便免疫化学测试在显著肠道疾病查中的负预测值:系统性审查和元分析
Zhen Junhai1, Liao Fei2, Zhang Jixiang2
1Department of General Practice, Renmin Hospital of Wuhan University.
International journal of surgery (London, England)
|June 26, 2024
概括
便免疫化学测试 (FIT) 显示了在初级保健中对显著肠病 (SBD) 查的高负预测值. 这种有价值的工具有助于全科医生排除SBD,但警仍然至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 诊断的准确性 诊断的准确性
- 主要护理医学 医疗保健
背景情况:
- 一般医生 (GPs) 在评估出现下肠症状的患者显著肠病 (SBD) 时面临挑战.
- 便免疫化学测试 (FIT) 已被提议用于SBD查,但其有效性需要进一步澄清.
研究的目的:
- 系统地评估FIT在SBD查中的诊断价值,在初级保健机构中对患有下肠症状的患者进行查.
- 用关键绩效指标来确定FIT的准确性.
主要方法:
- 进行了全面的元分析,系统地搜索了PubMed,Cochrane数据库和EMBASE.
- 包括的研究重点关注FIT在SBD查下肠症状患者的表现.
- 计算的指标包括灵敏度,特异性,正负概率比率 (PLR,NLR),诊断几率比率 (DOR) 和负预测值 (NPV),以及总结接收器操作特征 (SROC) 曲线分析.
主要成果:
- 分析包括8615名患者,其中1226人被诊断为SBD.
- 聚合FIT性能:灵敏度为0.65,特异性为0.85,PLR为4.2,NLR为0.41,DOR为10和NPV为0.90.
- 在SROC曲线下的聚合面积为0.82,表明整体诊断性能良好.
结论:
- FIT表现出有利的负预测值,使其成为全科医生在初级保健中排除SBD的宝贵工具.
- 虽然FIT有助于排除SBD,但持续的临床警和适当的转诊给胃肠病学家是必要的.
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