3 points, with a sensitivity of 87% and specificity of 79%. CONCLUSIONS The study identified a diagnostic support tool with four variables to predict increased risk of CAD. Validation in a clinical sample is needed to confirm variables and refine descriptors to enable clinicians to efficiently apply the tool.Optimum cutoff scores of ≥ 3/7 points will help identify those in whom CAD should be considered and further investigation instigated. The potential impact of the tool is to improve early recognition of CAD in those with acute headache or neck pain, thereby facilitating more timely medical intervention, preventing inappropriate treatment, and improving patient outcomes.Wordcount: 3195.
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Affiliation(s)
- Lucy Caroline Thomas
- School of Health and Rehabilitation Sciences, University of Queensland, QLD, Australia
- School of Health Sciences, The University of Newcastle, NSW, Australia
| | - Elizabeth Holliday
- School of Medicine and Public Health, The University of Newcastle, NSW, Australia
| | - John R. Attia
- School of Medicine and Public Health, The University of Newcastle, NSW, Australia
| | - Christopher Levi
- School of Medicine and Public Health, The University of Newcastle, NSW, Australia
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Zadro JR, Ferreira GE, Stahl-Timmins W, Egger V, Elkins MR, Gamble AR, O'Keeffe M, McCaffery KJ, Harris IA, Ardern CL, West CA, Maher CG, Hoffmann TC. Development of the Reporting Infographics and Visual Abstracts of Comparative studies (RIVA-C) checklist and guide. BMJ Evid Based Med 2024:bmjebm-2023-112784. [PMID: 38242568 DOI: 10.1136/bmjebm-2023-112784] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 12/22/2023] [Indexed: 01/21/2024]
Abstract
People often use infographics (also called visual or graphical abstracts) as a substitute for reading the full text of an article. This is a concern because most infographics do not present sufficient information to interpret the research appropriately and guide wise health decisions. The Reporting Infographics and Visual Abstracts of Comparative studies (RIVA-C) checklist and guide aims to improve the completeness with which research findings of comparative studies are communicated and avoid research findings being misinterpreted if readers do not refer to the full text. The primary audience for the RIVA-C checklist and guide is developers of infographics that summarise comparative studies of health and medical interventions. The need for the RIVA-C checklist and guide was identified by a survey of how people use infographics. Possible checklist items were informed by a systematic review of how infographics report research. We then conducted a two-round, modified Delphi survey of 92 infographic developers/designers, researchers, health professionals and other key stakeholders. The final checklist includes 10 items. Accompanying explanation and both text and graphical examples linked to the items were developed and pilot tested over a 6-month period. The RIVA-C checklist and guide was designed to facilitate the creation of clear, transparent and sufficiently detailed infographics which summarise comparative studies of health and medical interventions. Accurate infographics can ensure research findings are communicated appropriately and not misinterpreted. By capturing the perspectives of a wide range of end users (eg, authors, informatics editors, journal editors, consumers), we are hopeful of rapid endorsement and implementation of RIVA-C.
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Affiliation(s)
- Joshua R Zadro
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Giovanni E Ferreira
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | | | - Veronika Egger
- Is-design, International Institute for Information design (IIID), Vienna, Austria
| | - Mark R Elkins
- Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Andrew R Gamble
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Mary O'Keeffe
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Kirsten J McCaffery
- Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, Australia
| | - Ian A Harris
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
- Ingham Institute for Applied Medical Research, South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia
| | - Clare L Ardern
- Department of Physical Therapy, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Courtney A West
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Chris G Maher
- Sydney Musculoskeletal Health, Institute for Musculoskeletal Health, Sydney School of Public Health, Faculty of Medicine and Health, The University of Sydney and Sydney Local Health District, Sydney, NSW, Australia
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
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Trulson I, Klawonn F, von Pawel J, Holdenrieder S. Improvement of differential diagnosis of lung cancer by use of multiple protein tumor marker combinations. Tumour Biol 2024; 46:S81-S98. [PMID: 38277317 DOI: 10.3233/tub-230021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2024] Open
Abstract
BACKGROUND Differential diagnosis of non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC) in hospitalized patients is crucial for appropriate treatment choice. OBJECTIVE To investigate the relevance of serum tumor markers (STMs) and their combinations for the differentiation of NSCLC and SCLC subtypes. METHODS Between 2000 and 2003, 10 established STMs were assessed retrospectively in 311 patients with NSCLC, 128 with SCLC prior systemic first-line therapy and 51 controls with benign lung diseases (BLD), by automatized electrochemiluminescence immunoassay technology. Receiver operating characteristic (ROC) curves and logistic regression analyses were used to evaluate the diagnostic efficacy of both individual and multiple STMs with corresponding sensitivities at 90% specificity. Standards for Reporting of Diagnostic Accuracy (STARD guidelines) were followed. RESULTS CYFRA 21-1 (cytokeratin-19 fragment), CEA (carcinoembryonic antigen) and NSE (neuron specific enolase) were significantly higher in all lung cancers vs BLD, reaching AUCs of 0.81 (95% CI 0.76-0.87), 0.78 (0.73-0.84), and 0.88 (0.84-0.93), respectively. By the three marker combination, the discrimination between benign and all malignant cases was improved resulting in an AUC of 0.93 (95% CI 0.90-0.96). In NSCLC vs. BLD, CYFRA 21-1, CEA and NSE were best discriminative STMs, with AUCs of 0.86 (95% CI 0.81-0.91), 0.80 (0.74-0.85), and 0.85 (0.79-0.91). The three marker combination also improved the AUC: 0.92; 95% CI 0.89-0.96). In SCLC vs. BLD, ProGRP (pro-gastrin-releasing peptide) and NSE were best discriminative STMs, with AUCs of 0.89 (95% CI 0.84-0.94) and 0.96 (0.93-0.98), respectively, and slightly improved AUC of 0.97 (95% CI 0.95-0.99) when in combination. Finally, discrimination between SCLC and NSCLC was possible by ProGRP (AUC 0.86; 95% CI 0.81-0.91), NSE (AUC 0.83; 0.78-0.88) and CYFRA 21-1 (AUC 0.69; 0.64-0.75) and by the combination of the 3 STMs (AUC 0.93; 0.91-0.96), with a sensitivity of 88% at 90% specificity. CONCLUSIONS The results confirm the power of STM combinations for the differential diagnosis of lung cancer from benign lesions and between histological lung cancer subtypes.
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Affiliation(s)
- Inga Trulson
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
| | - Frank Klawonn
- Ostfalia University, Department of Computer Science, Wolfenbüttel, Germany
- Helmholtz Centre for Infection Research, Biostatistics, Braunschweig, Germany
| | | | - Stefan Holdenrieder
- Munich Biomarker Research Center, Institute of Laboratory Medicine, German Heart Centre Munich, Munich, Germany
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Dunker Ø, Uglem M, Bu Kvaløy M, Løseth S, Hjelland IE, Allen SM, Dehli Vigeland M, Kleggetveit IP, Sand T, Nilsen KB. Diagnostic accuracy of the 5.07 monofilament test for diabetes polyneuropathy: influence of age, sex, neuropathic pain and neuropathy severity. BMJ Open Diabetes Res Care 2023; 11:e003545. [PMID: 37989346 PMCID: PMC10660161 DOI: 10.1136/bmjdrc-2023-003545] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/13/2023] [Indexed: 11/23/2023] Open
Abstract
INTRODUCTION There is a need for simple and cheap diagnostic tools for diabetic polyneuropathy (DPN). We aimed to assess the diagnostic accuracy of the 5.07/10 g monofilament test in patients referred to polyneuropathy assessments, as well as to examine how disease severity, age, sex and neuropathic pain (NP) impact diagnostic accuracy. RESEARCH DESIGN AND METHODS Five Norwegian university hospitals recruited patients with diabetes aged 18-70 referred to neurological outpatient clinics for polyneuropathy assessments. The 5.07/10 g Semmes-Weinstein monofilament examination (SWME) was validated against the Toronto consensus for diagnosing diabetic neuropathies; the results were stratified by age, sex and NP. Disease severity was graded by a combined nerve conduction study (NCS) Z-score, and logistic regression was applied to assess whether disease severity was a predictor of diagnostic accuracy. RESULTS In total, 506 patients were included in the study. Global sensitivity was 0.60 (95% CI 0.55, 0.66), specificity 0.82 (95% CI 0.75, 0.87), positive and negative predictive values were 0.86 (95% CI 0.81, 0.90) and 0.52 (95% CI 0.46, 0.58), respectively, positive and negative likelihood ratios were 3.28 (95% CI 2.37, 4.53) and 0.49 (95% CI 0.42, 0.57), respectively. The SWME was less sensitive in females (0.43), had lower specificity in patients with NP (0.56), and performed worse in patients ≥50 years. NCS-based disease severity did not affect diagnostic accuracy (OR 1.15, 95% CI 0.95, 1.40). CONCLUSIONS This multicenter study demonstrates poor diagnostic performance for the 5.07/10 g SWME in patients with diabetes referred to polyneuropathy assessments; it is particularly unsuited for female patients and those with NP. The diagnostic accuracy of the SWME was not influenced by NCS-based disease severity, demonstrating that it does not perform better in patients with later stages of DPN. We do not recommend the use of the 5.07/10 g monofilament in the evaluation of patients with diabetes referred to polyneuropathy assessments.
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Affiliation(s)
- Øystein Dunker
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, Institute of Clinical Medicine, University of Oslo, Oslo, Norway
- Department of Neurology and Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
| | - Martin Uglem
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Marie Bu Kvaløy
- Department of Neurology, Section of Clinical Neurophysiology, Stavanger University Hospital, Stavanger, Norway
| | - Sissel Løseth
- Department of Neurology and Clinical Neurophysiology, University Hospital of North Norway, Tromsø, Norway
- Department of Clinical Medicine, The Artic University of Norway, Tromsø, Norway
| | - Ina Elen Hjelland
- Department of Clinical Neurophysiology, Haukeland University Hospital, Bergen, Norway
| | - Sara Maria Allen
- Department of Neurology and Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
| | | | - Inge Petter Kleggetveit
- Department of Neurology and Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
| | - Trond Sand
- Department of Neuromedicine and Movement Science, Norwegian University of Science and Technology Faculty of Medicine and Health Sciences, Trondheim, Norway
- Department of Neurology and Clinical Neurophysiology, St Olavs Hospital, Trondheim University Hospital, Trondheim, Norway
| | - Kristian Bernhard Nilsen
- Department of Research and Innovation, Oslo University Hospital, Oslo, Norway
- Department of Neurology and Clinical Neurophysiology, Oslo University Hospital, Oslo, Norway
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Ly A, Sirois C, Dionne CE. Sensitivity and specificity of algorithms for the identification of nonspecific low back pain in medico-administrative databases. Pain 2023; 164:1600-1607. [PMID: 36728479 DOI: 10.1097/j.pain.0000000000002861] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 12/14/2022] [Indexed: 02/03/2023]
Abstract
ABSTRACT Identifying nonspecific low back pain (LBP) in medico-administrative databases is a major challenge because of the number and heterogeneity of existing diagnostic codes and the absence of standard definitions to use as reference. The objective of this study was to evaluate the sensitivity and specificity of algorithms for the identification of nonspecific LBP from medico-administrative data using self-report information as the reference standard. Self-report data came from the PROspective Québec Study on Work and Health , a 24-year prospective cohort study of white-collar workers. All diagnostic codes that could be associated with nonspecific LBP were identified from the International Classification of Diseases, Ninth and Tenth Revisions ( ICD-9 and ICD-10 ) in physician and hospital claims. Seven algorithms for identifying nonspecific LBP were built and compared with self-report information. Sensitivity analyses were also conducted using more stringent definitions of LBP. There were 5980 study participants with (n = 2847) and without (n = 3133) LBP included in the analyses. An algorithm that included at least 1 diagnostic code for nonspecific LBP was best to identify cases of LBP in medico-administrative data with sensitivity varying between 8.9% (95% confidence interval [CI] 7.9-10.0) for a 1-year window and 21.5% (95% CI 20.0-23.0) for a 3-year window. Specificity varied from 97.1% (95% CI 96.5-97.7) for a 1-year window to 90.4% (95% CI 89.4-91.5) for a 3-year window. The low sensitivity we found reveals that the identification of nonspecific cases of LBP in administrative data is limited, possibly due to the lack of traditional medical consultation.
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Affiliation(s)
- Antarou Ly
- Department of Social and Preventive Medicine, Université Laval, Québec City, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
- Centre d'excellence sur le vieillissement de Québec (CEVQ) du Centre de recherche en santé durable VITAM, Québec City, QC, Canada
- Centre national de la recherche scientifique et technologique (CNRST)/Institut de recherche en sciences de la santé (IRSS), Ouagadougou, Burkina Faso
| | - Caroline Sirois
- Centre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
- Centre d'excellence sur le vieillissement de Québec (CEVQ) du Centre de recherche en santé durable VITAM, Québec City, QC, Canada
- Faculty of Pharmacy, Université Laval, Québec City, QC, Canada
| | - Clermont E Dionne
- Department of Social and Preventive Medicine, Université Laval, Québec City, QC, Canada
- Centre de recherche du CHU de Québec-Université Laval, Québec City, QC, Canada
- Centre d'excellence sur le vieillissement de Québec (CEVQ) du Centre de recherche en santé durable VITAM, Québec City, QC, Canada
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Stahl AC, Tietz AS, Dewey M, Kendziora B. Has the quality of reporting improved since it became mandatory to use the Standards for Reporting Diagnostic Accuracy? Insights Imaging 2023; 14:85. [PMID: 37184759 PMCID: PMC10184623 DOI: 10.1186/s13244-023-01432-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 04/14/2023] [Indexed: 05/16/2023] Open
Abstract
OBJECTIVES To investigate whether making the Standards for Reporting Diagnostic Accuracy (STARD) mandatory by the leading journal 'Radiology' in 2016 improved the quality of reporting of diagnostic accuracy studies. METHODS A validated search term was used to identify diagnostic accuracy studies published in Radiology in 2015 and 2019. STARD adherence was assessed by two independent reviewers. Each item was scored as yes (1 point) if adequately reported or as no (0 points) if not. The total STARD score per article was calculated. Wilcoxon-Mann-Whitney tests were used to evaluate differences of the total STARD scores between 2015 and 2019. In addition, the total STARD score was compared between studies stratified by study design, citation rate, and data collection. RESULTS The median number of reported STARD items for the total of 66 diagnostic accuracy studies from 2015 to 2019 was 18.5 (interquartile range [IQR] 17.5-20.0) of 29. Adherence to the STARD checklist significantly improved the STARD score from a median of 18.0 (IQR 15.5-19.5) in 2015 to a median of 19.5 (IQR 18.5-21.5) in 2019 (p < 0.001). No significant differences were found between studies stratified by mode of data collection (prospective vs. retrospective studies, p = 0.68), study design (cohort vs. case-control studies, p = 0.81), and citation rate (two groups divided by median split [< 0.56 citations/month vs. ≥ 0.56 citations/month], p = 0.54). CONCLUSIONS Making use of the STARD checklist mandatory significantly increased the adherence with reporting standards for diagnostic accuracy studies and should be considered by editors and publishers for widespread implementation. CRITICAL RELEVANCE STATEMENT Editors may consider making reporting guidelines mandatory to improve the scientific quality.
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Affiliation(s)
- Ann-Christine Stahl
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Anne-Sophie Tietz
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Marc Dewey
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany
| | - Benjamin Kendziora
- Department of Radiology, Charité - Universitätsmedizin Berlin (Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin), Berlin, Germany.
- Department of Dermatology and Allergy, University Hospital, Ludwig Maximilian University, Munich, Germany.
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10
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Dávila-Mendoza R, López-Ortiz G. [Extensions of guidelines for reporting types of study in medicine]. REVISTA MEDICA DEL INSTITUTO MEXICANO DEL SEGURO SOCIAL 2022; 60:675-682. [PMID: 36283054 PMCID: PMC10395921] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Accepted: 06/10/2022] [Indexed: 06/16/2023]
Abstract
The use of different guides to report types of study in the medical field has been widely disseminated for decades, however, their adherence and use by an important part of researchers is still limited, this has negatively impacted the dissemination of new findings, which has generated criticism regarding how medical research is designed, conducted and reported. Parallel to this, there are extensions to these guidelines which are little known and used by the personnel involved in research work, they focus on more specific approaches to report different types of studies, among which are: meta-analysis, systematic reviews, clinical trials randomized, diagnostic accuracy studies, observational studies, among others; for this reason, its promotion, knowledge, and use is of vital importance. The objective of this review is to synthesize the main extensions of the guidelines used in medical research; for this purpose, its main characteristics were reviewed, as well as application scenarios according to the level of evidence; Its adequate adherence will allow health personnel involved in research work to increase the transparency and quality of their findings, contemplate potential sources of bias, as well as the development of good practices for the presentation of their results according to the type of study selected.
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Affiliation(s)
- Rocío Dávila-Mendoza
- Universidad Nacional Autónoma de México, Facultad de Medicina, Subdivisión de Medicina Familiar. Ciudad de México, MéxicoUniversidad Nacional Autónoma de MéxicoMéxico
| | - Geovani López-Ortiz
- Universidad Nacional Autónoma de México, Facultad de Medicina, Subdivisión de Medicina Familiar. Ciudad de México, MéxicoUniversidad Nacional Autónoma de MéxicoMéxico
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11
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Accuracy of the short screening instrument for psychological problems (SSIPPE) in enuresis in the Identification of attention-deficit/ hyperactivity symptoms in the enuretic population. J Pediatr Urol 2022; 18:350.e1-350.e6. [PMID: 35283019 DOI: 10.1016/j.jpurol.2022.02.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/03/2021] [Revised: 02/03/2022] [Accepted: 02/04/2022] [Indexed: 12/31/2022]
Abstract
INTRODUCTION Enuresis prevalence is approximately 5-15% in children aged 6-7 years. The presence of attention deficit hyperactivity disorder (ADHD) in enuretic children is associated with 3 times greater risk of persistent enuresis. The Multimodal Treatment Study for ADHD (MTA) Swanson, Nolan, and Pelham version IV (SNAP-IV) is one of the most used instruments to evaluate ADHD symptoms, but it is a time-consuming questionnaire. OBJECTIVE This study aims to compare the accuracy of an easy questionnaire named Short Screening Instrument for Psychological Problems in Enuresis (SSIPPE) to MTA-SNAP-IV in identifying ADHD symptoms in children and adolescents with enuresis. METHODS ADHD symptoms screening was performed by applying SSIPPE and MTA-SNAP-IV in 160 children and adolescents with enuresis, aged 6-14 years, who regularly attended a specialized clinic for pediatric urology. RESULTS A total of 153 individuals with enuresis were included in the study (52% males), among them 55 (35.9%) were considered positive for inattention and hyperactivity-impulsivity by the MTA-SNAP-IV. Sensitivity for SSIPPE concerning MTA-SNAP-IV was 85.5%, and specificity was 84.7%, with an overall accuracy of 85% in identifying ADHD symptoms. DISCUSSION In the present study, we found high accuracy of SSIPPE in relation to MTA-SNAP-IV in identifying ADHD symptoms in the enuretic population, with substantial agreement between instruments. Its sensitivity and specificity were considered high for a screening method. However, there are some limitations. The population studied is composed of a group of children with enuresis, which can lead to an overestimation of the test's accuracy, as the disorder under investigation is more prevalent in this population. This can be explained by the high specificity of the test (84.7%) associated with the fact that the SSIPPE is an instrument tailored for an enuretic population, unlike the MTA-SNAP IV. CONCLUSION The SSIPPE has proven to be a reliable tool in identifying ADHD symptoms in the enuretic population. In addition to being a quick and easily applicable instrument.
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12
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Kazi S, Frank RA, Salameh J, Fabiano N, Absi M, Pozdnyakov A, Islam N, Korevaar DA, Cohen JF, Bossuyt PM, Leeflang MM, Cobey KD, Moher D, Schweitzer M, Menu Y, Patlas M, McInnes MD. Evaluating the Impact of Peer Review on the Completeness of Reporting in Imaging Diagnostic Test Accuracy Research. J Magn Reson Imaging 2022; 56:680-690. [DOI: 10.1002/jmri.28116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2021] [Revised: 01/28/2022] [Accepted: 02/02/2022] [Indexed: 11/08/2022] Open
Affiliation(s)
- Sakib Kazi
- Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| | - Robert A. Frank
- Department of Radiology, Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| | - Jean‐Paul Salameh
- Faculty of Health Sciences Queen's University Kingston Ontario Canada
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
| | | | - Marissa Absi
- Faculty of Medicine University of Ottawa Ottawa Ontario Canada
| | - Alex Pozdnyakov
- Michael G. DeGroote School of Medicine McMaster University Hamilton Ontario Canada
| | - Nayaar Islam
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
- School of Epidemiology and Public Health University of Ottawa Ottawa Ontario Canada
| | - Daniël A. Korevaar
- Department of Respiratory Medicine Amsterdam University Medical Centers, University of Amsterdam Amsterdam Netherlands
| | - Jérémie F. Cohen
- Department of Pediatrics Inserm UMR 1153 (Centre of Research in Epidemiology and Statistics), Necker–Enfants Malades Hospital, Assistance Publique – Hôpitaux de Paris Université de Paris Paris France
| | - Patrick M. Bossuyt
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC University of Amsterdam Amsterdam Netherlands
| | - Mariska M.G. Leeflang
- Epidemiology and Data Science, Amsterdam Public Health Research Institute, Amsterdam UMC University of Amsterdam Amsterdam Netherlands
| | - Kelly D. Cobey
- The University of Ottawa Heart Institute Ottawa Ontario Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program Ottawa Hospital Research Institute, University of Ottawa Ottawa Ontario Canada
| | - Mark Schweitzer
- Department of Radiology Wayne State University School of Medicine Detroit Michigan USA
| | - Yves Menu
- Department of Radiology Sorbonne Université‐APHP Paris France
| | - Michael Patlas
- Department of Radiology McMaster University Hamilton Ontario Canada
| | - Matthew D.F. McInnes
- Clinical Epidemiology Program Ottawa Hospital Research Institute Ottawa Ontario Canada
- Department of Radiology University of Ottawa Ottawa Ontario Canada
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13
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Santos M, Vollam S, Pimentel MA, Areia C, Young L, Roman C, Ede J, Piper P, King E, Harford M, Shah A, Gustafson O, Tarassenko L, Watkinson P. The Use of Wearable Pulse Oximeters in the Prompt Detection of Hypoxemia and During Movement: Diagnostic Accuracy Study. J Med Internet Res 2022; 24:e28890. [PMID: 35166690 PMCID: PMC8889481 DOI: 10.2196/28890] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2021] [Revised: 05/04/2021] [Accepted: 11/21/2021] [Indexed: 01/20/2023] Open
Abstract
Background Commercially available wearable (ambulatory) pulse oximeters have been recommended as a method for managing patients at risk of physiological deterioration, such as active patients with COVID-19 disease receiving care in hospital isolation rooms; however, their reliability in usual hospital settings is not known. Objective We report the performance of wearable pulse oximeters in a simulated clinical setting when challenged by motion and low levels of arterial blood oxygen saturation (SaO2). Methods The performance of 1 wrist-worn (Wavelet) and 3 finger-worn (CheckMe O2+, AP-20, and WristOx2 3150) wearable, wireless transmission–mode pulse oximeters was evaluated. For this, 7 motion tasks were performed: at rest, sit-to-stand, tapping, rubbing, drinking, turning pages, and using a tablet. Hypoxia exposure followed, in which inspired gases were adjusted to achieve decreasing SaO2 levels at 100%, 95%, 90%, 87%, 85%, 83%, and 80%. Peripheral oxygen saturation (SpO2) estimates were compared with simultaneous SaO2 samples to calculate the root-mean-square error (RMSE). The area under the receiver operating characteristic curve was used to analyze the detection of hypoxemia (ie, SaO2<90%). Results SpO2 estimates matching 215 SaO2 samples in both study phases, from 33 participants, were analyzed. Tapping, rubbing, turning pages, and using a tablet degraded SpO2 estimation (RMSE>4% for at least 1 device). All finger-worn pulse oximeters detected hypoxemia, with an overall sensitivity of ≥0.87 and specificity of ≥0.80, comparable to that of the Philips MX450 pulse oximeter. Conclusions The SpO2 accuracy of wearable finger-worn pulse oximeters was within that required by the International Organization for Standardization guidelines. Performance was degraded by motion, but all pulse oximeters could detect hypoxemia. Our findings support the use of wearable, wireless transmission–mode pulse oximeters to detect the onset of clinical deterioration in hospital settings. Trial Registration ISRCTN Registry 61535692; http://www.isrctn.com/ISRCTN61535692 International Registered Report Identifier (IRRID) RR2-10.1136/bmjopen-2019-034404
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Affiliation(s)
- Mauro Santos
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Sarah Vollam
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom.,Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Marco Af Pimentel
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom
| | - Carlos Areia
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom.,Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Louise Young
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom.,Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Cristian Roman
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Jody Ede
- Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Philippa Piper
- Adult Intensive Care Unit, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Elizabeth King
- Adult Intensive Care Unit, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom.,Therapies Clinical Service, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Mirae Harford
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom.,Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom
| | - Akshay Shah
- Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Owen Gustafson
- Adult Intensive Care Unit, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
| | - Lionel Tarassenko
- Institute of Biomedical Engineering, Department of Engineering Science, University of Oxford, Oxford, United Kingdom.,National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom
| | - Peter Watkinson
- National Institute for Health Research Oxford Biomedical Research Centre, Oxford, United Kingdom.,Critical Care Research Group, Nuffield Department of Clinical Neurosciences, University of Oxford, Oxford, United Kingdom.,Adult Intensive Care Unit, Oxford University Hospitals National Health Service Foundation Trust, Oxford, United Kingdom
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14
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Ni M, Adam ME, Akbar F, Huddy JR, Borsci S, Buckle P, Rubulotta F, Carr R, Fotheringham I, Wilson C, Tsang M, Harding S, White N, Hanna GB. Development and validation of ester impregnated pH strips for locating nasogastric feeding tubes in the stomach-a multicentre prospective diagnostic performance study. Diagn Progn Res 2021; 5:22. [PMID: 34903303 PMCID: PMC8670038 DOI: 10.1186/s41512-021-00111-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2021] [Accepted: 11/24/2021] [Indexed: 11/30/2022] Open
Abstract
BACKGROUND NG (nasogastric) tubes are used worldwide as a means to provide enteral nutrition. Testing the pH of tube aspirates prior to feeding is commonly used to verify tube location before feeding or medication. A pH at or lower than 5.5 was taken as evidence for stomach intubation. However, the existing standard pH strips lack sensitivity, especially in patients receiving feeding and antacids medication. We developed and validated a first-generation ester-impregnated pH strip test to improve the accuracy towards gastric placements in adult population receiving routine NG-tube feeding. The sensitivity was improved by its augmentation with the action of human gastric lipase (HGL), an enzyme specific to the stomach. METHODS We carried out a multi-centred, prospective, two-gate diagnostic accuracy study on patients who require routine NG-tube feeding in 10 NHS hospitals comparing the sensitivity of the novel pH strip to the standard pH test, using either chest X-rays or, in its absence, clinical observation of the absence of adverse events as the reference standard. We also tested the novel pH strips in lung aspirates from patients undergoing oesophageal cancer surgeries using visual inspection as the reference standard. We simulated health economics using a decision analytic model and carried out adoption studies to understand its route to commercialisation. The primary end point is the sensitivity of novel and standard pH tests at the recommended pH cut-off of 5.5. RESULTS A total of 6400 ester-impregnated pH strips were prepared based on an ISO13485 quality management system. A total of 376 gastric samples were collected from adult patients in 10 NHS hospitals who were receiving routine NG-tube feeding. The sensitivities of the standard and novel pH tests were respectively 49.2% (95% CI 44.1‑54.3%) and 70.2% (95% CI 65.6‑74.8%) under pH cut-off of 5.5 and the novel test has a lung specificity of 89.5% (95% CI 79.6%, 99.4%). Our simulation showed that using the novel test can potentially save 132 unnecessary chest X-rays per check per every 1000 eligible patients, or direct savings of £4034 to the NHS. CONCLUSIONS The novel pH test correctly identified significantly more patients with tubes located inside the stomach compared to the standard pH test used widely by the NHS. TRIAL REGISTRATION http://www.isrctn.com/ISRCTN11170249 , Registered 21 June 2017-retrospectively registered.
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Affiliation(s)
- Melody Ni
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
| | - Mina E. Adam
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
| | - Fatima Akbar
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
| | - Jeremy R. Huddy
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
| | - Simone Borsci
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
- grid.6214.10000 0004 0399 8953Cognitive Psychology and Ergonomics, University of Twente, Enschede, The Netherlands
| | - Peter Buckle
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
| | - Francesca Rubulotta
- grid.417895.60000 0001 0693 2181Imperial College Healthcare NHS Trust, London, UK
| | - Reuben Carr
- grid.421032.60000 0004 4648 5306Ingenza Ltd., Roslin, UK
| | | | - Claire Wilson
- grid.421032.60000 0004 4648 5306Ingenza Ltd., Roslin, UK
| | - Matthew Tsang
- grid.421032.60000 0004 4648 5306Ingenza Ltd., Roslin, UK
| | - Susan Harding
- grid.430342.20000 0001 0507 9019The Royal Bournemouth and Christchurch Hospitals NHS Foundation Trust, Bournemouth, UK
| | - Nichola White
- grid.451052.70000 0004 0581 2008Medway Maritime NHS Foundation Trust, Gillingham, UK
| | - George B. Hanna
- grid.7445.20000 0001 2113 8111Department of Surgery and Cancer, Imperial College London, Academic Surgical Unit, 10th Floor, QEQM Building, St. Mary’s Hospital, London, W2 1NY UK
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15
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Sounderajah V, Ashrafian H, Golub RM, Shetty S, De Fauw J, Hooft L, Moons K, Collins G, Moher D, Bossuyt PM, Darzi A, Karthikesalingam A, Denniston AK, Mateen BA, Ting D, Treanor D, King D, Greaves F, Godwin J, Pearson-Stuttard J, Harling L, McInnes M, Rifai N, Tomasev N, Normahani P, Whiting P, Aggarwal R, Vollmer S, Markar SR, Panch T, Liu X. Developing a reporting guideline for artificial intelligence-centred diagnostic test accuracy studies: the STARD-AI protocol. BMJ Open 2021; 11:e047709. [PMID: 34183345 PMCID: PMC8240576 DOI: 10.1136/bmjopen-2020-047709] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2020] [Accepted: 06/08/2021] [Indexed: 12/13/2022] Open
Abstract
INTRODUCTION Standards for Reporting of Diagnostic Accuracy Study (STARD) was developed to improve the completeness and transparency of reporting in studies investigating diagnostic test accuracy. However, its current form, STARD 2015 does not address the issues and challenges raised by artificial intelligence (AI)-centred interventions. As such, we propose an AI-specific version of the STARD checklist (STARD-AI), which focuses on the reporting of AI diagnostic test accuracy studies. This paper describes the methods that will be used to develop STARD-AI. METHODS AND ANALYSIS The development of the STARD-AI checklist can be distilled into six stages. (1) A project organisation phase has been undertaken, during which a Project Team and a Steering Committee were established; (2) An item generation process has been completed following a literature review, a patient and public involvement and engagement exercise and an online scoping survey of international experts; (3) A three-round modified Delphi consensus methodology is underway, which will culminate in a teleconference consensus meeting of experts; (4) Thereafter, the Project Team will draft the initial STARD-AI checklist and the accompanying documents; (5) A piloting phase among expert users will be undertaken to identify items which are either unclear or missing. This process, consisting of surveys and semistructured interviews, will contribute towards the explanation and elaboration document and (6) On finalisation of the manuscripts, the group's efforts turn towards an organised dissemination and implementation strategy to maximise end-user adoption. ETHICS AND DISSEMINATION Ethical approval has been granted by the Joint Research Compliance Office at Imperial College London (reference number: 19IC5679). A dissemination strategy will be aimed towards five groups of stakeholders: (1) academia, (2) policy, (3) guidelines and regulation, (4) industry and (5) public and non-specific stakeholders. We anticipate that dissemination will take place in Q3 of 2021.
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Affiliation(s)
- Viknesh Sounderajah
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Hutan Ashrafian
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
- Institute of Global Health Innovation, Imperial College London, London, UK
| | - Robert M Golub
- Journal of the American Medical Association, Chicago, Illinois, USA
| | | | | | - Lotty Hooft
- Cochrane Netherlands, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Karel Moons
- Cochrane Netherlands, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands
- Department of Epidemiology, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands
| | - Gary Collins
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - David Moher
- Centre for Journalology, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Patrick M Bossuyt
- Department of Epidemiology and Data Science, Amsterdam University Medical Centres, Duivendrecht, The Netherlands
| | - Ara Darzi
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Alastair K Denniston
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Health Data Research UK, London, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
| | | | - Daniel Ting
- Singapore Eye Research Institute, Singapore National Eye Center, Singapore
| | | | | | - Felix Greaves
- Department of Primary Care and Public Health, Imperial College London, London, UK
| | | | | | - Leanne Harling
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
| | - Matthew McInnes
- Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
| | - Nader Rifai
- Harvard Medical School, Boston, Massachusetts, USA
| | | | - Pasha Normahani
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
| | - Penny Whiting
- School of Social and Community Medicine, University of Bristol, Bristol, UK
| | - Ravi Aggarwal
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
- Institute of Global Health Innovation, Imperial College London, London, UK
| | | | - Sheraz R Markar
- Department of Surgery and Cancer, Imperial College London, Paddington, UK
| | - Trishan Panch
- Division of Health Policy and Management, Harvard T.H. Chan School of Public Health, Boston, Massachusetts, USA
| | - Xiaoxuan Liu
- Institute of Inflammation and Ageing, College of Medical and Dental Sciences, University of Birmingham, Birmingham, UK
- University Hospitals Birmingham NHS Foundation Trust, Birmingham, UK
- Health Data Research UK, London, UK
- Birmingham Health Partners Centre for Regulatory Science and Innovation, University of Birmingham, Birmingham, UK
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16
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Evaluation of the sensitivity and specificity of basal plasma adrenocorticotrophic hormone concentration for diagnosing pituitary pars intermedia dysfunction in horses: A systematic review. Vet J 2021; 275:105695. [PMID: 34099343 DOI: 10.1016/j.tvjl.2021.105695] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 04/12/2021] [Accepted: 05/19/2021] [Indexed: 02/01/2023]
Abstract
Measurement of basal adrenocorticotrophic hormone (ACTH) is currently used to diagnose pituitary pars intermedia dysfunction (PPID) in horses, yet a systematic review of the evidence for its use has not been undertaken. This study aimed to systematically review evidence regarding the sensitivity and specificity of the basal ACTH diagnostic test. Electronic databases were systematically searched in January 2019, September 2020 and January 2021, for English language publications published prior to these dates. Screening, data extraction and quality assessment of publications was undertaken by the authors using predefined criteria. Study design, methodology and information reported in included studies were assessed using Standards for Reporting of Diagnostic Accuracy (STARD) checklists. Risk of bias and applicability were appraised using the Quality Assessment tool for Diagnostic Accuracy Studies (QUADAS-2) quality assessment tool. Due to identified biases and marked between-study variations, meta-analysis was not undertaken. After removal of duplicates, 415 publications were identified, of which 25 were evaluated in full, with 11 of these meeting inclusion criteria. In most studies, basal ACTH was reported to have good sensitivity (overall median 75.5%; interquartile range [IQR], 64.0-86.5%; range, 36.0-100%) and excellent specificity (overall median, 95.2%; IQR, 84.2-98.9%; range, 63.3-100%). However, QUADAS-2 and STARD assessment highlighted that studies did not utilise optimal study design and/or study populations for the evaluation of a diagnostic test and the majority were subject to bias, or provided insufficient information to fully assess possible biases. Based on this review, basal ACTH performed better at ruling out PPID than detecting it.
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Korevaar DA, Bossuyt PM, McInnes MDF, Cohen JF. PRISMA-DTA for Abstracts: a new addition to the toolbox for test accuracy research. Diagn Progn Res 2021; 5:8. [PMID: 33795016 PMCID: PMC8017829 DOI: 10.1186/s41512-021-00097-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Centres, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, the Netherlands.
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - Matthew D F McInnes
- Departments of Radiology and Epidemiology, University of Ottawa, Ottawa, Canada
- Clinical Epidemiology Program, the Ottawa Hospital Research Institute, Ottawa, Canada
| | - Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France
- Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Center of Research in Epidemiology and Statistics (CRESS), Université de Paris, Paris, France
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Cohen JF, Deeks JJ, Hooft L, Salameh JP, Korevaar DA, Gatsonis C, Hopewell S, Hunt HA, Hyde CJ, Leeflang MM, Macaskill P, McGrath TA, Moher D, Reitsma JB, Rutjes AWS, Takwoingi Y, Tonelli M, Whiting P, Willis BH, Thombs B, Bossuyt PM, McInnes MDF. Preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts): checklist, explanation, and elaboration. BMJ 2021; 372:n265. [PMID: 33722791 PMCID: PMC7957862 DOI: 10.1136/bmj.n265] [Citation(s) in RCA: 29] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
For many users of the biomedical literature, abstracts may be the only source of information about a study. Hence, abstracts should allow readers to evaluate the objectives, key design features, and main results of the study. Several evaluations have shown deficiencies in the reporting of journal and conference abstracts across study designs and research fields, including systematic reviews of diagnostic test accuracy studies. Incomplete reporting compromises the value of research to key stakeholders. The authors of this article have developed a 12 item checklist of preferred reporting items for journal and conference abstracts of systematic reviews and meta-analyses of diagnostic test accuracy studies (PRISMA-DTA for Abstracts). This article presents the checklist, examples of complete reporting, and explanations for each item of PRISMA-DTA for Abstracts.
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Affiliation(s)
- Jérémie F Cohen
- Department of Pediatrics and Inserm UMR 1153 (Centre of Research in Epidemiology and Statistics), Necker - Enfants Malades Hospital, Assistance Publique - Hôpitaux de Paris, Université de Paris, Paris, France
| | - Jonathan J Deeks
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, Utrecht University, University Medical Center Utrecht, Utrecht, Netherlands
| | - Jean-Paul Salameh
- The Ottawa Hospital Research Institute Clinical Epidemiology Program, Ottawa, ON, Canada
- Faculty of Medicine, Queen's University, Kingston, ON, Canada
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Academic Medical Centers, Amsterdam, Netherlands
| | | | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Harriet A Hunt
- Exeter Test Group, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Chris J Hyde
- Exeter Test Group, College of Medicine and Health, University of Exeter, Exeter, UK
| | - Mariska M Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health, Academic Medical Centers, Amsterdam, Netherlands
| | | | - Trevor A McGrath
- Department of Radiology, University of Ottawa, Ottawa, ON, Canada
| | - David Moher
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
| | - Johannes B Reitsma
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, Utrecht University, University Medical Center Utrecht, Utrecht, Netherlands
| | - Anne W S Rutjes
- Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
| | - Yemisi Takwoingi
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
- NIHR Birmingham Biomedical Research Centre, University Hospitals Birmingham NHS Foundation Trust and University of Birmingham, Birmingham, UK
| | - Marcello Tonelli
- Department of Medicine, University of Calgary, Calgary, AB, Canada
| | - Penny Whiting
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK
| | - Brian H Willis
- Institute of Applied Health Research, University of Birmingham, Birmingham, UK
| | - Brett Thombs
- Lady Davis Institute of the Jewish General Hospital and Department of Psychiatry, McGill University, Montréal, QC, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam Public Health, Academic Medical Centers, Amsterdam, Netherlands
| | - Matthew D F McInnes
- University of Ottawa, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, ON, Canada
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Wright B, Howard B, Wayant C, Vassar M. STARD Adherence in an Interventional Radiology Guideline for Diagnostic Arteriography. Clin Med Res 2021; 19:26-31. [PMID: 33547165 PMCID: PMC7987091 DOI: 10.3121/cmr.2020.1549] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/24/2019] [Revised: 08/17/2020] [Accepted: 12/09/2020] [Indexed: 11/18/2022]
Abstract
Objective: To assess the quality of reporting in diagnostic accuracy studies (DAS) referenced by the Quality Improvement Guidelines for Diagnostic Arteriography and their adherence to the Standards for Reporting of Diagnostic Accuracy (STARD) statement.Materials and Methods: Citations specific to the Society of Interventional Radiology's Quality Improvement Guidelines for Diagnostic Arteriography were collected. Using the 34-item STARD checklist, two authors in a duplicate and blinded fashion documented the number of items reported per diagnostic accuracy study. Authors met, and any discrepancies were resolved in a resolution meeting.Results: Of the 26 diagnostic accuracy studies included, the mean number of STARD items reported was 17.8 (SD ± 3.1). The median adherence was 18 (IQR, 17-19) items. Ten articles were published prior to 2003, the original date of STARD publication, and 16 articles were published after 2003. The mean number of reported items for the articles published prior to STARD 2003, and after STARD 2003 was 17.4 (SD ± 2.4) and 18.1 (SD ± 3.5), respectively. There were 14 STARD items that demonstrated an adherence of < 25%, and 13 an adherence > 75%.Conclusion: The dichotomous distribution of adherence to the STARD statement by DAS investigated demonstrates that areas of deficient reporting may be present and require attention to ensure complete and transparent reporting in the future.
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Affiliation(s)
- Bryan Wright
- Oklahoma State University Center for Health Sciences, Psychology Department, 1111 West 17th Street, Tulsa, OK 74107
| | - Benjamin Howard
- Oklahoma State University Center for Health Sciences, Psychology Department, 1111 West 17th Street, Tulsa, OK 74107
| | - Cole Wayant
- Oklahoma State University Center for Health Sciences, Psychology Department, 1111 West 17th Street, Tulsa, OK 74107
| | - Matt Vassar
- Oklahoma State University Center for Health Sciences, Psychology Department, 1111 West 17th Street, Tulsa, OK 74107
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Page MJ, McKenzie JE, Bossuyt PM, Boutron I, Hoffmann TC, Mulrow CD, Shamseer L, Tetzlaff JM, Moher D. Updating guidance for reporting systematic reviews: development of the PRISMA 2020 statement. J Clin Epidemiol 2021; 134:103-112. [PMID: 33577987 DOI: 10.1016/j.jclinepi.2021.02.003] [Citation(s) in RCA: 881] [Impact Index Per Article: 293.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2020] [Revised: 01/22/2021] [Accepted: 02/03/2021] [Indexed: 12/22/2022]
Abstract
OBJECTIVES To describe the processes used to update the PRISMA 2009 statement for reporting systematic reviews, present results of a survey conducted to inform the update, summarize decisions made at the PRISMA update meeting, and describe and justify changes made to the guideline. METHODS We reviewed 60 documents with reporting guidance for systematic reviews to generate suggested modifications to the PRISMA 2009 statement. We invited 220 systematic review methodologists and journal editors to complete a survey about the suggested modifications. The results of these projects were discussed at a 21-member in-person meeting. Following the meeting, we drafted the PRISMA 2020 statement and refined it based on feedback from co-authors and a convenience sample of 15 systematic reviewers. RESULTS The review of 60 documents revealed that all topics addressed by the PRISMA 2009 statement could be modified. Of the 110 survey respondents, more than 66% recommended keeping six of the original checklist items as they were and modifying 15 of them using wording suggested by us. Attendees at the in-person meeting supported the revised wording for several items but suggested rewording for most to enhance clarity, and further refinements were made over six drafts of the guideline. CONCLUSIONS The PRISMA 2020 statement consists of updated reporting guidance for systematic reviews. We hope that providing this detailed description of the development process will enhance the acceptance and uptake of the guideline and assist those developing and updating future reporting guidelines.
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Affiliation(s)
- Matthew J Page
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia.
| | - Joanne E McKenzie
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, Netherlands
| | - Isabelle Boutron
- Université de Paris, Centre of Epidemiology and Statistics (CRESS), Inserm, F 75004, Paris, France
| | - Tammy C Hoffmann
- Institute for Evidence-Based Healthcare, Faculty of Health Sciences and Medicine, Bond University, Gold Coast, Australia
| | - Cynthia D Mulrow
- University of Texas Health Science Center at San Antonio, San Antonio, TX, United States
| | - Larissa Shamseer
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada
| | | | - David Moher
- School of Epidemiology and Public Health, Faculty of Medicine, University of Ottawa, Ottawa, Canada; Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa
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Tsuzuki S, Watanabe A, Iwata M, Toyama H, Terasawa T. Gallium citrate-67 single-photon emission computed tomography/computed tomography for localizing the foci of classic fever and inflammation of unknown origin: A retrospective study of diagnostic yield. ASIA OCEANIA JOURNAL OF NUCLEAR MEDICINE & BIOLOGY 2021; 9:111-122. [PMID: 34250140 PMCID: PMC8255517 DOI: 10.22038/aojnmb.2020.53188.1364] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 11/30/2020] [Accepted: 12/25/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVES Only few studies have assessed the use of gallium citrate-67 single-photon emission computed tomography/computed tomography (67Ga-SPECT/CT) for localizing the foci of classic fever of unknown origin (FUO) and inflammation of unknown origin (IUO). Hence, the current study aimed to assess the diagnostic contribution of 67Ga-SPECT/CT in a tertiary referral setting where nuclear imaging tests are performed after an unsuccessful comprehensive primary diagnostic workup. METHODS We retrospectively assessed the medical records of 27 adult patients with FUO/IUO who had an unsuccessful diagnostic workup and who underwent 67Ga-SPECT/CT for the localization of FUO/IUO foci in our university hospital between 2013 and 2019. The primary outcome was diagnostic yield. The secondary outcomes were overall clinical efficacy and spontaneous remission of FUO/IUO symptoms in patients with a negative 67Ga-SPECT/CT finding. RESULTS Almost all patients completed the recommended diagnostic workup, except for urine culture and abdominal ultrasonography. Moreover, prior to 67Ga-SPECT/CT, all patients underwent thoraco-abdominopelvic CT scan, which was a non-diagnostic procedure. After a median follow-up of 843 days, the cause was identified in 16 (59%) patients. 67Ga-SPECT/CT successfully localized the FUO/IUO foci in eight patients (diagnostic yield = 30%; 95% confidence interval [CI]: 14%-50%). However, the causes remained unknown during follow-up in 11 (41%) patients. Among them, five experienced spontaneous regression of symptoms. 67Ga-SPECT/CT was negative in four of the five patients with spontaneous regression in symptoms without a definite cause. Considering this an important event, the overall clinical efficacy of 67Ga-SPECT/CT increased to 44% (95% CI: 25%-65%). CONCLUSION 67Ga-SPECT/CT had an acceptable diagnostic yield for the localization of FUO/IUO foci, which are challenging to diagnose, in a contemporary tertiary referral care setting. In patients who experienced spontaneous regression in symptoms with an unexplained cause, the absence of abnormal uptake might indicate prospective spontaneous remission. Thus, 67Ga-SPECT/CT could be an active first-line nuclear imaging modality in settings where fluorine-18-fluorodeoxy glucose positron emission tomography and computed tomography is not available for the assessment of FUO/IUO causes.
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Affiliation(s)
- Seiichiro Tsuzuki
- Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Japan
| | - Ayumi Watanabe
- Department of Radiology, Fujita Health University School of Medicine, Japan
| | - Mitsunaga Iwata
- Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Japan
| | - Hiroshi Toyama
- Department of Radiology, Fujita Health University School of Medicine, Japan
| | - Teruhiko Terasawa
- Department of Emergency and General Internal Medicine, Fujita Health University School of Medicine, Japan
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Ullrich C, Stürmlinger A, Wensing M, Krug K. Qualitative research methods in medical dissertations: an observational methodological study on prevalence and reporting quality of dissertation abstracts in a German university. BMC Med Res Methodol 2020; 20:301. [PMID: 33302886 PMCID: PMC7727214 DOI: 10.1186/s12874-020-01186-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 12/02/2020] [Indexed: 11/10/2022] Open
Abstract
Background Qualitative methods offer a unique contribution to health research. Academic dissertations in the medical field provide an opportunity to explore research practice. Our aim was to assess the use of qualitative methods in dissertations in the medical field. Methods By means of a methodological observational study, an analysis of all academic medical dissertations’ abstracts between 1998 and 2018 in a repository databank of a large medical university faculty in Germany was performed. This included MD dissertations (Dr. med. (dent.)) and medical science dissertations (Dr. sc. hum.). All abstracts including “qualitativ*” were screened for studies using qualitative research methods. Data were extracted from abstracts using a category grid considering a) general characteristics (year, language, degree type), b) discipline, c) study design (mixed methods/qualitative only, data conduction, data analysis), d) sample (size and participants) and e) technologies used (data analysis software and recording technology). Thereby reporting quality was assessed. Results In total, 103 abstracts of medical dissertations between 1998 and 2018 (1.4% of N = 7619) were included, 60 of MD dissertations and 43 of medical sciences dissertations. Half of the abstracts (n = 51) referred to dissertations submitted since 2014. Most abstracts related to public health/hygiene (n = 27) and general practice (n = 26), followed by medical psychology (n = 19). About half of the studies (n = 47) used qualitative research methods exclusively, the other half (n = 56) used mixed methods. For data collection, primarily individual interviews were used (n = 80), followed by group interviews (n = 33) and direct observation (n = 11). Patients (n = 36), physicians (n = 36) and healthcare professionals (n = 17) were the most frequent research participants. Incomplete reporting of participants and data analysis was common (n = 67). Nearly half of the abstracts (n = 46) lacked information on how data was analysed, most of the remaining (n = 43) used some form of content analysis. In summary, 36 abstracts provided all crucial data (participants, sample size,; data collection and analysis method). Conclusion A small number of academic dissertations used qualitative research methods. About a third of these reported all key aspects of the methods used in the abstracts. Further research on the quality of choice and reporting of methods for qualitative research in dissertations is recommended.
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Affiliation(s)
- Charlotte Ullrich
- Department of General Practice and Health Services Research, University of Heidelberg Hospital, INF 130.3, 69120, Heidelberg, Germany.
| | - Anna Stürmlinger
- Department of General Practice and Health Services Research, University of Heidelberg Hospital, INF 130.3, 69120, Heidelberg, Germany
| | - Michel Wensing
- Department of General Practice and Health Services Research, University of Heidelberg Hospital, INF 130.3, 69120, Heidelberg, Germany
| | - Katja Krug
- Department of General Practice and Health Services Research, University of Heidelberg Hospital, INF 130.3, 69120, Heidelberg, Germany
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23
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Kolanu N, Silverstone EJ, Ho BH, Pham H, Hansen A, Pauley E, Quirk AR, Sweeney SC, Center JR, Pocock NA. Clinical Utility of Computer-Aided Diagnosis of Vertebral Fractures From Computed Tomography Images. J Bone Miner Res 2020; 35:2307-2312. [PMID: 32749735 DOI: 10.1002/jbmr.4146] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2020] [Revised: 05/27/2020] [Accepted: 07/04/2020] [Indexed: 11/09/2022]
Abstract
Osteoporotic vertebral compression fractures (VCFs) are a risk factor for morbidity and mortality, frequently asymptomatic and often present in computed tomography (CT) scans performed for unrelated conditions. Computer-aided diagnosis (CAD) of VCF from such images can potentially improve identification and treatment of osteoporosis. This single-blinded, single tertiary center study compared a CAD (Zebra Medical Vision®) to an adjudicated imaging specialist reevaluation using a retrospective consecutive sample of abdominal and thoracic CT scans (n = 2357) performed as part of routine care. Subjects over 50 years between January 1, 2019 and May 12, 2019 were included. Duplicates and unanalyzable scans were excluded resulting in a total of 1696 CT scans. The sensitivity, specificity, and accuracy were calculated for all VCF and for Genant grades 2 or 3 (ie, height loss of >25%) using imaging specialist as the gold standard. Prestudy VCF reporting by hospital-rostered radiologist was used to calculate the number of scans needed to screen (NNS) to detect one additional VCF using CAD. Prevalence of any VCF was 24% (406/1696) and of Genant 2/3 VCF was 18% (280/1570). The sensitivity and specificity were 54% and 92%, for all fractures, respectively, and 65% and 92% for Genant 2/3 fractures, respectively. Accuracy for any VCF, and for detection of Genant 2/3 VCF, was 83% and 88%, respectively. Of 221 CAD-detected VCFs, 133 (60.2%) were reported prestudy resulting in 88 additional fractures (72 Genant 2/3) being identified by CAD. NNS to detect one additional VCF was 19 scans for all fractures and 23 for Genant 2/3 fractures. Thus, the CAD tested in this study had a high specificity with moderate sensitivity to detect incidental vertebral fractures in CT scans performed for routine care. A low NNS suggests it is an efficient tool to assist radiologists and clinicians to improve detection and reporting of vertebral fractures. © 2020 American Society for Bone and Mineral Research (ASBMR).
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Affiliation(s)
- Nithin Kolanu
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia.,Garvan Institute of Medical Research, Sydney, NSW, Australia
| | - Elizabeth J Silverstone
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Bao H Ho
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Hiep Pham
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Ash Hansen
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Emma Pauley
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Anna R Quirk
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Sarah C Sweeney
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia
| | - Jacqueline R Center
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia.,Garvan Institute of Medical Research, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
| | - Nicholas A Pocock
- Endocrinology/Radiology and Nuclear Medicine, St Vincent's Hospital, Darlinghurst, NSW, Australia.,Garvan Institute of Medical Research, Sydney, NSW, Australia.,Faculty of Medicine, University of New South Wales, Sydney, NSW, Australia
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24
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Ntini I, Vadlin S, Olofsdotter S, Ramklint M, Nilsson KW, Engström I, Sonnby K. The Montgomery and Åsberg Depression Rating Scale - self-assessment for use in adolescents: an evaluation of psychometric and diagnostic accuracy. Nord J Psychiatry 2020; 74:415-422. [PMID: 32125211 DOI: 10.1080/08039488.2020.1733077] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/15/2023]
Abstract
Background: The Montgomery-Åsberg Depression Rating Scale - Self Assessment (MADRS-S) is used to assess symptom severity in major depressive disorder (MDD) among adolescents, but its psychometric properties and diagnostic accuracy are unclear.Aim: The aim of this study was to explore psychometric properties, including diagnostic accuracy, of the MADRS-S in adolescent psychiatric outpatients.Method: Adolescent psychiatric outpatients (N = 105, mean age 16 years, 46 boys) completed the MADRS-S and were interviewed using the Kiddie Schedule for Affective Disorders and Schizophrenia for School-Age Children (K-SADS).Results: In principal component analysis, two components with eigenvalues of 4.6 and 1.3 explained 51.1% and 14.4% of the variance, respectively. On the first component loaded items assessing Mood, Feelings of unease, Appetite, Initiative, Pessimism, and Zest for life. On the second component loaded items assessing Sleep, Ability to concentrate, and Emotional involvement. Cronbach's alpha (internal consistency) for all items was 0.87. Spearman's rho was 0.68 for concurrent validity (correlation between total MADRS-S-score and K-SADS MDD severity score). In receiver-operating characteristic analysis, the area under the curve was 0.86 (95% confidence interval 0.78-0.93, p < .001). For all the participants, the highest combined sensitivity and specificity were reached using cut-offs of 15 and 16 (sensitivity 0.82, specificity 0.86). Optimizing sensitivity for MDD, with specificity still ≥0.5, cut off for all was 9, for boys 7 and for girls 10.Conclusion: Psychometric properties of MADRS-S showed good reliability and validity as well as satisfying diagnostic accuracy, indicating good to excellent properties for MDD screening of adolescent psychiatric patients.
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Affiliation(s)
- I Ntini
- University Health Care Research Center, Faculty of Medicine and Health, Universitetssjukvårdens forskningscentrum (UFC), Örebro University, Örebro, Sweden
| | - S Vadlin
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - S Olofsdotter
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - M Ramklint
- Psychiatry - Department of Neuroscience, Uppsala University, Uppsala, Sweden
| | - K W Nilsson
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
| | - I Engström
- University Health Care Research Center, Faculty of Medicine and Health, Universitetssjukvårdens forskningscentrum (UFC), Örebro University, Örebro, Sweden
| | - K Sonnby
- Center for Clinical Research, Uppsala University, County of Västmanland, Hospital of Region Västmanland, Västerås, Sweden
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Langhorst J, Kairey L, Oberle A, Boone J, Dobos G, Juette H, Tannapfel A, Rueffer A. Assessing Histological Inflammatory Activity in Patients With Ulcerative Colitis: A Diagnostic Accuracy Study Testing Fecal Biomarkers Lactoferrin and Calprotectin. CROHN'S & COLITIS 360 2020; 2:otaa053. [PMID: 36776494 PMCID: PMC9802191 DOI: 10.1093/crocol/otaa053] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/13/2020] [Indexed: 11/13/2022] Open
Abstract
Background and Aims Histological remission has arisen as the optimal treatment outcome in ulcerative colitis (UC). The aim of this retrospective study was to explore the diagnostic performance of the noninvasive fecal biomarkers calprotectin (FC) and lactoferrin (FL) compared to the histological indices Nancy Index (NI) and Riley Index (RI). Methods This study is a retrospective diagnostic accuracy study based on secondary analysis of patient data from 2002 to 2017 extracted from medical registries of our clinics in Essen-Mitte, Germany. Patients with UC underwent a colonoscopy, with biopsies taken from the rectum and the sigmoid scored by 2 experienced pathologists according to NI and RI and provided a stool sample within 7 days pre- or post-colonoscopy. Diagnostic accuracy of recommended cutoffs for FC (>50 μg/g) and FL (≥7.25 μg/g) were tested against our reference standard (NI ≥2) in terms of specificity, sensitivity, positive predictive value, negative predictive value, and accuracy (effectiveness). Results The number of patients with UC recruited was n = 226, aged 45.2 (SD 13.3). Histological indices were highly correlated (r = 0.980, P < 0.001). Fecal biomarkers correlated moderately with NI (FC: r = 0.383, P < 0.001; FL: r = 0.420, P < 0.001) and RI (FC: r = 0.395, P < 0.001; FL: r = 0.424, P < 0.001). Fecal biomarker concentrations were increased in patients with active histological disease (NI ≥2), median [IQR], FC 69.72 [20.07-254.38], FL 18.59 [6.06-44.42], compared to those with inactive disease (NI ≤1), FC 12.35 [3.89 - 32.16], FL 3.14 [0.75-11.05], z = -6.60, P < 0.001. Fecal biomarker concentrations differed significantly across NI grades 0-4 (FC: H4 = 45.2; FL: H4 = 47.5, both P < 0.001). Patients with grade 0 had significantly lower concentrations of fecal biomarkers than those with grade 3 (median; FC 10.94 vs 72.22; FL 2.30 vs 29.10; both P < 0.001) or grade 4 (FC 10.94 vs 67.00; FL 2.30 vs 27.64; both P < 0.001), as well as grade 2 for FC only (10.94 vs 56.22, P = 0.001). Concentrations were also lower in patients with grade 1 compared to those with grade 3 (FC 17.49 vs 72.22; FL 4.24 vs. 29.10; both P ≤ 0.001) or grade 4 (FC 17.49 vs 67.00; FL 4.24 vs 27.64; both P < 0.001).Receiver operating characteristics area under the curve showed moderate diagnostic accuracy for both FC 0.76 (95% confidence interval [CI] 0.70-0.83) and FL 0.73 (95% CI 0.66-0.80). Optimized cutoffs for both FC (≥34.29) and FL (≥5.85 μg/g) had slightly improved accuracy, compared with the manufacturer's cutoffs (FC: 69.9% vs 65.9%; FL: 71.7% vs 69.0%). Conclusions Fecal biomarkers calprotectin and lactoferrin correlate with histological disease activity and differentiate between patients in histological remission from those with evidence of moderate to severe disease activity. Their noninvasiveness, in addition to being inexpensive, supports their use in the clinical monitoring of patients with UC.
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Affiliation(s)
- Jost Langhorst
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Bamberg, Germany,Chair for Integrative Medicine, University of Duisburg, Essen, Germany,Address correspondence to: Jost Langhorst, MD, Buger Str. 80, 96049 Bamberg, Germany ()
| | - Lana Kairey
- Department of Internal and Integrative Medicine, Klinikum Bamberg, Bamberg, Germany
| | - Angela Oberle
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | | | - Gustav Dobos
- Department of Internal and Integrative Medicine, Kliniken Essen-Mitte, Faculty of Medicine, University of Duisburg-Essen, Essen, Germany
| | - Hendrik Juette
- Institute for Pathology, Ruhr University Bochum, Bochum, Germany
| | - Andrea Tannapfel
- Institute for Pathology, Ruhr University Bochum, Bochum, Germany
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26
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Heus P, Reitsma JB, Collins GS, Damen JAAG, Scholten RJPM, Altman DG, Moons KGM, Hooft L. Transparent Reporting of Multivariable Prediction Models in Journal and Conference Abstracts: TRIPOD for Abstracts. Ann Intern Med 2020; 173:42-47. [PMID: 32479165 DOI: 10.7326/m20-0193] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
Clear and informative reporting in titles and abstracts is essential to help readers and reviewers identify potentially relevant studies and decide whether to read the full text. Although the TRIPOD (Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis) statement provides general recommendations for reporting titles and abstracts, more detailed guidance seems to be desirable. The authors present TRIPOD for Abstracts, a checklist and corresponding guidance for reporting prediction model studies in abstracts. A list of 32 potentially relevant items was the starting point for a modified Delphi procedure involving 110 experts, of whom 71 (65%) participated in the web-based survey. After 2 Delphi rounds, the experts agreed on 21 items as being essential to report in abstracts of prediction model studies. This number was reduced by merging some of the items. In a third round, participants provided feedback on a draft version of TRIPOD for Abstracts. The final checklist contains 12 items and applies to journal and conference abstracts that describe the development or external validation of a diagnostic or prognostic prediction model, or the added value of predictors to an existing model, regardless of the clinical domain or statistical approach used.
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Affiliation(s)
- Pauline Heus
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
| | - Johannes B Reitsma
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
| | - Gary S Collins
- Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, and National Institute for Health Research Oxford Biomedical Research Centre, John Radcliffe Hospital, Oxford, United Kingdom (G.S.C.)
| | - Johanna A A G Damen
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
| | - Rob J P M Scholten
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
| | - Douglas G Altman
- Centre for Statistics in Medicine, Botnar Research Centre, University of Oxford, Oxford, United Kingdom (D.G.A.)
| | - Karel G M Moons
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
| | - Lotty Hooft
- Cochrane Netherlands and Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Utrecht, the Netherlands (P.H., J.B.R., J.A.D., R.J.S., K.G.M., L.H.)
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Jang MA, Kim B, Lee YK. Reporting Quality of Diagnostic Accuracy Studies in Laboratory Medicine: Adherence to Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015. Ann Lab Med 2020; 40:245-252. [PMID: 31858765 PMCID: PMC6933069 DOI: 10.3343/alm.2020.40.3.245] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2019] [Revised: 08/23/2019] [Accepted: 11/22/2019] [Indexed: 12/21/2022] Open
Abstract
Background Poor reporting quality in diagnostic accuracy studies hampers an adequate judgment of the validity of the study. The Standards for Reporting of Diagnostic Accuracy Studies (STARD) statement was published to improve the reporting quality of diagnostic accuracy studies. This study aimed to evaluate the adherence of diagnostic accuracy studies published in Annals of Laboratory Medicine (ALM) to STARD 2015 and to identify directions for improvement in the reporting quality of these studies. Methods Two independent authors assessed articles published in ALM between 2012–2018 for compliance with 30 STARD 2015 checklist items to identify all eligible diagnostic accuracy studies published during this period. We included 66 diagnostic accuracy studies. A total of the fulfilled STARD items were calculated, and adherence was analyzed on an individual-item basis. Results The overall mean±SD number of STARD items reported for the included studies was 11.2±2.7. Only five (7.6%) studies adhered to more than 50% of the 30 items. No study satisfied more than 80% of the items. Large variability in adherence to reporting standards was detected across items, ranging from 0% to 100%. Conclusions Adherence to STARD 2015 is suboptimal among diagnostic accuracy studies published in ALM. Our study emphasizes the necessity of adherence to STARD to improve the reporting quality of future diagnostic accuracy studies to be published in ALM.
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Affiliation(s)
- Mi Ae Jang
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea
| | - Bohyun Kim
- Department of Laboratory Medicine, Soonchunhyang University Cheonan Hospital, Soonchunhyang University College of Medicine, Cheonan, Korea
| | - You Kyoung Lee
- Department of Laboratory Medicine and Genetics, Soonchunhyang University Bucheon Hospital, Soonchunhyang University College of Medicine, Bucheon, Korea.
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Dratsch T, Caldeira L, Maintz D, Dos Santos DP. Artificial intelligence abstracts from the European Congress of Radiology: analysis of topics and compliance with the STARD for abstracts checklist. Insights Imaging 2020; 11:59. [PMID: 32335763 PMCID: PMC7183515 DOI: 10.1186/s13244-020-00866-7] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 04/02/2020] [Indexed: 12/17/2022] Open
Abstract
OBJECTIVES To analyze all artificial intelligence abstracts presented at the European Congress of Radiology (ECR) 2019 with regard to their topics and their adherence to the Standards for Reporting Diagnostic accuracy studies (STARD) checklist. METHODS A total of 184 abstracts were analyzed with regard to adherence to the STARD criteria for abstracts as well as the reported modality, body region, pathology, and use cases. RESULTS Major topics of artificial intelligence abstracts were classification tasks in the abdomen, chest, and brain with CT being the most commonly used modality. Out of the 10 STARD for abstract criteria analyzed in the present study, on average, 5.32 (SD = 1.38) were reported by the 184 abstracts. Specifically, the highest adherence with STARD for abstracts was found for general interpretation of results of abstracts (100.0%, 184 of 184), clear study objectives (99.5%, 183 of 184), and estimates of diagnostic accuracy (96.2%, 177 of 184). The lowest STARD adherence was found for eligibility criteria for participants (9.2%, 17 of 184), type of study series (13.6%, 25 of 184), and implications for practice (20.7%, 44 of 184). There was no significant difference in the number of reported STARD criteria between abstracts accepted for oral presentation (M = 5.35, SD = 1.31) and abstracts accepted for the electronic poster session (M = 5.39, SD = 1.45) (p = .86). CONCLUSIONS The adherence with STARD for abstract was low, indicating that providing authors with the related checklist may increase the quality of abstracts.
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Affiliation(s)
- Thomas Dratsch
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Liliana Caldeira
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - David Maintz
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany
| | - Daniel Pinto Dos Santos
- Institute of Diagnostic and Interventional Radiology, University Hospital of Cologne, Kerpener Str. 62, 50937, Cologne, Germany.
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29
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Cohen JF, Korevaar DA, Boutron I, Gatsonis CA, Hopewell S, McInnes MDF, Moher D, von Elm E, Bossuyt PM. Reporting guidelines for journal and conference abstracts. J Clin Epidemiol 2020; 124:186-192. [PMID: 32315722 DOI: 10.1016/j.jclinepi.2020.04.012] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2020] [Accepted: 04/14/2020] [Indexed: 12/15/2022]
Affiliation(s)
- Jérémie F Cohen
- Université de Paris, CRESS, Inserm, INRA, F75004 Paris, France; Department of General Pediatrics and Pediatric Infectious Diseases, Necker Hospital for Sick Children, APHP, Université de Paris, Paris, France.
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
| | | | - Constantine A Gatsonis
- Department of Biostatistics, Brown University School of Public Health, Providence, Rhode Island, USA
| | - Sally Hopewell
- Centre for Statistics in Medicine, Nuffield Department of Orthopaedics, Rheumatology and Musculoskeletal Sciences, University of Oxford, Oxford, UK
| | - Matthew D F McInnes
- Centre for Journalology, Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - David Moher
- Department of Radiology, University of Ottawa; Ottawa Hospital Research Institute, Clinical Epidemiology Program, Ottawa, Canada; School of Epidemiology and Public Health, University of Ottawa, Canada
| | - Erik von Elm
- Cochrane Switzerland, Centre for Primary Care and Public Health, University of Lausanne, Lausanne, Switzerland
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands
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Slavin V, Creedy DK, Gamble J. Comparison of screening accuracy of the Patient Health Questionnaire-2 using two case-identification methods during pregnancy and postpartum. BMC Pregnancy Childbirth 2020; 20:211. [PMID: 32290813 PMCID: PMC7158032 DOI: 10.1186/s12884-020-02891-2] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2019] [Accepted: 03/24/2020] [Indexed: 12/16/2022] Open
Abstract
BACKGROUND Variation exists regarding perinatal depression screening. A two-step screening method has been recommended. According to a maternity-focused core outcome set developed by the International Consortium for Health Outcomes Measurement, women who score 3 or more on the PHQ-2 then complete the Edinburgh Postnatal Depression Scale (EPDS). Limited evidence exists regarding the screening accuracy of the PHQ-2 in childbearing women. An alternative case-identification method may be more sensitive for perinatal women. We aimed to [1] evaluate the screening accuracy of the PHQ-2 during the perinatal period using two case-identification methods, and [2] measure the variability of accuracy over four time-points during pregnancy and postpartum. METHODS A prospective, longitudinal cohort study was conducted with 309 consecutive women who completed the PHQ-2 and EPDS during pregnancy (booking, 36-weeks) and postpartum (6-, 26-weeks). EPDS was the reference standard using cut-off scores for 'at least probable minor depression' during pregnancy (≥ 13) and postpartum (≥ 10) and for 'probable major depression' during pregnancy (≥ 15) and postpartum (≥ 13). PHQ-2 was analysed using two methods: [1] scored (cut-points ≥ 2 and ≥ 3), [2] dichotomous yes/no (positive response to either question) against EPDS cut-points for at least probable minor and probable major depression. Receiver operating characteristic analyses determined accuracy. RESULTS Probable major depression: Over four timepoints PHQ-2 ≥ 3 revealed lowest sensitivity (36-79%) but highest specificity (94-98%). An alternative case-identification method revealed high sensitivity (93-100%), but lowest specificity (58-71%). Minor depression: PHQ-2 ≥ 3 revealed the lowest sensitivity (19-50%) but highest specificity (95-98%). An alternative case-identification method revealed the highest sensitivity (81-100%) and moderate specificity (60-74%). CONCLUSIONS Recommended method of case-identification (PHQ-2 ≥ 3) missed an unacceptable number of women at-risk of depression. As a clinical decision-making tool, an alternative, dichotomous method maximized case-identification and is recommended. Further, the literature identified inconsistent reporting of the PHQ-2 and the alternative case-identification method hindering the ability to synthesise data. The future use and reporting of consistent question wording and response format will improve outcome reporting and synthesis. Further research in larger and diverse maternity populations is recommended.
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Affiliation(s)
- Valerie Slavin
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia.
- Women, Newborn & Children's Services, Gold Coast University Hospital, 1 Hospital Boulevard, Southport, Qld, 4215, Australia.
| | - Debra K Creedy
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia
| | - Jenny Gamble
- Transforming Maternity Care Collaborative, School of Nursing & Midwifery, Griffith University, Logan Campus, University Drive, Meadowbrook, Qld, 4131, Australia
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Korevaar DA, Salameh JP, Vali Y, Cohen JF, McInnes MDF, Spijker R, Bossuyt PM. Searching practices and inclusion of unpublished studies in systematic reviews of diagnostic accuracy. Res Synth Methods 2020; 11:343-353. [PMID: 31981399 PMCID: PMC7317757 DOI: 10.1002/jrsm.1389] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2019] [Revised: 11/05/2019] [Accepted: 11/22/2019] [Indexed: 12/12/2022]
Abstract
Introduction Many diagnostic accuracy studies are never reported in full in a peer‐reviewed journal. Searching for unpublished studies may avoid bias due to selective publication, enrich the power of systematic reviews, and thereby help to reduce research waste. We assessed searching practices among recent systematic reviews of diagnostic accuracy. Methods We extracted data from 100 non‐Cochrane systematic reviews of diagnostic accuracy indexed in MEDLINE and published between October 2017 and January 2018 and from all 100 Cochrane systematic reviews of diagnostic accuracy published by December 2018, irrespective of whether meta‐analysis had been performed. Results Non‐Cochrane and Cochrane reviews searched a median of 4 (IQR 3‐5) and 6 (IQR 5‐9) databases, respectively; most often MEDLINE/PubMed (n = 100 and n = 100) and EMBASE (n = 81 and n = 100). Additional efforts to identify studies beyond searching bibliographic databases were performed in 76 and 98 reviews, most often through screening reference lists (n = 71 and n = 96), review/guideline articles (n = 18 and n = 52), or citing articles (n = 3 and n = 42). Specific sources of unpublished studies were searched in 22 and 68 reviews, for example, conference proceedings (n = 4 and n = 18), databases only containing conference abstracts (n = 2 and n = 33), or trial registries (n = 12 and n = 39). At least one unpublished study was included in 17 and 23 reviews. Overall, 39 of 2082 studies (1.9%) included in non‐Cochrane reviews were unpublished, and 64 of 2780 studies (2.3%) in Cochrane reviews, most often conference abstracts (97/103). Conclusion Searching practices vary considerably across systematic reviews of diagnostic accuracy. Unpublished studies are a minimal fraction of the evidence included in recent reviews.
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Affiliation(s)
- Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam University Medical Centres, University of Amsterdam, The Netherlands
| | - Jean-Paul Salameh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada
| | - Yasaman Vali
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
| | - Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, Assistance Publique-Hôpitaux de Paris, Paris, France.,Inserm UMR 1153 (Centre of Research in Epidemiology and Statistics), Paris Descartes University, France
| | - Matthew D F McInnes
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Canada.,Department of Radiology, University of Ottawa, Ottawa, Canada
| | - René Spijker
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, Utrecht University, The Netherlands.,Medical Library, Amsterdam University Medical Centers, University of Amsterdam, Amsterdam, the Netherlands
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam University Medical Centres, University of Amsterdam, Amsterdam, the Netherlands
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Accuracy of Published Indications for Predicting Use of Damage Control During Laparotomy for Trauma. J Surg Res 2019; 248:45-55. [PMID: 31863936 DOI: 10.1016/j.jss.2019.11.010] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 09/24/2019] [Accepted: 11/02/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND Although studies have identified published indications that experts and practicing surgeons agree indicate use of damage control (DC) laparotomy, it is unknown whether these indications predict use of the procedure in practice. MATERIALS AND METHODS We conducted a diagnostic performance study of the accuracy of a set of published appropriateness indications for predicting use of DC laparotomy. We included consecutive adults that underwent emergent laparotomy for trauma (2011-2016) at Memorial Hermann Hospital. RESULTS We included 1141 injured adults. Two published preoperative appropriateness indications [a systolic blood pressure (BP) persistently <90 mmHg or core body temperature <34°C] produced moderate shifts in the pretest probability of conducting DC instead of definitive laparotomy. Five published intraoperative appropriateness indications produced large and often conclusive changes in the pretest probability of conducting DC during emergent laparotomy. These included the finding of a devascularized or completely disrupted pancreas, duodenum, or pancreaticoduodenal complex; an estimated intraoperative blood loss >4 L; administration of >10 U of packed red blood cells (PRBCs); and a systolic BP persistently <90 mmHg or arterial pH persistently <7.2 during operation. Most indications that produced large changes in the pretest probability of conducting DC laparotomy had an incidence of 2% or less. CONCLUSIONS This study suggests that published appropriateness indications accurately predict use of DC laparotomy in practice. Intraoperative variables exert greater influence on the decision to conduct DC laparotomy than preoperative variables, and those indications that produce large shifts in the pretest probability of conducting DC laparotomy are uncommonly encountered.
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Cohen JF, Korevaar DA, Bossuyt PM. Diagnostic accuracy studies need more informative abstracts. Eur J Clin Microbiol Infect Dis 2019; 38:1383-1385. [PMID: 31049744 DOI: 10.1007/s10096-019-03570-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
Affiliation(s)
- Jérémie F Cohen
- Department of General Pediatrics and Pediatric Infectious Diseases, Necker-Enfants Malades Hospital, APHP, Paris Descartes University, 149 rue de Sèvres, 75015, Paris, France. .,Inserm UMR 1153, Obstetrical, Perinatal and Pediatric Epidemiology Research Team, Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité (CRESS), Paris Descartes University, 53 avenue de l'Observatoire, 75014, Paris, France.
| | - Daniël A Korevaar
- Department of Respiratory Medicine, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105 AZ, Amsterdam, The Netherlands
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Kandel P, Brand EC, Pelt J, Ball CT, Chen WC, Bouras EP, Gomez V, Raimondo M, Woodward TA, Wallace MB. Endoscopic scar assessment after colorectal endoscopic mucosal resection scars: when is biopsy necessary (EMR Scar Assessment Project for Endoscope (ESCAPE) trial). Gut 2019; 68:1633-1641. [PMID: 30635409 DOI: 10.1136/gutjnl-2018-316574] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/04/2018] [Revised: 11/28/2018] [Accepted: 12/08/2018] [Indexed: 02/07/2023]
Abstract
OBJECTIVE It is unclear whether endoscopic assessment of scars after colorectal endoscopic mucosal resection (EMR) has to include biopsies, even if endoscopy is negative. Vice versa, endoscopic diagnosis of recurrent adenoma may not require biopsy before endoscopic reinterventions. We prospectively analysed various endoscopic modalities in the diagnosis of recurrence following EMR. DESIGN We conducted a prospective study of patients undergoing colonoscopy after EMR of large (≥20 mm) colorectal neoplasia. Endoscopists predicted recurrence and confidence level with four imaging modes: high-definition white light (WL) and narrow-band imaging (NBI) with and without near focus (NF). Separately, 26 experienced endoscopists assessed offline images. RESULTS Two hundred and thirty patients with 255 EMR scars were included. The prevalence of recurrent adenoma was 24%. Diagnostic values were high for all modes (negative predictive value (NPV) ≥97%, positive predictive value (PPV) ≥81%, sensitivity ≥90%, specificity ≥93% and accuracy ≥93%). In high-confidence cases, NBI with NF had NPV of 100% (95% CI 98% to 100%) and sensitivity of 100% (95% CI 93% to 100%). Use of clips at initial EMR increased diagnostic inaccuracy (adjusted OR=1.68(95% CI 1.01 to 2.75)). In offline assessment, specificity was high for all imaging modes (mean: ≥93% (range: 55%-100%)), while sensitivity was significantly higher for NBI-NF (82%(72%-93%)%)) compared with WL (69%(38%-86%); p<0.001), WL-NF (68%(55%-83%); p<0.001) and NBI (71%(59%-90%); p<0.001). CONCLUSION Our study demonstrates very high sensitivity and accuracy for all four imaging modalities, especially NBI with NF, for diagnosis of recurrent neoplasia after EMR. Our data strongly suggest that in cases of high confidence negative optical diagnosis based on NBI-NF, no biopsy is needed to confirm absence of recurrence during colorectal EMR follow-up. A high confidence positive optical diagnosis can lead to immediate resection of any suspicious area. In all cases of low confidence, biopsy is still required. TRIAL REGISTRATION NUMBER NCT02668198.
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Affiliation(s)
- Pujan Kandel
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Eelco Christiaan Brand
- Department of Gastroenterology and Hepatology, University Medical Center Utrecht, Utrecht, The Netherlands
| | - Joe Pelt
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Colleen T Ball
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Jacksonville, Florida, USA
| | - Wei-Chung Chen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Ernest P Bouras
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Victoria Gomez
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Massimo Raimondo
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Timothy A Woodward
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
| | - Michael B Wallace
- Division of Gastroenterology and Hepatology, Mayo Clinic, Jacksonville, Florida, USA
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Pilz S, Keppel MH, Trummer C, Theiler-Schwetz V, Pandis M, Borzan V, Pittrof M, Obermayer-Pietsch B, Grübler MR, Verheyen N, Stepan V, Meinitzer A, Voelkl J, März W, Tomaschitz A. Diagnostic Accuracy of the Aldosterone-to-Active Renin Ratio for Detecting Primary Aldosteronism. J Endocr Soc 2019; 3:1748-1758. [PMID: 31528833 PMCID: PMC6735732 DOI: 10.1210/js.2019-00145] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/14/2019] [Accepted: 07/15/2019] [Indexed: 11/19/2022] Open
Abstract
Context The aldosterone-to-active renin ratio (AARR) is the recommended screening test for primary aldosteronism (PA), but prospective study data on its sensitivity and specificity are sparse. Objective To investigate the diagnostic accuracy of the AARR for detecting PA. Design Prospective diagnostic accuracy study. Setting This study was conducted from February 2009 to August 2015 at the outpatient clinic of the Department of Endocrinology and Diabetology of the Medical University of Graz, Austria. Participants Four hundred patients with arterial hypertension who were referred to a tertiary care center for screening for endocrine hypertension. Intervention Participants had a determination of the AARR (index test) and a second AARR determination followed by a saline infusion test (SIT) after 2 to 6 weeks. PA was diagnosed in individuals with any AARR ≥3.7 ng/dL/µU/mL [including a plasma aldosterone concentration (PAC) of ≥9 ng/dL] who had a PAC ≥10 ng/dL after the SIT. We did not substantially alter antihypertensive drug intake. Main Outcome Measures Primary outcome was the receiver-operating characteristic (ROC) curve of the AARR in diagnosing PA. Results A total of 382 participants were eligible for analyses; PA was diagnosed in 18 (4.7%) patients. The area under the ROC curve of the AARR in detecting PA was 0.973 (95% CI, 0.956 to 0.990). Sensitivity and specificity for a positive AARR in diagnosing PA were 100% (95% CI, 81.5% to 100.0%) and 89.6% (95% CI, 86.0% to 92.5%), respectively. Conclusions The AARR has good diagnostic accuracy for detecting PA.
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Affiliation(s)
- Stefan Pilz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Martin H Keppel
- University Institute for Medical and Chemical Laboratory Diagnostics, Paracelsus Medical University, Salzburg, Austria
| | - Christian Trummer
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Verena Theiler-Schwetz
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Marlene Pandis
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Valentin Borzan
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Matthias Pittrof
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Barbara Obermayer-Pietsch
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria.,CBmed, Center for Biomarker Research in Medicine, Graz, Austria
| | - Martin R Grübler
- Department of Cardiology, Swiss Cardiovascular Center Bern, Bern University Hospital, University of Bern, Bern, Switzerland
| | - Nicolas Verheyen
- Department of Cardiology, Medical University of Graz, Graz, Austria
| | - Vinzenz Stepan
- Department of Internal Medicine, Division of Endocrinology and Diabetology, Medical University of Graz, Graz, Austria
| | - Andreas Meinitzer
- Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical, University of Graz, Graz, Austria
| | - Jakob Voelkl
- Institute for Physiology, Johannes Kepler University Linz, Linz, Austria.,Departments of Nephrology and Medical Intensive Care and Internal Medicine and Cardiology, Charité University Medicine, Campus Virchow-Klinikum, Berlin, Germany.,German Centre for Cardiovascular Research, Berlin, Germany
| | - Winfried März
- Clinical Institute of Medical and Chemical Laboratory Diagnostics Medical, University of Graz, Graz, Austria.,Synlab Academy, Mannheim, Germany.,Nephrology, Hypertensiology, Rheumatology, Endocrinology, Diabetology, Medical Clinic V, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
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Dewey M, Bosserdt M, Dodd JD, Thun S, Kressel HY. Clinical Imaging Research: Higher Evidence, Global Collaboration, Improved Reporting, and Data Sharing Are the Grand Challenges. Radiology 2019; 291:547-552. [PMID: 30938629 DOI: 10.1148/radiol.2019181796] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
Abstract
The four grand challenges of imaging research—increasing evidence levels, enhancing global collaboration, improving research reporting quality, and sharing trial data—can be addressed, utilizing the tail wind of digital transformation, by consolidating actions of all stakeholders, with the ultimate goal of evidence-based, reproducible, generalizable, and broadly accepted results that will improve the quality and consistency of patient care.
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Affiliation(s)
- Marc Dewey
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität and Freie Universität zu Berlin, Schumannstr 20/21, Berlin 10117, Germany (M.D., M.B.); Berlin Institute of Health, Berlin, Germany (M.D., S.T.); Department of Radiology, St. Vincent's University Hospital School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.); and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Mass (H.Y.K.)
| | - Maria Bosserdt
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität and Freie Universität zu Berlin, Schumannstr 20/21, Berlin 10117, Germany (M.D., M.B.); Berlin Institute of Health, Berlin, Germany (M.D., S.T.); Department of Radiology, St. Vincent's University Hospital School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.); and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Mass (H.Y.K.)
| | - Jonathan D Dodd
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität and Freie Universität zu Berlin, Schumannstr 20/21, Berlin 10117, Germany (M.D., M.B.); Berlin Institute of Health, Berlin, Germany (M.D., S.T.); Department of Radiology, St. Vincent's University Hospital School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.); and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Mass (H.Y.K.)
| | - Sylvia Thun
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität and Freie Universität zu Berlin, Schumannstr 20/21, Berlin 10117, Germany (M.D., M.B.); Berlin Institute of Health, Berlin, Germany (M.D., S.T.); Department of Radiology, St. Vincent's University Hospital School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.); and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Mass (H.Y.K.)
| | - Herbert Y Kressel
- From the Department of Radiology, Charité-Universitätsmedizin Berlin, Humboldt-Universität and Freie Universität zu Berlin, Schumannstr 20/21, Berlin 10117, Germany (M.D., M.B.); Berlin Institute of Health, Berlin, Germany (M.D., S.T.); Department of Radiology, St. Vincent's University Hospital School of Medicine, University College Dublin, Dublin, Ireland (J.D.D.); and Department of Radiology, Beth Israel Deaconess Medical Center, Harvard University, Boston, Mass (H.Y.K.)
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McInnes MD, Lim CS, van der Pol CB, Salameh JP, McGrath TA, Frank RA. Reporting Guidelines for Imaging Research. Semin Nucl Med 2019; 49:121-135. [DOI: 10.1053/j.semnuclmed.2018.11.008] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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May LA, Guillerman RP, Zhang W, Orth RC. Unfounded conclusions of equivalence in diagnostic accuracy studies: a pervasive fallacy of inference in pediatric radiology scientific abstracts. Pediatr Radiol 2018; 48:1861-1866. [PMID: 30105569 DOI: 10.1007/s00247-018-4222-9] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/21/2018] [Revised: 06/18/2018] [Accepted: 07/27/2018] [Indexed: 11/25/2022]
Abstract
BACKGROUND In studies of diagnostic performance that fail to detect a statistically significant difference between compared techniques, investigators often declare evidence of equivalence or similarity without having actually tested that assertion due to incorrect methodology or insufficient statistical power. OBJECTIVE The purpose of our investigation is to measure the prevalence of unfounded assertions of equivalence or similarity in comparison studies presented at the International Pediatric Radiology (IPR) meeting of 2016 and promote awareness of this fallacy of inference to the pediatric radiology community. MATERIALS AND METHODS Two pediatric radiologists independently reviewed the methodology and reporting quality of the 194 scientific paper abstracts from the 2016 IPR meeting. All comparison studies were identified and those failing to detect a statistically significance difference and making a claim of equivalence or similarity in the results or conclusion were assessed for a description of the study design type, statistical power and sample size estimator calculation. RESULTS Of 194 scientific paper abstracts, 112 (58%) were comparison studies. Of these, 36/112 (32%) made unfounded inferences of equivalence or similarity in diagnostic imaging performance. No study had an equivalence or non-inferiority design. No abstract specified the statistical power of the study, and only one abstract acknowledged a small sample size as a limitation in detecting a statistically significant difference. CONCLUSION Inadequate reporting and unfounded inferences of equivalence or similarity were common in diagnostic performance comparison studies presented at IPR 2016. Failure to recognize these limitations could have adverse consequences by leading to the adoption of unvalidated imaging techniques.
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Affiliation(s)
- Lauren A May
- Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA.
- Department of Radiology, San Antonio Military Medical Center, 3551 Roger Brooke Drive, San Antonio, TX, 78234, USA.
| | - R Paul Guillerman
- Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Wei Zhang
- Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
| | - Robert C Orth
- Edward B. Singleton Department of Pediatric Radiology, Texas Children's Hospital, Houston, TX, USA
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Strouse PJ. Superiority vs. equivalence/non-inferiority: study design and meeting abstracts. Pediatr Radiol 2018; 48:1831-1832. [PMID: 30209537 DOI: 10.1007/s00247-018-4258-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/02/2018] [Indexed: 10/28/2022]
Affiliation(s)
- Peter J Strouse
- Section of Pediatric Radiology, C. S. Mott Children's Hospital, Department of Radiology, University of Michigan Health System, Room 3-231, 1540 E. Hospital Drive, Ann Arbor, MI, 48109-4252, USA.
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40
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Alstergren P, Pigg M, Kopp S. Clinical diagnosis of temporomandibular joint arthritis. J Oral Rehabil 2018; 45:269-281. [DOI: 10.1111/joor.12611] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/24/2018] [Indexed: 12/26/2022]
Affiliation(s)
- P. Alstergren
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Specialized Pain Rehabilitation; Skåne University Hospital; Lund Sweden
- Orofacial Pain Unit; Faculty of Odontology; Malmö University; Malmö Sweden
- Section for Orofacial Pain and Jaw Function; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
| | - M. Pigg
- Scandinavian Center for Orofacial Neurosciences (SCON); Malmö Sweden
- Department of Endodontics; Faculty of Odontology; Malmö University; Malmö Sweden
| | - S. Kopp
- Section for Orofacial Pain and Jaw Function; Department of Dental Medicine; Karolinska Institutet; Huddinge Sweden
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McInnes MDF, Moher D, Thombs BD, McGrath TA, Bossuyt PM, Clifford T, Cohen JF, Deeks JJ, Gatsonis C, Hooft L, Hunt HA, Hyde CJ, Korevaar DA, Leeflang MMG, Macaskill P, Reitsma JB, Rodin R, Rutjes AWS, Salameh JP, Stevens A, Takwoingi Y, Tonelli M, Weeks L, Whiting P, Willis BH. Preferred Reporting Items for a Systematic Review and Meta-analysis of Diagnostic Test Accuracy Studies: The PRISMA-DTA Statement. JAMA 2018; 319:388-396. [PMID: 29362800 DOI: 10.1001/jama.2017.19163] [Citation(s) in RCA: 1762] [Impact Index Per Article: 293.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
Importance Systematic reviews of diagnostic test accuracy synthesize data from primary diagnostic studies that have evaluated the accuracy of 1 or more index tests against a reference standard, provide estimates of test performance, allow comparisons of the accuracy of different tests, and facilitate the identification of sources of variability in test accuracy. Objective To develop the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) diagnostic test accuracy guideline as a stand-alone extension of the PRISMA statement. Modifications to the PRISMA statement reflect the specific requirements for reporting of systematic reviews and meta-analyses of diagnostic test accuracy studies and the abstracts for these reviews. Design Established standards from the Enhancing the Quality and Transparency of Health Research (EQUATOR) Network were followed for the development of the guideline. The original PRISMA statement was used as a framework on which to modify and add items. A group of 24 multidisciplinary experts used a systematic review of articles on existing reporting guidelines and methods, a 3-round Delphi process, a consensus meeting, pilot testing, and iterative refinement to develop the PRISMA diagnostic test accuracy guideline. The final version of the PRISMA diagnostic test accuracy guideline checklist was approved by the group. Findings The systematic review (produced 64 items) and the Delphi process (provided feedback on 7 proposed items; 1 item was later split into 2 items) identified 71 potentially relevant items for consideration. The Delphi process reduced these to 60 items that were discussed at the consensus meeting. Following the meeting, pilot testing and iterative feedback were used to generate the 27-item PRISMA diagnostic test accuracy checklist. To reflect specific or optimal contemporary systematic review methods for diagnostic test accuracy, 8 of the 27 original PRISMA items were left unchanged, 17 were modified, 2 were added, and 2 were omitted. Conclusions and Relevance The 27-item PRISMA diagnostic test accuracy checklist provides specific guidance for reporting of systematic reviews. The PRISMA diagnostic test accuracy guideline can facilitate the transparent reporting of reviews, and may assist in the evaluation of validity and applicability, enhance replicability of reviews, and make the results from systematic reviews of diagnostic test accuracy studies more useful.
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Affiliation(s)
- Matthew D F McInnes
- Department of Radiology, University of Ottawa, Ottawa, Ontario, Canada
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - David Moher
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
| | - Brett D Thombs
- Lady Davis Institute of the Jewish General Hospital, Montreal, Quebec, Canada
- Department of Psychiatry, McGill University, Montreal, Quebec, Canada
| | - Trevor A McGrath
- University of Ottawa Department of Radiology, Ottawa, Ontario, Canada
| | - Patrick M Bossuyt
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands
| | - Tammy Clifford
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario
| | - Jérémie F Cohen
- Department of Pediatrics, Necker-Enfants Malades Hospital, Assistance Publique Hôpitaux de Paris, Paris Descartes University, Paris, France
- Inserm UMR 1153, Research Center for Epidemiology and Biostatistics Sorbonne Paris Cité, Paris Descartes University, Paris, France
| | | | | | - Lotty Hooft
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | | | | | - Daniël A Korevaar
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands
| | - Mariska M G Leeflang
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics, University of Amsterdam, Academic Medical Center, Amsterdam, the Netherlands
| | | | - Johannes B Reitsma
- Cochrane Netherlands, Julius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands
| | - Rachel Rodin
- Public Health Agency of Canada, Ottawa, Ontario, Canada
| | - Anne W S Rutjes
- Institute of Social and Preventive Medicine, Berner Institut für Hausarztmedizin, University of Bern, Bern, Switzerland
| | - Jean-Paul Salameh
- Clinical Epidemiology Program, Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- School of Epidemiology and Public Health, University of Ottawa, Ottawa, Ontario, Canada
| | - Adrienne Stevens
- Ottawa Hospital Research Institute, Ottawa, Ontario, Canada
- Translational Research in Biomedicine Program, School of Medicine, University of Split, Split, Croatia
| | | | | | - Laura Weeks
- Canadian Agency for Drugs and Technologies in Health, Ottawa, Ontario
| | - Penny Whiting
- University of Bristol, National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care West, Bristol, England
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Michelessi M, Lucenteforte E, Miele A, Oddone F, Crescioli G, Fameli V, Korevaar DA, Virgili G. Diagnostic accuracy research in glaucoma is still incompletely reported: An application of Standards for Reporting of Diagnostic Accuracy Studies (STARD) 2015. PLoS One 2017; 12:e0189716. [PMID: 29240827 PMCID: PMC5730182 DOI: 10.1371/journal.pone.0189716] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 11/30/2017] [Indexed: 12/19/2022] Open
Abstract
Background Research has shown a modest adherence of diagnostic test accuracy (DTA) studies in glaucoma to the Standards for Reporting of Diagnostic Accuracy Studies (STARD). We have applied the updated 30-item STARD 2015 checklist to a set of studies included in a Cochrane DTA systematic review of imaging tools for diagnosing manifest glaucoma. Methods Three pairs of reviewers, including one senior reviewer who assessed all studies, independently checked the adherence of each study to STARD 2015. Adherence was analyzed on an individual-item basis. Logistic regression was used to evaluate the effect of publication year and impact factor on adherence. Results We included 106 DTA studies, published between 2003–2014 in journals with a median impact factor of 2.6. Overall adherence was 54.1% for 3,286 individual rating across 31 items, with a mean of 16.8 (SD: 3.1; range 8–23) items per study. Large variability in adherence to reporting standards was detected across individual STARD 2015 items, ranging from 0 to 100%. Nine items (1: identification as diagnostic accuracy study in title/abstract; 6: eligibility criteria; 10: index test (a) and reference standard (b) definition; 12: cut-off definitions for index test (a) and reference standard (b); 14: estimation of diagnostic accuracy measures; 21a: severity spectrum of diseased; 23: cross-tabulation of the index and reference standard results) were adequately reported in more than 90% of the studies. Conversely, 10 items (3: scientific and clinical background of the index test; 11: rationale for the reference standard; 13b: blinding of index test results; 17: analyses of variability; 18; sample size calculation; 19: study flow diagram; 20: baseline characteristics of participants; 28: registration number and registry; 29: availability of study protocol; 30: sources of funding) were adequately reported in less than 30% of the studies. Only four items showed a statistically significant improvement over time: missing data (16), baseline characteristics of participants (20), estimates of diagnostic accuracy (24) and sources of funding (30). Conclusions Adherence to STARD 2015 among DTA studies in glaucoma research is incomplete, and only modestly increasing over time.
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Affiliation(s)
| | - Ersilia Lucenteforte
- Department of Translational Surgery and Medicine, University of Florence, Florence, Italy
| | - Alba Miele
- Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
| | | | - Giada Crescioli
- Department of Translational Surgery and Medicine, University of Florence, Florence, Italy
| | - Valeria Fameli
- Ophthalmology unit, Department of Sens, Organs, University of Rome “Sapienza”, Rome, Italy
| | - Daniël A. Korevaar
- Department of Clinical Epidemiology, Biostatistics and Bioinformatics (KEBB), Academic Medical Centre (AMC), University of Amsterdam (UvA), Amsterdam, The Netherlands
| | - Gianni Virgili
- Neurosciences, Psychology, Drug Research and Child Health (NEUROFARBA), University of Florence, Florence, Italy
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Herráiz-Adillo Á, Soriano-Cano A, Martínez-Hortelano JA, Garrido-Miguel M, Mariana-Herráiz JÁ, Martínez-Vizcaíno V, Notario-Pacheco B. Simultaneous inter-arm and inter-leg systolic blood pressure differences to diagnose peripheral artery disease: a diagnostic accuracy study. Blood Press 2017; 27:112-119. [DOI: 10.1080/08037051.2017.1400903] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Affiliation(s)
- Ángel Herráiz-Adillo
- Department of Primary Care, Health Service of Castilla-La Mancha (SESCAM), Tragacete, Spain
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | - Alba Soriano-Cano
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
| | | | | | | | - Vicente Martínez-Vizcaíno
- Health and Social Research Center, Universidad de Castilla-La Mancha, Cuenca, Spain
- Facultad de Ciencias de la Salud, Universidad Autónoma de Chile, Talca, Chile
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Korevaar DA, Cohen JF, de Ronde MWJ, Virgili G, Dickersin K, Bossuyt PMM. Reporting Weaknesses in Conference Abstracts of Diagnostic Accuracy Studies in Ophthalmology. JAMA Ophthalmol 2016; 133:1464-7. [PMID: 26447954 DOI: 10.1001/jamaophthalmol.2015.3577] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
IMPORTANCE Conference abstracts present information that helps clinicians and researchers to decide whether to attend a presentation. They also provide a source of unpublished research that could potentially be included in systematic reviews. We systematically assessed whether conference abstracts of studies that evaluated the accuracy of a diagnostic test were sufficiently informative. OBSERVATIONS We identified all abstracts describing work presented at the 2010 Annual Meeting of the Association for Research in Vision and Ophthalmology. Abstracts were eligible if they included a measure of diagnostic accuracy, such as sensitivity, specificity, or likelihood ratios. Two independent reviewers evaluated each abstract using a list of 21 items, selected from published guidance for adequate reporting. A total of 126 of 6310 abstracts presented were eligible. Only a minority reported inclusion criteria (5%), clinical setting (24%), patient sampling (10%), reference standard (48%), whether test readers were masked (7%), 2 × 2 tables (16%), and confidence intervals around accuracy estimates (16%). The mean number of items reported was 8.9 of 21 (SD, 2.1; range, 4-17). CONCLUSIONS AND RELEVANCE Crucial information about study methods and results is often missing in abstracts of diagnostic studies presented at the Association for Research in Vision and Ophthalmology Annual Meeting, making it difficult to assess risk for bias and applicability to specific clinical settings.
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Affiliation(s)
- Daniël A Korevaar
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Jérémie F Cohen
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands2Inserm U1153, Center for Epidemiology and Statistics Sorbonne Paris Cité, Paris Descartes University, Pari
| | - Maurice W J de Ronde
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
| | - Gianni Virgili
- Department of Translational Surgery and Medicine, Eye Clinic, University of Florence, Florence, Italy
| | - Kay Dickersin
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Patrick M M Bossuyt
- Department of Clinical Epidemiology, Biostatistics, and Bioinformatics, Academic Medical Center, University of Amsterdam, Amsterdam, the Netherlands
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