Glypican-3 versus alpha-fetoprotein as a biomarker for hepatocellular carcinoma: a diagnostic meta-analysis

Objective:To assess the diagnostic accuracy of serum GPC3 versus alpha-fetoprotein(AFP)for HCC by using the method of system review.Methods:PubMed and EMBASE were searched from its inception to 20,April 2014 for studies that compared diagnostic accuracy of serum GPC3 with AFP for HCC.Sensitivity,specificity and other measures were pooled using random-effects models.Summary receiver operating characteristic curve analysis was used to summarize the overall test performance.Results:Fourteen studies were included in this meta-analysis.Summary estimates for serum GPC3 and AFP in diagnosing HCC were as follows:sensitivity,69%(95%confidence interval(CI),56-80%)vs.60%(95%CI,50-69%);specificity,91%(95%CI,76-97%)vs.92%(95%CI,84-98%);diagnostic odds ratio(DOR),22(95%CI,6-83)vs.18(95%CI,8-41);and area under sROC,0.85(95%CI,0.81-0.88)vs.0.80(95%CI,0.76-0.83).The pooled sensitivity and specificity for(GPC3+AFP)and AFP were:sensitivity 80%(95%CI,75-85%)vs.64%(95%CI,53-73%)and specificity 86%(95%CI,74-93%)vs.96%(95%CI,86-99%).A significant heterogeneity was found among the ten studies,and meta-regression and subgroup meta-analysis suggested that race and assay type were probably responsible for the heterogeneity.Conclusions:Serum GPC3 may be a promising diagnostic marker of HCC and it was helpful for early detection of primary hepatocellular carcinoma when combined with AFP.More studies for specific race of patients,and using certain methods for detecting GPC3 are required to further confirm the diagnostic value of GPC3 for HCC.

Urea breath test for Helicobacter pylori infection in adult dyspeptic patients: A meta-analysis of diagnostic test accuracy

BACKGROUND Helicobacter pylori(H.pylori)infection has been well-established as a significant risk factor for several gastrointestinal disorders.The urea breath test(UBT)has emerged as a leading non-invasive method for detecting H.pylori.Despite numerous studies confirming its substantial accuracy,the reliability of UBT results is often compromised by inherent limitations.These findings underscore the need for a rigorous statistical synthesis to clarify and reconcile the diagnostic accuracy of the UBT for the diagnosis of H.pylori infection.AIM To determine and compare the diagnostic accuracy of 13C-UBT and 14C-UBT for H.pylori infection in adult patients with dyspepsia.METHODS We conducted an independent search of the PubMed/MEDLINE,EMBASE,and Cochrane Central databases until April 2022.Our search included diagnostic accuracy studies that evaluated at least one of the index tests(^(13)C-UBT or ^(14)C-UBT)against a reference standard.We used the QUADAS-2 tool to assess the methodo-logical quality of the studies.We utilized the bivariate random-effects model to calculate sensitivity,specificity,positive and negative test likelihood ratios(LR+and LR-),as well as the diagnostic odds ratio(DOR),and their 95%confidence intervals.We conducted subgroup analyses based on urea dosing,time after urea administration,and assessment technique.To investigate a possible threshold effect,we conducted Spearman correlation analysis,and we generated summary receiver operating characteristic(SROC)curves to assess heterogeneity.Finally,we visually inspected a funnel plot and used Egger’s test to evaluate publication bias.endorsing both as reliable diagnostic tools in clinical practice.CONCLUSION In summary,our study has demonstrated that ^(13)C-UBT has been found to outperform the ^(14)C-UBT,making it the preferred diagnostic approach.Additionally,our results emphasize the significance of carefully considering urea dosage,assessment timing,and measurement techniques for both tests to enhance diagnostic precision.Nevertheless,it is crucial for researchers and clinicians to evaluate the strengths and limitations of our findings before implementing them in practice.

Diagnostic Accuracy of Computerized Bowel Sound Analysis with Non-Invasive Devices for Irritable Bowel Syndrome:A Systematic Review and Meta-Analysis

Objective To assess the diagnostic accuracy of bowel sound analysis for irritable bowel syndrome(IBS)with a systematic review and meta-analysis.Methods We searched MEDLINE,Embase,the Cochrane Library,Web of Science,and IEEE Xplore databases until September 2023.Cross-sectional and case-control studies on diagnostic accuracy of bowel sound analysis for IBS were identified.We estimated the pooled sensitivity,specificity,positive likelihood ratio,negative likeli-hood ratio,and diagnostic odds ratio with a 95% confidence interval(CI),and plotted a summary receiver operat-ing characteristic curve and evaluated the area under the curve.Results Four studies were included.The pooled diagnostic sensitivity,specificity,positive likelihood ratio,nega-tive likelihood ratio,and diagnostic odds ratio were 0.94(95%CI,0.87‒0.97),0.89(95%CI,0.81‒0.94),8.43(95%CI,4.81‒14.78),0.07(95%CI,0.03‒0.15),and 118.86(95%CI,44.18‒319.75),respectively,with an area under the curve of 0.97(95%CI,0.95‒0.98).Conclusions Computerized bowel sound analysis is a promising tool for IBS.However,limited high-quality data make the results'validity and applicability questionable.There is a need for more diagnostic test accuracy studies and better wearable devices for monitoring and analysis of IBS.

Evaluating the diagnostic accuracy of microRNA-494 as a biomarker in cancers:A systematic review and meta-analysis

MicroRNA-494(miR-494)has emerged as a potential diagnostic biomarker for cancer detection,but conflicting reports have led to uncertainty regarding its clinical utility.This study aims to address these discrepancies by conducting a comprehensive metaanalysis of miR-494 diagnostic performance across various cancer types.A comprehensive literature search was performed across multiple databases,including PubMed,Web of Science,Wanfang databases,and CNKI(China National Knowledge Infrastructure),with a cutoff date of April 23,2024.Eligible studies were identified using predefined inclusion criteria and various search strategies to ensure a thorough coverage of the available evidence.To evaluate the diagnostic performance of miR-494 in cancer detection,relevant measures such as sensitivity,specificity,and other diagnostic accuracy indicators were extracted from the included studies.These data were synthesized using bivariate meta-analysis models to generate pooled estimates of miR-494 diagnostic performance.All statistical analyses were conducted using the STATA 16.0 software.This meta-analysis pooled data from 8 studies,comprising a total of 647 cancer cases and 407 healthy controls.The aggregated diagnostic performance of miR-494 was as follows:a sensitivity of 0.67(95%confidence interval[CI],0.52–0.80),a specificity of 0.85(95%CI,0.77–0.91),and an area under the curve of 0.86(95%CI,0.82–0.88),indicating good overall diagnostic accuracy.The diagnostic odds ratio(DOR)was 12.11(95%CI,7–21),suggesting that miR-494 has strong discriminatory power in distinguishing cancer patients from healthy individuals.The positive likelihood ratio of 4.62(95%CI,3.1–6.8)and negative likelihood ratio of 0.38(95%CI,0.26–0.56)further support the diagnostic utility of miR-494.Deeks’funnel plot asymmetry test was employed to assess potential publication bias,yielding a P value of 0.50,which suggests the absence of significant bias in the included studies.The meta-analysis results suggest that miR-494 exhibits promising diagnostic performance in detecting cancer,with moderate accuracy.The pooled sensitivity,specificity,and high area under the receiver operating characteristic curve highlight its potential as a cancer biomarker,indicating its utility in early detection and accurate diagnosis.

Advancing healthcare through laboratory on a chip technology:Transforming microorganism identification and diagnostics

In a recent case report in the World Journal of Clinical Cases,emphasized the crucial role of rapidly and accurately identifying pathogens to optimize patient treatment outcomes.Laboratory-on-a-chip(LOC)technology has emerged as a transformative tool in health care,offering rapid,sensitive,and specific identification of microorganisms.This editorial provides a comprehensive overview of LOC technology,highlighting its principles,advantages,applications,challenges,and future directions.Success studies from the field have demonstrated the practical benefits of LOC devices in clinical diagnostics,epidemiology,and food safety.Comparative studies have underscored the superiority of LOC technology over traditional methods,showcasing improvements in speed,accuracy,and portability.The future integration of LOC with biosensors,artificial intelligence,and data analytics promises further innovation and expansion.This call to action emphasizes the importance of continued research,investment,and adoption to realize the full potential of LOC technology in improving healthcare outcomes worldwide.

The effects of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents:a meta-analysis

Brain-derived neurotrophic factor is a crucial neurotrophic factor that plays a significant role in brain health. Although the vast majority of meta-analyses have confirmed that exercise interventions can increase brain-derived neurotrophic factor levels in children and adolescents, the effects of specific types of exercise on brain-derived neurotrophic factor levels are still controversial. To address this issue, we used meta-analytic methods to quantitatively evaluate, analyze, and integrate relevant studies. Our goals were to formulate general conclusions regarding the use of exercise interventions, explore the physiological mechanisms by which exercise improves brain health and cognitive ability in children and adolescents, and provide a reliable foundation for follow-up research. We used the Pub Med, Web of Science, Science Direct, Springer, Wiley Online Library, Weipu, Wanfang, and China National Knowledge Infrastructure databases to search for randomized controlled trials examining the influences of exercise interventions on brain-derived neurotrophic factor levels in children and adolescents. The extracted data were analyzed using Review Manager 5.3. According to the inclusion criteria, we assessed randomized controlled trials in which the samples were mainly children and adolescents, and the outcome indicators were measured before and after the intervention. We excluded animal experiments, studies that lacked a control group, and those that did not report quantitative results. The mean difference(MD;before versus after intervention) was used to evaluate the effect of exercise on brain-derived neurotrophic factor levels in children and adolescents. Overall, 531 participants(60 children and 471 adolescents, 10.9–16.1 years) were included from 13 randomized controlled trials. Heterogeneity was evaluated using the Q statistic and I^(2) test provided by Review Manager software. The meta-analysis showed that there was no heterogeneity among the studies(P = 0.67, I^(2) = 0.00%). The combined effect of the interventions was significant(MD = 2.88, 95% CI: 1.53–4.22, P < 0.0001), indicating that the brain-derived neurotrophic factor levels of the children and adolescents in the exercise group were significantly higher than those in the control group. In conclusion, different types of exercise interventions significantly increased brain-derived neurotrophic factor levels in children and adolescents. However, because of the small sample size of this meta-analysis, more high-quality research is needed to verify our conclusions. This metaanalysis was registered at PROSPERO(registration ID: CRD42023439408).

Storage time affects the level and diagnostic efficacy of plasma biomarkers for neurodegenerative diseases

Several promising plasma biomarker proteins,such as amyloid-β(Aβ),tau,neurofilament light chain,and glial fibrillary acidic protein,are widely used for the diagnosis of neurodegenerative diseases.However,little is known about the long-term stability of these biomarker proteins in plasma samples stored at-80°C.We aimed to explore how storage time would affect the diagnostic accuracy of these biomarkers using a large cohort.Plasma samples from 229 cognitively unimpaired individuals,encompassing healthy controls and those experiencing subjective cognitive decline,as well as 99 patients with cognitive impairment,comprising those with mild cognitive impairment and dementia,were acquired from the Sino Longitudinal Study on Cognitive Decline project.These samples were stored at-80°C for up to 6 years before being used in this study.Our results showed that plasma levels of Aβ42,Aβ40,neurofilament light chain,and glial fibrillary acidic protein were not significantly correlated with sample storage time.However,the level of total tau showed a negative correlation with sample storage time.Notably,in individuals without cognitive impairment,plasma levels of total protein and tau phosphorylated protein threonine 181(p-tau181)also showed a negative correlation with sample storage time.This was not observed in individuals with cognitive impairment.Consequently,we speculate that the diagnostic accuracy of plasma p-tau181 and the p-tau181 to total tau ratio may be influenced by sample storage time.Therefore,caution is advised when using these plasma biomarkers for the identification of neurodegenerative diseases,such as Alzheimer's disease.Furthermore,in cohort studies,it is important to consider the impact of storage time on the overall results.

Diagnostic value of interleukin-8 in colorectal cancer:A case-control study and meta-analysis

AIM: To assess the diagnostic value of serum interleukin-8 (IL-8) in the detection of colorectal cancer (CRC).

Diagnostic performance of magnifying narrow-band imaging for early gastric cancer: A meta-analysis

AIM: To investigate the performance of magnifying endoscopy with narrow-band imaging(ME-NBI) in the diagnosis of early gastric cancer(EGC).METHODS: Systematic literature searches were conducted until February 2014 in Pub Med, EMBASE, Web of Science, Ovid, Scopus and the Cochrane Library databases by two independent reviewers. Meta-analysis was performed to calculate the pooled sensitivity, specificity and diagnostic odds ratio and to construct a summary receiver operating characteristic(ROC) curve. Subgroup analyses were performed based on the morphology type of lesions, diagnostic standard, the size of lesions, type of assessment, country and sample size to explore possible sources of heterogeneity. A Deeks' asymmetry test was used to evaluate the publication bias.RESULTS: Fourteen studies enrolling 2171 patients were included. The pooled sensitivity, specificity and diagnostic odds ratio for ME-NBI diagnosis of EGC were 0.86(95%CI: 0.83-0.89), 0.96(95%CI: 0.95-0.97) and 102.75(95%CI: 48.14-219.32), respectively, with the area under ROC curve being 0.9623. Among the 14 studies, six also evaluated the diagnostic value of conventional white-light imaging, with a sensitivityof 0.57(95%CI: 0.50-0.64) and a specificity of 0.79(95%CI: 0.76-0.81). When using "VS"(vessel plus surface) ME-NBI diagnostic systems in gastric lesions of depressed macroscopic type, the pooled sensitivity and specificity were 0.64(95%CI: 0.52-0.75) and 0.96(95%CI: 0.95-0.98). For the lesions with a diameter less than 10 mm, the sensitivity and specificity were 0.74(95%CI: 0.65-0.82) and 0.98(95%CI: 0.97-0.98).CONCLUSION: ME-NBI is a promising endoscopic tool in the diagnosis of early gastric cancer and might be helpful in further target biopsy.

Diagnostic accuracy of transient elastography (Fibro Scan) in detection of esophageal varices in patients with cirrhosis: A meta-analysis

AIM To investigate the diagnostic accuracy of Fibro Scan(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, MetaD isc1.4 and RevM an5.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.

Diagnostic efficacy of the Japan Narrow-band-imaging Expert Team and Pit pattern classifications for colorectal lesions: A meta-analysis

BACKGROUND Pit pattern classification using magnifying chromoendoscopy is the established method for diagnosing colorectal lesions. The Japan Narrow-band-imaging(NBI) Expert Team(JNET) classification is a novel NBI magnifying endoscopic classification that focuses on the vessel, and surface patterns.AIM To determine the diagnostic efficacy of each category of the JNET and Pit pattern classifications for colorectal lesions.METHODS A systematic literature search was performed using PubMed, Embase, the Cochrane Library, and Web of Science databases. The pooled sensitivity, specificity, diagnostic odds ratio, and area under the summary receiver operating characteristic curve of each category of the JNET and Pit pattern classifications were calculated.RESULTS A total of 19227 colorectal lesions in 31 studies were included. The diagnostic performance of the JNET classification was equivalent to the Pit pattern classification in each corresponding category. The pooled sensitivity, specificity,and area under the curve(AUC) for each category of the JNET classification were as follows: 0.73(95%CI: 0.55-0.85), 0.99(95%CI: 0.97-1.00), and 0.97(95%CI: 0.95-0.98), respectively, for Type 1;0.88(95%CI: 0.78-0.94), 0.72(95%CI: 0.64-0.79), and 0.84(95%CI: 0.81-0.87), respectively, for Type 2 A;0.56(95%CI: 0.47-0.64), 0.91(95%CI: 0.79-0.96), and 0.72(95%CI: 0.68-0.76), respectively, for Type 2 B;0.51(95%CI: 0.42-0.61), 1.00(95%CI: 1.00-1.00), and 0.90(95%CI: 0.87-0.93), respectively, for Type 3.CONCLUSION This meta-analysis suggests that the diagnostic efficacy of the JNET classification may be equivalent to that of the Pit pattern classification. However, due to its simpler and clearer clinical application, the JNET classification should be promoted for the classification of colorectal lesions, and to guide the treatment strategy.

Diagnostic accuracy of K-ras mutation for pancreatic carcinoma:a meta-analysis

BACKGROUND:The conventional tests for the diagnosis of early stage pancreatic carcinoma are not acceptable.This metaanalysis is to evaluate the accuracy of K-ras mutation for the diagnosis of pancreatic carcinoma.DATA SOURCES:A systemic search of all relevant literature was performed in Web of Science,EMBASE,Cochrane Database,and MEDLINE(PubMed as the search engine) prior to June 1,2011.Thirty-four studies fulfilled the inclusion criteria and data were pooled for analysis.RESULTS:The pooled estimates for K-ras mutation in diagnosis of pancreatic carcinoma were as follows:sensitivity 0.68(95% CI:0.66-0.71),specificity 0.87(95% CI:0.85-0.88),positive likelihood ratio 4.54(95% CI:3.47-5.94),negative likelihood ratio 0.37(95% CI:0.30-0.44) and diagnostic odds ratio 14.90(95% CI:10.02-22.15).Summary receiver operating characteristic analysis demonstrated that the maximum joint sensitivity and specificity was 0.79,and the overall area under the curve was 0.86.CONCLUSIONS:Diagnostic accuracy of K-ras mutation was not superior to that of conventional tests.Therefore,K-ras mutation analysis alone is not recommended for the diagnosis of pancreatic carcinoma.

Diagnostic accuracy of real-time tissue elastography for breast cancer:a meta-analysis

Objective The present study aimed to determine the accuracy of real-time tissue elastography （RTE） for the diagnosis of breast cancer. Methods The search was conducted in the PubMed, Web of Science, Cochrane Library, and China Biology Medicine databases from inception through December 31, 2014, without language restrictions. The meta-analysis was conducted using STATA version 12.0 and Meta-Disc version 1.4. We calculated the summary statistics for sensitivity （Sen）, specificity （Spe）, positive and negative likelihood ratio （LR＋/LR–）, diagnostic odds ratio （DOR）, and summary receiver operating characteristic （SROC） curve. Results Ten studies that met al inclusion criteria were included in the meta-analysis. A total of 608 ma-lignant breast lesions and 1292 benign breast tumors were assessed. Al breast lesions were histological y confirmed after RTE. The pooled Sen was 0.83 （95% CI = 0.79–0.86）; the pooled Spe was 0.86 （95% CI = 0.84–0.88）. The pooled LR＋ was 9.87 （95% CI = 2.66–36.71）; the pooled LR– was 0.20 （95% CI = 0.17–0.23）. The pooled DOR of RTE for the diagnosis of breast cancer was 62.21 （95% CI = 33.88–114.24）. The area under the SROC curve was 0.9334 （standard error = 0.00125）. We found no evidence of publica-tion bias （t = –0.57, P = 0.582）. Conclusion RTE may have high diagnostic accuracy for the dif erential diagnosis of benign and malig-nant breast tumors. RTE may be a good tool for breast cancer diagnosis.

Diagnostic Value of Dual-Energy CT in Differentiating Malignant and Benign Thyroid Nodules: A Systematic Review and Meta-Analysis

Objectives: To evaluate the diagnostic performance of the quantitative iodine parameters, including Iodine Concentration (IC), Normalized Iodine Concentration (NIC), and λHU, in distinguishing malignant and benign thyroid nodules. Methods: Relevant studies were searched from Web of Science, PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure database and other complementary sources from inception to May 20, 2020. Study selection, data extraction, quality assessment, and data analyses were performed following the Cochrane standards and the PRISMA-DTA guideline. Results: Eight studies were included (595 patients with 737 thyroid nodules). The pooled sensitivity, specificity and summary diagnostic odds ratio of IC were 79% (95% CI: 69% - 86%), 76% (95% CI: 65% - 84%) and 11 (95% CI: 5 - 27) respectively;those of NIC were 78% (95% CI: 70% - 85%), 80% (95% CI: 74% - 85%) and 15 (95% CI: 9 - 24) respectively;those of λHU were 80% (95% CI: 71% - 87%), 77% (95% CI: 70% - 83%) and 14 (95% CI: 8 - 24) respectively. Conclusion: DECT can be a potential evaluation tool for thyroid nodules. The NIC may be the most sensitive iodine parameter and could be comparable between different DECT machines in thyroid nodule assessment.

Diagnostic accuracy and clinical utility of non-English versions of Edinburgh Post-Natal Depression Scale for screening post-natal depression in India:A meta-analysis

BACKGROUND The prevalence of post-natal depression(PND)is high in India,as it is in many other low to middle income countries.There is an urgent need to identify PND and treat the mother as early as possible.Among the many paper and pencil tests available to identify PND,the Edinburgh Postnatal Depression Scale(EPDS)is a widely used and validated measure in India.However,the summary diagnostic accuracy and clinical utility data are not available for this measure.AIM To establish summary data for the global diagnostic accuracy parameter as well as the clinical utility of the non-English versions of the EPDS in India.METHODS Two researchers independently searched the PubMed,EMBASE,MEDKNOW and IndMED databases for published papers,governmental publications,conference proceedings and grey literature from 2000-2018.Seven studies that evaluated the diagnostic accuracy of EPDS in five Indian languages against DSM/ICD were included in the final analysis.Two other investigators extracted the Participants’details,Index measures,Comparative reference measures,and Outcomes of diagnostic accuracy data,and appraised the study quality using QUADS-2.Deek’s plots were used to evaluate publication bias.We used the area under the curve of the hierarchical summary area under the receiver operating characteristic curve,with the random effect model,to summarize the global diagnostic accuracy of EPDS.Using the 2×2 table,we calculated positive and negative likelihood ratios.From the likelihood ratios,the Fagan’s nomogram was built for evaluating clinical utility using the Bayesian approach.We calculated the 95%confidence interval(95%CI)whenever indicated.STATA(version 15)with MIDAS and METANDI modules were used.RESULTS There was no publication bias.The area under the curve for EPDS was 0.97(95%CI:0.95-0.98).The pre-test probability for the nomogram was 22%.For a positive likelihood ratio of 9,the positive post-test probability was 72%(95%CI:68%,76%)and for a negative LR of 0.08,the negative post-test probability was 2%(95%CI:1%,3%).CONCLUSION In this meta-analysis,we established the summary global diagnostic parameter and clinical utility of the non-English versions of the EPDS in India.This work demonstrates that these non-English versions are accurate in their diagnosis of PND and can help clinicians in their diagnostic reasoning.

Diagnostic value of lncRNAs as potential biomarkers for oral squamous cell carcinoma diagnosis:a meta-analysis

Objective Several studies have revealed the critical role of long non-coding RNAs(lncRNAs)as biomarkers for diagnosing oral squamous cell carcinoma(OSCC).However,the data remain inconsistent.This meta-analysis was performed to summarize the potential of lncRNAs as OSCC biomarkers.Methods We searched PubMed,Cochrane Library,Web of Science,and China National Knowledge Infrastructure databases for literature published until December 10,2020.Study quality was assessed using Quality Assessment for Studies of Diagnostic Accuracy-2,and sensitivity,specificity,and other measures regarding lncRNAs for OSCC diagnosis were pooled using bivariate meta-analysis models.Data analyses were performed using STATA 14.0.Results Overall,8 studies with 981 cases and 585 controls were included in the pooled analysis.The pooled sensitivity,specificity,positive likelihood ratio,negative likelihood ratio,diagnostic odds ratio,and area under the receiver operating characteristic curve values were as follows:0.76[95%confidence interval(CI),0.65–0.84],0.90(95%CI,0.82–0.95),7.5(95%CI,4.20–13.40),0.27(95%CI,0.18–0.39),28(95%CI,13.00–58.00),0.90(95%CI,0.87–0.93),respectively.Deeks’funnel plot asymmetry test(P=0.56)indicated no potential publication bias.Conclusion Our meta-analytical evidence suggests that lncRNAs could be employed as a potential non-invasive diagnostic tool for OSCC.

Diagnostic Accuracy of the Malnutrition Screening Tool (MST) in Adult Cancer Patients: a Systematic Literature Review and Meta-Analysis

Objective According to literature,cancer patients have the highest incidence of malnutrition among hospital patients(40%-80%).Despite this high prevalence,this condition is still under-diagnosed.The aim of this study was to conduct a systematic literature review and meta-analysis to assess the diagnostic performance of the Malnutrition Screening Tool(MST),a simple tool that can be applied in a busy setting where a comprehensive assessment at screening would be impractical.Methods PubMed,EMBASE and Cochrane central register of controlled trials were systematically searched to identify records relevant to the research question.The QUADAS-2 was used to assess the quality of each included study and the meta-analysis was conducted using the hierarchical bivariate model in STATA.Results Seven records were included in this study and the overall sensitivity specificity,diagnostic odds ratio(DOR).The pooled sensitivity and specificity generated after the meta-analysis in STATA were 0.78(95%CI:0.64-0.88)and 0.82(95%CI:0.76-0.87),respectively.The corresponding DOR was 16.33(95%CI:7.08-37.67).The positive likelihood ratio(LR+)was+4.39(95%CI:3.02-6.38),and the negative likelihood ratio(LR-)were 0.27(95%CI:0.16-0.47)and the 1/LR-3.72(2.14-6.46).Conclusion These results showed that the MST provides weak diagnostic evidence when used to screen for malnutrition in adult cancer patients.

Diagnostic Power of Diffusion-weighted Magnetic Resonance Imaging for the Presence of Lymph Node Metastasis:A Meta-analysis

Present work was designed to quantitatively evaluate the performance of diffusion-weighted magnetic resonance imaging（DWI） in the diagnosis of the presence of metastasis in lymph nodes（LNs）. Eligible studies were identified from systematical Pub Med and EMBASE searches. Data were extracted. Meta-analyses were performed to generate pooled sensitivity and specificity on the basis of per-node, per-lesion and per-patient, respectively. Fourteen publications（2458 LNs, 404 lesions and 334 patients） were eligible. Per-node basis demonstrated the pooled sensitivity and specificity was 0.82（P〈0.0001） and 0.90（P〈0.0001）, respectively. Per-lesion basis illustrated the pooled sensitivity and specificity was 0.73（P=0.0036） and 0.85（P〈0.0001）, respectively. Per-patient basis indicated the pooled sensitivity and specificity was 0.67（P=0.0909） and 0.86（P〈0.0001）, respectively. In conclusion, DWI has rather a negative predictive value for the diagnosis of LN metastasis presence. The difference of the mean apparent diffusion coefficients between benign and malignant LNs is not yet stable. Therefore, the DWI technique has to be further improved.

Single-balloon and spiral enteroscopy may have similar diagnostic and therapeutic yields to double-balloon enteroscopy:Results from a meta-analysis of randomized controlled trials and prospective studies

BACKGROUND Double-balloon,single-balloon,and spiral enteroscopy(DBE,SBE,and SE)have revolutionized the management of intestinal diseases.However,evidence about efficacies of these methods is lacking.We aimed to conduct a meta-analysis comparing the clinical outcomes among DBE,SBE,and SE.METHODS We searched randomized controlled trials and prospective studies in MEDLINE,PubMed,EMBASE,Cochrane Library,and Chinese CQVIP database.Studies referencing the comparison of at least two of these three methods were included.Primary outcome was diagnostic yield.Other outcomes were therapeutic yield,total enteroscopy,examination time,time to maximum insertion,and depth of maximal insertion(DMI).RESULTS Eleven studies including 727 patients were identified:DBE vs SE(n=6),DBE vs SBE(n=4),and SBE vs SE(n=1).The diagnostic and therapeutic yields did not differ significantly when comparing DBE with SE[odds ratio(OR)=1.19,95%confidence interval(CI):0.68-2.08;OR=1.17,95%CI:0.61-2.23]and DBE with SBE(OR=0.85,95%CI:0.55-1.33;OR=1.71,95%CI:0.64-4.60).Total enteroscopy,examination time,time to maximum insertion,and DMI were similar between SBE and DBE.DBE was superior to SE with regard to DMI[mean difference(MD)=36.76,95%CI:5.09-68.43],with longer time to maximum insertion(MD=15.14,95%CI:12-18.27)and examination time(MD=12.98,95%CI:9.57-16.38).CONCLUSION DBE and SBE have similar clinical outcomes.Compared with DBE,SE seems to have similar diagnostic and therapeutic yields,but shorter procedural time in cost of less depth of insertion.SE needs further evaluation vs SBE.DBE is recommended for complete enteroscopy.

Prevalence and Risk Factors of Postoperative Pressure Ulcers:A Systematic Review and Meta-analysis of Diagnostic Test

[Objectives]The paper was to analyze the total prevalence of postoperative pressure ulcers in patients and to reveal the epidemic law.[Methods]By searching English databases such as PubMed,Google Academics,Scopus,Science Direct and Web of Science(WOS),a total of 2018 English articles on pressure ulcers published from January 2015 to December 2020 were selected.According to the inclusion criteria,19 high-quality literatures were selected for the study,and the extended function of meta-analysis software of Review Manager 5.1 diagnostic test was used for data statistics and meta analysis of the results.[Results]There were 19 literatures with a total of 9400 patients included in the meta-analysis.The results showed that the total prevalence estimate of postoperative pressure ulcers was 20.00%(CI 95%:15.3-24.1).The total prevalence estimate of postoperative pressure ulcers in males was 10.1%(CI 95%:7.2-13.02),and that in females was 12.8%(CI 95%:8.1-17.3).The total prevalence estimates of stage I to IV postoperative pressure ulcers were 17.02%(CI 95%:11.06-22.09),6.7%(CI 95%:3.76-9.69),0.9%(CI 95%:0.21-1.26)and 0.4%(CI 95%:-0.05-0.8),respectively.[Conclusions]The prevalence of postoperative pressure ulcers is generally high.The prevalence of postoperative pressure ulcers in females is higher than that in males,and the prevalence of stage I pressure ulcers is higher than that of other stages,which is related to age,gender and other related risk factors.