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Accuracy of diagnostic tests for perilymphatic fistula: protocol for a systematic review
Maksym Situkho1,2, Tetsuo Ikezono3, Marte Myhrum1,2
1Department of Otorhinolaryngology and Head and Neck Surgery, Oslo University Hospital, Oslo, Norway.
Insights
Perilymphatic fistula (PLF) diagnosis lacks accurate testing. This systematic review assesses the accuracy of current diagnostic tests for PLF, aiming to improve patient outcomes through better detection methods.
Area of Science:
- Otolaryngology
- Diagnostic Accuracy Studies
- Inner Ear Disorders
Background:
- Perilymphatic fistula (PLF) involves abnormal inner ear fluid leakage.
- Early surgical intervention is crucial for favorable audiological and vestibular outcomes.
- Current diagnostic methods, like intraoperative visualization, lack established accuracy metrics.
Purpose of the Study:
- To systematically review literature on diagnostic tests for PLF.
- To determine the accuracy (sensitivity and specificity) of diagnostic tests for human PLF detection.
Main Methods:
- Systematic literature search of multiple databases (MEDLINE, EMBASE, etc.).
- Inclusion of original peer-reviewed articles with diagnostic test accuracy data for PLF.
- Risk of bias assessed using QUADAS-2; evidence strength evaluated with GRADE framework.
Main Results:
- This section is to be populated upon completion of the systematic review.
- Quantitative synthesis planned for high-quality studies; narrative summary otherwise.
- Accuracy data for various diagnostic tests will be presented.
Conclusions:
- This section is to be populated upon completion of the systematic review.
- Findings will inform clinical practice regarding optimal PLF diagnostic strategies.
- Improved diagnostic accuracy is expected to enhance patient management and outcomes.
Abstract:
Perilymphatic fistula (PLF) is a challenging inner ear condition, characterized by the abnormal connection between inner and middle ear and subsequent leakage of inner ear liquid (perilymph) into the middle ear. Early surgical intervention for PLF might lead to favorable audiological and vestibular outcomes. The conventional reference standard of PLF detection is the intraoperative visualization of perilymph leakage during explorative tympanotomy or endoscopic inspection; the specificity and sensitivity of this method is unknown. Systematic reviews assessing the accuracy of diagnostic tests for PLF are not available.
Objective:
To systematically review the literature for qualitative evidence exploring the diagnostic tests for the PLF diagnosis. The proposed systematic review will answer the following question: What is the accuracy of diagnostic tests in detecting perilymphatic fistula in humans?
Methods:
Eligibility criteria: original peer-reviewed articles regarding studies on humans of any age containing data with diagnostic test accuracy estimation (sensitivity and specificity) for PLF diagnosis or in which diagnostic test accuracy could be calculated based on data provided, without language, study design or study date limits. MEDLINE, EMBASE, the Cochrane Central Register of Controlled Trials, Scopus, and Web of Science will be searched for eligible articles. Additional manual searches will be performed. Covidence software will be used for title and abstract screening, full text review and data extraction. The risk of bias assessment will be conducted using the Quality Assessment of Diagnostic Test Accuracy 2 (QUADAS-2) tool. If two or more high-quality articles evaluating the same diagnostic test will be identified, their findings will be quantitatively synthesized; if a quantitative synthesis is not feasible, the results will be described in a narrative summary. Grading of Recommendations, Assessment, Development, and Evaluations (GRADE) framework will be used to evaluate evidence strength. Study funded by Oslo University Hospital.
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