Objective To systematically review the diagnostic value of Presepsin for sepsis. Methods Literatures were searched from PubMed, The Cochrane Library (Issue 6, 2017), EMbase, CNKI, CBM, VIP, and WanFang database, and the time was from inception to June 2017, to collect diagnostic studies about Presepsin for sepsis. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies by QUADAS-2 tool. Then meta-analysis was performed by using RevMan 5.3 and Meta-Disc 1.4 software. Pooled sensitivity (Sen), specificity (Spe), positive likelihood ratio (LR+), negative likelihood ratio (LR-), diagnostic odds ratio (DOR), and area under the curve (AUC) of summary receiver operating characteristic curve (SROC) were calculated to assess the diagnostic value of individual diagnostic tests. Results A total of 23 studies with 2 925 sepsis patients and 1 852 controls were finally included. The results of meta-analysis showed that the pooled Sen, Spe, LR+, LR-, DOR, and AUC was 0.80 ［95% CI was (0.78, 0.81), P<0.000 1］, 0.83 ［95%CI was (0.81, 0. 84), P<0.000 1］, 4.78 ［95%CI was (3.62, 6.31), P<0.000 1］, 0.22 ［95%CI was (0.18, 0.27), P<0.000 1］, 23.64 ［95%CI was (16.00, 34.92), P<0.000 1］, and 0.91 ［95%CI was (0.89, 0.94), P<0.001］, respectively. Subgroup analysis showed that the pooled Sen, Spe, LR+, LR-, DOR, and AUC in Caucasian was 0.83 ［95% CI was (0.80, 0.86), P=0.000 1］, 0.79 ［95% CI was (0.76, 0.82), P<0.000 1］, 4.38 ［95%CI was (2.40, 8.02), P<0.000 1］, 0.23 ［95%CI was (0.16, 0.31), P=0.007 8］, 21.09 ［95% CI was (8.82, 50.41), P<0.000 1］, and 0.91 ［95%CI was (0.87, 0.92), P<0.001］ respectively, and in Asian was 0.79 ［95% CI was (0.77, 0.80), P<0.000 1］, 0.85 ［95%CI was (0.83, 0.87), P<0.000 1］,4.74 ［95%CI was (3.82, 5.89), P=0.011 1］, 0.22 ［95% CI was (0.17, 0.28), P<0.000 1］, 24.95 ［95%CI was (16.07, 38.74), P<0.000 1］, and 0.92 ［95%CI was (0.90, 0.95), P=0.001］ respectively, there was no significant difference between Caucasian and Asian in diagnostic accuracy of Presepsin (Z=0.41, P>0.05). Conclusion Current evidence indicates that Presepsin has great early diagnostic value for sepsis.
Objective To explore the efficacy of a novel detection technique of circulating tumor cells (CTCs) to identify benign and malignant lung nodules. Methods Nanomagnetic CTC detection based on polypeptide with epithelial cell adhesion molecule (EpCAM)-specific recognition was performed on enrolled patients with pulmonary nodules. There were 73 patients including 48 patients with malignant lesions as a malignant group and 25 patients with benign lesion as a benign group. There were 13 males and 35 females at age of 57.0±11.9 years in the malignant group and 11 males and 14 females at age of 53.1±13.2 years in the benign group. e calculated the differential diagnostic efficacy of CTC count, and conducted subgroup analysis according to the consolidation-tumor ratio, while compared with PET/CT on the efficacy. Results CTC count of the malignant group was significantly higher than that of the benign group (0.50/ml vs. 0.00/ml, P<0.05). Subgroup analysis according to consolidation tumor ratio (CTR) revealed that the difference was statistically significant in pure ground glass (pGGO) nodules 1.00/mlvs. 0.00/ml, P<0.05), but not in part-solid or pure solid nodules. For pGGO nodules, the area under the receiver operating characteristic (ROC) curve of CTC count was 0.833, which was significantly higher than that of maximum of standardized uptake value (SUVmax) (P<0.001). Its sensitivity and specificity was 80.0% and 83.3%, respectively. Conclusion The peptide-based nanomagnetic CTC detection system can differentiate malignant tumor and benign lesions in pulmonary nodules presented as pGGO. It is of great clinical potential as a noninvasive, nonradiating method to identify malignancies in pulmonary nodules.
ObjectiveTo analyze the diagnostic efficacy of colloidal gold immunochromatography assay (GICA) in detection of SARS-CoV-2.MethodsUsing GICA detection kits from three different manufacturers, 33 serum samples were collected from 12 patients with SARS-CoV-2 infection at different time and 45 serum samples from 45 patients without SARS-CoV-2 infection were collected from West China Hospital of Sichuan University from January to February, 2020.ResultsThe sensitivity, specificity, positive predictive value and negative predictive value of the three GICA reagents were 66.7% - 90.9%, 73.3% - 100.0%, 71.4% - 100.0% and 80.4% - 91.7% respectively. The rates of missed diagnosis and misdiagnosis were 9.1% - 33.3% and 0 - 26.7%, respectively. The positive rate decreased with titer increasing. The interference factors mainly included human immunodeficiency virus infection, high rheumatoid factor blood samples, and hemolysis.ConclusionClinical laboratories should pay attention to the differences in the detection ability and potential cross-reaction of different reagents, or use a combination of multiple antibodies.
Scientific and rigorous study design could improve the reliability of results of the comparative diagnostic test accuracy studies. The design procedures of a comparative diagnostic test accuracy study included: constructing the clinical questions, identifying the appropriate gold standard, selecting the representative patient sample, calculating the sample size, blindly interpreting and comparing the results of diagnostic tests, and setting up the cut-off value. This paper introduced 5 categories of the designs of comparative diagnostic test accuracy studies: fully paired, partially paired with a random subset, partially paired with a nonrandom subset, unpaired randomized, and unpaired nonrandomized design.
Comparative diagnostic test accuracy study, a type of diagnostic accuracy test, aims to compare accuracy of two or more index tests in a study. The application of GRADE in comparative test accuracy differs from single test accuracy, mainly including the selection of appropriate comparative study designs, additional criteria for judging risk of bias, and the consequences of using comparative measures of test accuracy. The study focuses on basic principles and methods of GRADE approach in systematic reviews of comparative test accuracy to promote the understanding and application of the method by domestic scholars.
The comparative diagnostic test accuracy (CDTA) study is an important part of diagnostic test accuracy, which aims to compare the accuracy of two or more index tests in the same study. With the development of CDTA studies and the methodology of systematic reviews, the number of CDTA systematic reviews has grown year by year and has provided evidence to support clinical decision-making. Compared with systematic review of single diagnostic test accuracy, the CDTA systematic review has its own unique features, especially in data extraction, risk of bias, and statistical analysis. This paper introduced the steps and precautions for writing a CDTA systematic review to provide references for CDTA systematic reviewers.