Diagnostic accuracy of transient elastography (FibroScan) in detection of esophageal varices in patients with cirrhosis: A meta-analysis
| Autor: | Kai-Lin Tang, Qian Tang, Xing-Sheng Hu, Jing-Hong Shi, Xin-Jie Wang, Xu Wang, Ke Pu, Zhong-Qi Long |
|---|---|
| Rok vydání: | 2017 |
| Předmět: |
Liver Cirrhosis
medicine.medical_specialty Transient elastography Cirrhosis Diagnostic accuracy Esophageal varices Esophageal and Gastric Varices Severity of Illness Index Gastroenterology 03 medical and health sciences Esophagus 0302 clinical medicine Predictive Value of Tests Internal medicine Odds Ratio Humans Medicine In patient FibroScan business.industry General Medicine medicine.disease ROC Curve 030220 oncology & carcinogenesis Meta-analysis Elasticity Imaging Techniques 030211 gastroenterology & hepatology Esophagoscopy business Meta-Analysis |
| Zdroj: | World Journal of Gastroenterology |
| ISSN: | 1007-9327 |
| Popis: | AIM To investigate the diagnostic accuracy of FibroScan (FS) in detecting esophageal varices (EV) in cirrhotic patients. METHODS Through a systemic literature search of multiple databases, we reviewed 15 studies using endoscopy as a reference standard, with the data necessary to calculate pooled sensitivity (SEN) and specificity (SPE), positive and negative LR, diagnostic odds ratio (DOR) and area under receiver operating characteristics (AUROC). The quality of the studies was rated by the Quality Assessment of Diagnostic Accuracy studies-2 tool. Clinical utility of FS for EV was evaluated by a Fagan plot. Heterogeneity was explored using meta-regression and subgroup analysis. All statistical analyses were conducted via Stata12.0, MetaDisc1.4 and RevMan5. RESULTS In 15 studies (n = 2697), FS detected the presence of EV with the summary sensitivities of 84% (95%CI: 81.0%-86.0%), specificities of 62% (95%CI: 58.0%- 66.0%), a positive LR of 2.3 (95%CI: 1.81-2.94), a negative LR of 0.26 (95%CI: 0.19-0.35), a DOR of 9.33 (95%CI: 5.84-14.92) and an AUROC of 0.8262. FS diagnosed the presence of large EV with the pooled SEN of 0.78 (95%CI: 75.0%-81.0%), SPE of 0.76 (95%CI: 73.0%-78.0%), a positive and negative LR of 3.03 (95%CI: 2.38-3.86) and 0.30 (95%CI: 0.23-0.39) respectively, a summary diagnostic OR of 10.69 (95%CI: 6.81-16.78), and an AUROC of 0.8321. A meta-regression and subgroup analysis indicated different etiology could serve as a potential source of heterogeneity in the diagnosis of the presence of EV group. A Deek’s funnel plot suggested a low probability for publication bias. CONCLUSION Using FS to measure liver stiffness cannot provide high accuracy for the size of EV due to the various cutoff and different etiologies. These limitations preclude widespread use in clinical practice at this time; therefore, the results should be interpreted cautiously given its SEN and SPE. |
| Databáze: | OpenAIRE |
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