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Frontiers in Oncology 2022This study aimed to perform a meta-analysis to evaluate the diagnostic performance of radiomics in predicting axillary lymph node metastasis (ALNM) and sentinel lymph...
BACKGROUND
This study aimed to perform a meta-analysis to evaluate the diagnostic performance of radiomics in predicting axillary lymph node metastasis (ALNM) and sentinel lymph node metastasis (SLNM) in breast cancer.
MATERIALS AND METHODS
Multiple electronic databases were systematically searched to identify relevant studies published before April 29, 2022: PubMed, Embase, Web of Science, Cochrane Library, China National Knowledge Infrastructure, and Wanfang Data. The quality of the included studies was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. The overall diagnostic odds ratio (DOR), sensitivity, specificity, and area under the curve (AUC) were calculated to evaluate the diagnostic performance of radiomic features for lymph node metastasis (LNM) in patients with breast cancer. Spearman's correlation coefficient was determined to assess the threshold effect, and meta-regression and subgroup analyses were performed to explore the possible causes of heterogeneity.
RESULTS
A total of 30 studies with 5611 patients were included in the meta-analysis. Pooled estimates suggesting overall diagnostic accuracy of radiomics in detecting LNM were determined: DOR, 23 (95% CI, 16-33); sensitivity, 0.86 (95% CI, 0.82-0.88); specificity, 0.79 (95% CI, 0.73-0.84); and AUC, 0.90 (95% CI, 0.87-0.92). The meta-analysis showed significant heterogeneity between sensitivity and specificity across the included studies, with no evidence for a threshold effect. Meta-regression and subgroup analyses showed that combined clinical factors, modeling method, region, and imaging modality (magnetic resonance imaging [MRI], ultrasound, computed tomography [CT], and X-ray mammography [MMG]) contributed to the heterogeneity in the sensitivity analysis ( < 0.05). Furthermore, modeling methods, MRI, and MMG contributed to the heterogeneity in the specificity analysis ( < 0.05).
CONCLUSION
Our results show that radiomics has good diagnostic performance in predicting ALNM and SLNM in breast cancer. Thus, we propose this approach as a clinical method for the preoperative identification of LNM.
PubMed: 36518318
DOI: 10.3389/fonc.2022.1046005 -
Diagnostics (Basel, Switzerland) May 2022(1) Background: The comparative performance of various diagnostic methods for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection remains unclear.... (Review)
Review
Diagnostic Performance of Antigen Rapid Diagnostic Tests, Chest Computed Tomography, and Lung Point-of-Care-Ultrasonography for SARS-CoV-2 Compared with RT-PCR Testing: A Systematic Review and Network Meta-Analysis.
(1) Background: The comparative performance of various diagnostic methods for severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection remains unclear. This study aimed to investigate the comparison of the 3 index test performances of rapid antigen diagnostic tests (RDTs), chest computed tomography (CT), and lung point-of-care-ultrasonography (US) with reverse transcription-polymerase chain reaction (RT-PCR), the reference standard, to provide more evidence-based data on the appropriate use of these index tests. (2) Methods: We retrieved data from electronic literature searches of PubMed, Cochrane Library, and EMBASE from 1 January 2020, to 1 April 2021. Diagnostic performance was examined using bivariate random-effects diagnostic test accuracy (DTA) and Bayesian network meta-analysis (NMA) models. (3) Results: Of the 3992 studies identified in our search, 118 including 69,445 participants met our selection criteria. Among these, 69 RDT, 38 CT, and 15 US studies in the pairwise meta-analysis were included for DTA with NMA. CT and US had high sensitivity of 0.852 (95% credible interval (CrI), 0.791-0.914) and 0.879 (95% CrI, 0.784-0.973), respectively. RDT had high specificity, 0.978 (95% CrI, 0.960-0.996). In accuracy assessment, RDT and CT had a relatively higher than US. However, there was no significant difference in accuracy between the 3 index tests. (4) Conclusions: This meta-analysis suggests that, compared with the reference standard RT-PCR, the 3 index tests (RDTs, chest CT, and lung US) had similar and complementary performances for diagnosis of SARS-CoV-2 infection. To manage and control COVID-19 effectively, future large-scale prospective studies could be used to obtain an optimal timely diagnostic process that identifies the condition of the patient accurately.
PubMed: 35741112
DOI: 10.3390/diagnostics12061302 -
International Journal of Sports... Aug 2018Although pre-performance massage is frequently used in sports settings, the evidence regarding its effects on muscle strength and functional performance is...
BACKGROUND
Although pre-performance massage is frequently used in sports settings, the evidence regarding its effects on muscle strength and functional performance is equivocal.Purpose: The purpose of this systematic review was to synthesize the findings of randomized controlled trials (RCTs) investigating the effects of pre-performance massage on strength and functional performance.Study Design: Systematic review with qualitative analysis.
METHODS
Eight electronic databases were searched from inception until June 2017. Methodological quality of included studies were assessed using Physiotherapy Evidence Database scale. Data was synthesized qualitatively.
RESULTS
Nine crossover RCTs with varied methodological qualities met inclusion criteria. Six out of nine studies had low quality, while two were of moderate-quality and one was high-quality. Following the descriptive analysis using within-group effect sizes of interventions used in included studies, no evidence was found to support the use of any kind of massage interventions (passive manual massage or self-massage) to enhance maximal strength, sprint or jump performances of young healthy subjects. In fact, there appears to be limited evidence which implies the negative effects of passive manual massage. In particular, longer-duration (> 9 minutes) of massage interventions tended to result in negative effects on lower-limb maximal strength, sprint performance and jump height.
CONCLUSION
In conclusion, the use of longer-duration pre-performance massage cannot be recommended for enhancing young athletes' strength and performance in sprint and vertical jump. More high-quality RCTs are necessary to examine overall effects of pre-performance massage on athletes' performance.
LEVEL OF EVIDENCE
1a.
PubMed: 30276011
DOI: No ID Found -
Neuro-oncology Mar 2016For the past decade (18)F-fluoro-ethyl-l-tyrosine (FET) and (18)F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) have been used for the assessment of... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
For the past decade (18)F-fluoro-ethyl-l-tyrosine (FET) and (18)F-fluoro-deoxy-glucose (FDG) positron emission tomography (PET) have been used for the assessment of patients with brain tumor. However, direct comparison studies reported only limited numbers of patients. Our purpose was to compare the diagnostic performance of FET and FDG-PET.
METHODS
We examined studies published between January 1995 and January 2015 in the PubMed database. To be included the study should: (i) use FET and FDG-PET for the assessment of patients with isolated brain lesion and (ii) use histology as the gold standard. Analysis was performed on a per patient basis. Study quality was assessed with STARD and QUADAS criteria.
RESULTS
Five studies (119 patients) were included. For the diagnosis of brain tumor, FET-PET demonstrated a pooled sensitivity of 0.94 (95% CI: 0.79-0.98) and pooled specificity of 0.88 (95% CI: 0.37-0.99), with an area under the curve of 0.96 (95% CI: 0.94-0.97), a positive likelihood ratio (LR+) of 8.1 (95% CI: 0.8-80.6), and a negative likelihood ratio (LR-) of 0.07 (95% CI: 0.02-0.30), while FDG-PET demonstrated a sensitivity of 0.38 (95% CI: 0.27-0.50) and specificity of 0.86 (95% CI: 0.31-0.99), with an area under the curve of 0.40 (95% CI: 0.36-0.44), an LR+ of 2.7 (95% CI: 0.3-27.8), and an LR- of 0.72 (95% CI: 0.47-1.11). Target-to-background ratios of either FDG or FET, however, allow distinction between low- and high-grade gliomas (P > .11).
CONCLUSIONS
For brain tumor diagnosis, FET-PET performed much better than FDG and should be preferred when assessing a new isolated brain tumor. For glioma grading, however, both tracers showed similar performances.
Topics: Brain Neoplasms; Fluorodeoxyglucose F18; Glioma; Humans; Neoplasm Grading; Positron-Emission Tomography; Radiopharmaceuticals
PubMed: 26243791
DOI: 10.1093/neuonc/nov148 -
Jornal de Pediatria 2016This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in... (Review)
Review
OBJECTIVE
This systematic review aimed to verify the available scientific evidence on the clinical performance and diagnostic accuracy of nutritional screening tools in hospitalized pediatric patients.
DATA SOURCE
A search was performed in the Medline (National Library of Medicine United States), LILACS (Latin American and Caribbean Health Sciences), PubMed (US National Library of Medicine National Institutes of Health), in the SCIELO (Scientific Electronic Library Online), through CAPES portal (Coordenação de Aperfeiçoamento de Pessoal de Nível Superior), bases Scopus e Web of Science. The descriptors used in accordance with the Descriptors in Health Sciences (DeCS)/Medical Subject Headings (MeSH) list were "malnutrition", "screening", and "pediatrics", as well as the equivalent words in Portuguese.
SUMMARY OF THE FINDINGS
The authors identified 270 articles published between 2004 and 2014. After applying the selection criteria, 35 were analyzed in full and eight articles were included in the systematic review. We evaluated the methodological quality of the studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS). Five nutritional screening tools in pediatrics were identified. Among these, the Screening Tool for the Assessment of Malnutrition in Pediatrics (STAMP) showed high sensitivity, almost perfect inter-rater agreement and between the screening and the reference standard; the Screening Tool Risk on Nutritional Status and Growth (STRONGkids) showed high sensitivity, lower percentage of specificity, substantial intra-rater agreement, and ease of use in clinical practice.
CONCLUSIONS
The studies included in this systematic review showed good performance of the nutritional screening tools in pediatrics, especially STRONGkids and STAMP. The authors emphasize the need to perform for more studies in this area. Only one tool was translated and adapted to the Brazilian pediatric population, and it is essential to carry out studies of tool adaptation and validation for this population.
Topics: Adolescent; Child; Child, Hospitalized; Child, Preschool; Female; Humans; Infant; Male; Malnutrition; Nutrition Surveys; Nutritional Status; Reproducibility of Results; Risk Assessment; Risk Factors; Sensitivity and Specificity
PubMed: 26859247
DOI: 10.1016/j.jped.2015.08.011 -
Biology of Sport Sep 2022Since the analysis of worst-case scenarios (WCS) has been increasing knowledge about match demands and possible impacts for the training process, it seems important to... (Review)
Review
Since the analysis of worst-case scenarios (WCS) has been increasing knowledge about match demands and possible impacts for the training process, it seems important to summarize the evidence to provide useful information for the soccer community. Thus, the purpose of this systematic review was to summarize the evidence about WCS in professional soccer. A systematic review of PubMed, SPORTDiscus, and FECYT (Web of Sciences, CCC, DIIDW, KJD, MEDLINE, RSCI, and SCIELO) was performed according to the guidelines for performing systematic reviews in sport science. From the 85 studies initially identified, 12 were fully reviewed, and their outcome measures were extracted and analyzed. There was an inverse relationship between the duration of WCS windows and running output during match play. Occurrences of WCS during soccer matches were also position-dependent across studies, at least, when analyzing performance with the total distance covered variable, although different outputs were identified between women and men players. Future research should consider analyzing the impact of contextual variables (match status, team formation, and match location) on peak match values and the weight of these moderators.
PubMed: 35959320
DOI: 10.5114/biolsport.2022.107022 -
PLOS Global Public Health 2023To evaluate the performance of visual inspection with acetic acid (VIA) testing, visual inspection with Lugol's iodine (VILI), primary HPV testing, and conventional Pap...
OBJECTIVE
To evaluate the performance of visual inspection with acetic acid (VIA) testing, visual inspection with Lugol's iodine (VILI), primary HPV testing, and conventional Pap smear in detecting CIN2+ among non-pregnant women aged 30-65 in LMICs between 1990 and 2020.
DESIGN
Systematic review and meta-analysis.
SETTING AND PARTICIPANTS
Low- and middle-income countries, non-pregnant women aged 30-65.
METHODS
CENTRAL (Cochrane Library), CINAHL, Embase, Global Health, PubMed, and Web of Science databases were systematically searched to identify studies evaluating the performance of cervical cancer screening methods in LMICs. A diagnostic test accuracy meta-analysis was conducted to evaluate the performance of 4 screening methods in detecting CIN2+ relative to biopsy or cytology reference standards. Pooled statistics for sensitivity, specificity, diagnostic odds ratios, and summary receiver operating characteristic curves were determined for each method. Subgroup analyses were performed to examine whether there was variation in performance based on different reference standards for defining CIN2+, specifically: colposcopy-directed biopsy, biopsy alone, colposcopy alone, or liquid-based cytology.
RESULTS
Eighteen studies were identified through systematic review. Twelve studies were included in meta-analysis; 11 were cross-sectional and 1 was a randomized controlled clinical trial. The remaining six of the eighteen studies were inclided in a narrative syntehsis. Pooled estimates for sensitivity for VIA, VILI, primary HPV testing, and conventional Pap smear were 72.3%, 64.5%, 79.5%, and 60.2%, respectively; pooled estimates for specificity were 74.5%, 68.5%, 72.6%, and 97.4%, respectively; the diagnostic odds ratios were 7.31, 3.73, 10.42, 69.48, respectively; and the area under the summary receiver operating characteristic curves were 0.766, 0.647, 0.959, and 0.818, respectively. Performance of the screening method varied based on the reference standard used; pooled estimates using either colposcopy-directed biopsy or biopsy alone as the reference standard generally reported lower estimates; pooled estimates using either colposcopy alone or liquid-based cytology as references reported higher estimates.
CONCLUSIONS AND IMPLICATIONS
This meta-analysis found primary HPV testing to be the highest performing cervical cancer screening method in accurately identifying or excluding CIN2+. Further evaluation of performance at different CIN thresholds is warranted.
PubMed: 36963095
DOI: 10.1371/journal.pgph.0001598 -
Parasites & Vectors Oct 2015Gastrointestinal nematode (GIN) infections are common in domestic sheep and impact directly and indirectly on the health of infected animals as well as on the associated... (Meta-Analysis)
Meta-Analysis Review
BACKGROUND
Gastrointestinal nematode (GIN) infections are common in domestic sheep and impact directly and indirectly on the health of infected animals as well as on the associated economic production. In this study, we aim at summarizing the current knowledge on the influence of GIN infections on sheep production by conducting a systematic review. A subsequent meta-analysis of relevant studies was performed to provide an estimate of the effect of GIN infections on weight gain, wool production and milk yield.
METHODS
A literature search was performed on the CAB, Pubmed and Web of Science database for the period 1960-2012. Inclusion criteria were: 1) Measurement of at least one production parameter. 2) Comparison between groups of sheep with different nematode burdens. 3) Same conditions regarding all aspects except parasite burden between groups. 4) Quantitative measurements of one or more production traits.
RESULTS
Altogether, 88 studies describing 218 trials were included in this review. The majority of studies (86%) reported that GIN infections had a negative effect on production but this was reported to be statistically significant in only 43% of the studies. Meta-analysis indicated that performances of sheep infected with nematodes was 85, 90 and 78% of the performance in uninfected individuals for weight gain, wool production and milk yield respectively. Our results suggest a possible reporting bias or small study effect for the estimation of the impact of GIN infections on weight gain. Finally, a general linear model provided an estimate for the decrease in weight gain in relation to the increase in faecal egg count of nematodes.
CONCLUSION
This study underlines the importance of GIN infections for sheep production and highlights the need to improve parasite management in sheep, in particular in face of challenges such as anthelmintic resistance.
Topics: Animals; Body Weight; Helminthiasis; Intestinal Diseases, Parasitic; Lactation; Milk; Nematode Infections; Sheep; Sheep Diseases; Wool
PubMed: 26496893
DOI: 10.1186/s13071-015-1164-z -
Frontiers in Physiology 2021The objective measurement of fatigue is of critical relevance in areas such as occupational health and safety as fatigue impairs cognitive and motor performance, thus...
The objective measurement of fatigue is of critical relevance in areas such as occupational health and safety as fatigue impairs cognitive and motor performance, thus reducing productivity and increasing the risk of injury. Wearable systems represent highly promising solutions for fatigue monitoring as they enable continuous, long-term monitoring of biomedical signals in unattended settings, with the required comfort and non-intrusiveness. This is a p rerequisite for the development of accurate models for fatigue monitoring in real-time. However, monitoring fatigue through wearable devices imposes unique challenges. To provide an overview of the current state-of-the-art in monitoring variables associated with fatigue via wearables and to detect potential gaps and pitfalls in current knowledge, a systematic review was performed. The Scopus and PubMed databases were searched for articles published in English since 2015, having the terms "fatigue," "drowsiness," "vigilance," or "alertness" in the title, and proposing wearable device-based systems for non-invasive fatigue quantification. Of the 612 retrieved articles, 60 satisfied the inclusion criteria. Included studies were mainly of short duration and conducted in laboratory settings. In general, researchers developed fatigue models based on motion (MOT), electroencephalogram (EEG), photoplethysmogram (PPG), electrocardiogram (ECG), galvanic skin response (GSR), electromyogram (EMG), skin temperature (T), eye movement (EYE), and respiratory (RES) data acquired by wearable devices available in the market. Supervised machine learning models, and more specifically, binary classification models, are predominant among the proposed fatigue quantification approaches. These models were considered to perform very well in detecting fatigue, however, little effort was made to ensure the use of high-quality data during model development. Together, the findings of this review reveal that methodological limitations have hindered the generalizability and real-world applicability of most of the proposed fatigue models. Considerably more work is needed to fully explore the potential of wearables for fatigue quantification as well as to better understand the relationship between fatigue and changes in physiological variables.
PubMed: 34975541
DOI: 10.3389/fphys.2021.790292 -
BMC Medical Education Jul 2022There is significant variability in the performance and outcomes of invasive medical procedures such as percutaneous coronary intervention, endoscopy, and bronchoscopy....
BACKGROUND
There is significant variability in the performance and outcomes of invasive medical procedures such as percutaneous coronary intervention, endoscopy, and bronchoscopy. Peer evaluation is a common mechanism for assessment of clinician performance and care quality, and may be ideally suited for the evaluation of medical procedures. We therefore sought to perform a systematic review to identify and characterize peer evaluation tools for practicing clinicians, assess evidence supporting the validity of peer evaluation, and describe best practices of peer evaluation programs across multiple invasive medical procedures.
METHODS
A systematic search of Medline and Embase (through September 7, 2021) was conducted to identify studies of peer evaluation and feedback relating to procedures in the field of internal medicine and related subspecialties. The methodological quality of the studies was assessed. Data were extracted on peer evaluation methods, feedback structures, and the validity and reproducibility of peer evaluations, including inter-observer agreement and associations with other quality measures when available.
RESULTS
Of 2,135 retrieved references, 32 studies met inclusion criteria. Of these, 21 were from the field of gastroenterology, 5 from cardiology, 3 from pulmonology, and 3 from interventional radiology. Overall, 22 studies described the development or testing of peer scoring systems and 18 reported inter-observer agreement, which was good or excellent in all but 2 studies. Only 4 studies, all from gastroenterology, tested the association of scoring systems with other quality measures, and no studies tested the impact of peer evaluation on patient outcomes. Best practices included standardized scoring systems, prospective criteria for case selection, and collaborative and non-judgmental review.
CONCLUSIONS
Peer evaluation of invasive medical procedures is feasible and generally demonstrates good or excellent inter-observer agreement when performed with structured tools. Our review identifies common elements of successful interventions across specialties. However, there is limited evidence that peer-evaluated performance is linked to other quality measures or that feedback to clinicians improves patient care or outcomes. Additional research is needed to develop and test peer evaluation and feedback interventions.
Topics: Bronchoscopy; Endoscopy; Feedback; Humans; Peer Review, Health Care; Percutaneous Coronary Intervention; Prospective Studies; Reproducibility of Results; Surgical Procedures, Operative
PubMed: 35906652
DOI: 10.1186/s12909-022-03652-9