The accuracy of diagnostic tests for GH deficiency in adults: a systematic review and meta-analysis

Hazem, Ahmad; Elamin, Mohamed B.; Málaga, Germán; Bancos, Irina; Prevost, Yolanda; Zeballos-Palacios, Claudia; Velasquez, Edgar R; Erwin, Patricia J.; Natt, Neena; Montori, Víctor M.; Murad, M. Hassan

doi:10.1530/eje-11-0476

Cited by 14 publications

(6 citation statements)

References 49 publications

(35 reference statements)

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“…The median number of studies in the analyses was 13 (IQR 9–19) with a range from 4 to 118. Two review authors mentioned that a minimum of twenty homogeneous studies was required to perform a test [71,72]. …”

Section: Resultsmentioning

confidence: 99%

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Enst

Ochodo

Scholten

et al. 2014

BMC Med Res Methodol

318

196

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BackgroundThe validity of a meta-analysis can be understood better in light of the possible impact of publication bias. The majority of the methods to investigate publication bias in terms of small study-effects are developed for meta-analyses of intervention studies, leaving authors of diagnostic test accuracy (DTA) systematic reviews with limited guidance. The aim of this study was to evaluate if and how publication bias was assessed in meta-analyses of DTA, and to compare the results of various statistical methods used to assess publication bias.MethodsA systematic search was initiated to identify DTA reviews with a meta-analysis published between September 2011 and January 2012. We extracted all information about publication bias from the reviews and the two-by-two tables. Existing statistical methods for the detection of publication bias were applied on data from the included studies.ResultsOut of 1,335 references, 114 reviews could be included. Publication bias was explicitly mentioned in 75 reviews (65.8%) and 47 of these had performed statistical methods to investigate publication bias in terms of small study-effects: 6 by drawing funnel plots, 16 by statistical testing and 25 by applying both methods. The applied tests were Egger’s test (n = 18), Deeks’ test (n = 12), Begg’s test (n = 5), both the Egger and Begg tests (n = 4), and other tests (n = 2). Our own comparison of the results of Begg’s, Egger’s and Deeks’ test for 92 meta-analyses indicated that up to 34% of the results did not correspond with one another.ConclusionsThe majority of DTA review authors mention or investigate publication bias. They mainly use suboptimal methods like the Begg and Egger tests that are not developed for DTA meta-analyses. Our comparison of the Begg, Egger and Deeks tests indicated that these tests do give different results and thus are not interchangeable. Deeks’ test is recommended for DTA meta-analyses and should be preferred.

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Section: Resultsmentioning

confidence: 99%

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Enst

Ochodo

Scholten

et al. 2014

BMC Med Res Methodol

318

196

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“…By reading the full texts of the included studies, we were able to identify how the different stages of liver fibrosis were reported using the Scheur, METAVIR, Ishak, and HAI systems. Since the histological definitions of liver fibrosis were similar [ 7 , 70 – 73 ], we unified the stages of liver fibrosis to mild fibrosis ( F ≥ 1), significant fibrosis ( F ≥ 2), advanced fibrosis ( F ≥ 3), and cirrhosis (F4). However, only two studies discussed mild fibrosis ( F ≥ 1), which made pooled analysis in this group impossible.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic Value of Serum Chitinase-3-Like Protein 1 for Liver Fibrosis: A Meta-analysis

Huang

Zhuang

Yang

et al. 2022

BioMed Research International

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Background. Serum chitinase-3-like protein 1 (CHI3L1) is a promising marker for diagnosing liver fibrosis. This meta-analysis was carried out to assess the diagnostic performance of serum CHI3L1 for the estimation of liver fibrosis. Methods. Systematic searches were performed on PubMed, Embase, Web of Science, Scopus, the Cochrane Library, Google Scholar, Sinomed, the China National Knowledge Infrastructure (CNKI), the Chinese Medical Journal Database, and the Wanfang databases for available studies. The primary studies were screened strictly according to inclusion and exclusion criteria, and sensitivity, specificity, and other measures of accuracy of serum CHI3L1 for evaluating liver fibrosis were pooled with 95% confidence intervals. I 2 was calculated to assess heterogeneity, and sources of heterogeneity were explored by subgroup analysis. Deeks’ test was used to assess for publication bias, and likelihood ratio was used to determine posttest probability. Results. Our research integrated 11 articles, accounting for 1897 patients older than 18 years old. The pooled sensitivity and specificity for significant fibrosis, advanced fibrosis, and cirrhosis were 0.79 and 0.82 with an area under the receiver operating characteristic curve (AUC) of 0.85, 0.81 and 0.83 with an AUC of 0.91, and 0.72 and 0.74 with an AUC of 0.85, respectively. Random-effects models were used to assess for significant heterogeneity, and subgroup analysis showed that age and aetiology of included patients were likely sources of heterogeneity. No potential publication bias was found for serum CHI3L1 in the diagnosis of significant fibrosis, advanced fibrosis, or cirrhosis, and posttest probability was moderate. Conclusion. Measurement of serum CHI3L1 is a feasible diagnostic tool for liver fibrosis.

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“…They also observed significant number of false positive results in the control group. However, this study had few limitations; most importantly, the majority of patients involved in this study had mild TBI, second PD-GHRH stimulation is not a well-standardized test and is not used commonly for the diagnosis of GHD[ 81 ] and is not pertinent to confirm results acquired from ITT which is more sensitive. Third, GHRH-arginine test was used only for those patients who had contraindications to other tests though it has been more commonly used test and is also more widely available.…”

Section: Ncidence Of P Ituitary mentioning

confidence: 99%

“…Third, GHRH-arginine test was used only for those patients who had contraindications to other tests though it has been more commonly used test and is also more widely available. [ 81 ] Recently, a systematic review has been published in which authors compared either the prevalence of abnormal endocrine tests was higher in TBI patients as compared to controls or not and included only those studies that applied at least one endocrine test in a matched control group. [ 5 ] They found that pooled prevalence of GHD was 7.7% and 1.4% in patients and controls respectively ( P < 0.001) according to the results obtained from ITT using local cut-offs values by Klose et al .…”

Section: Ncidence Of P Ituitary mentioning

confidence: 99%

Pituitary and/or hypothalamic dysfunction following moderate to severe traumatic brain injury: Current perspectives

Javed

Qamar

Sathyapalan

2015

Indian J Endocr Metab

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There is an increasing deliberation regarding hypopituitarism following traumatic brain injury (TBI) and recent data have suggested that pituitary dysfunction is very common among survivors of patients having moderate-severe TBI which may evolve or resolve over time. Due to high prevalence of pituitary dysfunction after moderate-severe TBI and its association with increased morbidity and poor recovery and the fact that it can be easily treated with hormone replacement, it has been suggested that early detection and treatment is necessary to prevent long-term neurological consequences. The cause of pituitary dysfunction after TBI is still not well understood, but evidence suggests few possible primary and secondary causes. Results of recent studies focusing on the incidence of hypopituitarism in the acute and chronic phases after TBI are varied in terms of severity and time of occurrence. Although the literature available does not show consistent values and there is difference in study parameters and diagnostic tests used, it is clear that pituitary dysfunction is very common after moderate to severe TBI and patients should be carefully monitored. The exact timing of development cannot be predicted but has suggested regular assessment of pituitary function up to 1 year after TBI. In this narrative review, we aim to explore the current evidence available regarding the incidence of pituitary dysfunction in acute and chronic phase post-TBI and recommendations for screening and follow-up in these patients. We will also focus light over areas in this field worthy of further investigation.

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The accuracy of diagnostic tests for GH deficiency in adults: a systematic review and meta-analysis

Cited by 14 publications

References 49 publications

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Investigation of publication bias in meta-analyses of diagnostic test accuracy: a meta-epidemiological study

Diagnostic Value of Serum Chitinase-3-Like Protein 1 for Liver Fibrosis: A Meta-analysis

Pituitary and/or hypothalamic dysfunction following moderate to severe traumatic brain injury: Current perspectives

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