Articles: sensitivity-specificity.
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Carbon monoxide (CO) poisoning is one of the most common causes of poisoning death and its diagnosis requires an elevated carboxyhemoglobin (COHb) level. Noninvasive CO saturation by pulse oximetry (SpCO) has been available since 2005 and has the advantage of being portable and easy to use, but its accuracy in determining blood COHb level is controversial. To evaluate the accuracy of SpCO (index test) to estimate COHb (reference test). ⋯ The mean bias was 0.75% and the LOA was -7.08% to 8.57%, 95% CI (-8.89 to 10.38) (2794 subjects and 4646 observations). Noninvasive measurement of COHb (SpCO) using current pulse CO oximeters do not seem to be highly accurate to estimate blood COHb (moderate sensitivity and specificity, large LOA). They should probably not be used to confirm (rule-in) or exclude (rule-out) CO poisoning with certainty.
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Meta Analysis
Aortic propagation velocity in predicting coronary artery disease: A systematic review and meta-analysis.
Coronary artery disease (CAD) and its outcome, myocardial infarction, is yet a significant etiology of mortality and morbidity nowadays. The aortic propagation velocity (APV) can be a simple, straightforward and novel echocardiographic index for the risk stratification in the evaluation of CAD. In this meta-analysis, we evaluated the predictive role of APV in CAD. ⋯ There was a predictive role of APV in CAD with suitable specificity and sensitivity. Moreover, aortic distensibility and aortic strain were significantly different in CAD and non-CAD patients. APV could be used as a good noninvasive tool for screening CAD.
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Review Meta Analysis
Diagnostic accuracy of the physical exam in emergency department patients with acute vertigo or dizziness: Systematic review and meta-analysis for GRACE-3.
History and physical examination are key features to narrow the differential diagnosis of central versus peripheral causes in patients presenting with acute vertigo. We conducted a systematic review and meta-analysis of the diagnostic test accuracy of physical examination findings. ⋯ Most neurologic examination findings have low sensitivity and high specificity for a central cause in patients with acute vertigo or dizziness. In acute vestibular syndrome (monophasic, continuous, persistent dizziness), HINTS and HINTS+ have high sensitivity when performed by trained clinicians.
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Point-of-Care Ultrasound (POCUS) is a quick, useful, noninvasive, and inexpensive diagnostic tool used for the diagnosis of trauma, abdominal pain, dyspnea, and chest pain in the emergency department (ED). However, the diagnostic accuracy of ultrasound in the ED may be different from those reported in previous studies owing to the setting and time constraints in ED. ⋯ The use of ultrasound for the diagnosis of acute appendicitis in the ED showed that ultrasound has high overall sensitivity and specificity for the diagnosis of acute appendicitis. however, high heterogeneity among the included studies was observed.
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J Coll Physicians Surg Pak · Feb 2023
Review Meta AnalysisComparison of Contrast-enhanced versus Non-enhanced Helical Computed Tomography in the Diagnosis of Acute Appendicitis: A Meta-analysis.
The aim of this review was to compare the performance of contrast-enhanced versus non-contrast-enhanced helical computed tomography (CT) for acute appendicitis as reported. A systematic search of PubMed and Embase was conducted. The sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and area under the summary receiver operating characteristic curves (AUC) were evaluated using Meta-DiSc. ⋯ The AUC was not statistically different (Z=0.737, p=0.461). This data suggest that the contrast-enhanced CT has better diagnostic performance for acute appendicitis than non-contrast CT. Key Words: Acute appendicitis, Contrast-enhanced computed tomography' scan, Non-contrast-enhanced computed tomography' scan, Meta-analysis.