Chapter 4 Results - etheses Repository

More documents

Recommendations

Info

accuracy were interpreted cautiously if there was significant heterogeneity. 49 In addition to meta-analyses that generated summary estimates primarily of LR’s, summary sensitivity and specificity using the bivariate model 50;51 and summary ROC curves using the hierarchical summary receiver operating characteristic (HSROC) model 50;52 were also generated where on balance, they would add to the interpretation of the results. 53 LR’s are considered more clinically meaningful as measures of test accuracy 46-48 and would allow estimation of probabilities for use in a decision analytic modelling. These post test probabilities can be used to calculate the absolute effects of interventions according to test results. 54 Publication and related biases were assessed using funnel plots of diagnostic odds ratio (dOR) against corresponding variances amongst reviews with more than 10 studies. 35 Appendix V aids for the interpretation of summary ROC curves and funnel plots. Stata version 8.2 software was used in the statistical analyses. The procedural flow chart for systematic reviews of test accuracy is shown in Figure 2. 39
Figure 2 Flow chart of procedures for reviews of test accuracy studies Data extraction Delineation of separate populations, tests and reference standards Data syntheses Information sought from each study: •Inclusion & exclusion criteria •Study design quality •Description of populations, index test, and reference standards Asymptomatic antenatal women with singleton pregnancy Symptomatic women with threatened preterm labour (singleton pregnancy) List of tests (Appendix II) List of tests (Appendix II) Birth before 34 weeks’ gestation Birth before 37 weeks’ gestation Birth within 2 - 7 days of testing Birth before 34 weeks’ gestation Birth before 37 weeks’ gestation 40 Heterogeneity analysis (Graphical/statistical) •Forest plots of likelihood ratios (LR’s) •Threshold analysis •Sensitivity/specificity plots in ROC space •χ2 test •Meta-regression, funnel plot analysis if >10 studies (minimum exploratory variables: quality (high/low)) Meta-analysis •If no significant heterogeneity use summary LR’s •If significant heterogeneity, summary LR’s is not provided but: •if ≥2 ideal quality* studies available, pooled these (random effects model) and provide summary LR’s from these highest quality studies • if 1 ideal quality study is available, use this LR estimates •if no ideal quality study is available, use the highest quality study available and if there is ≥2 of them, use the largest study by sample size *Ideal study = consec utive, cohort, prospective, blinding in place, and adequate test description to allow for replication
Page 1 and 2: ACCURACY OF TESTS FOR PREDICTING SP
Page 3 and 4: Abstract Spontaneous preterm birth
Page 5 and 6: Acknowledgements In undertaking thi
Page 7 and 8: Table of contents Chapter 1 Thesis
Page 9 and 10: Absence of fetal breathing movement
Page 11 and 12: Figure 15 Forest plots of likelihoo
Page 17 and 18: eference standards (outcome of spon
Page 19 and 20: Table 18 Individual accuracy result
Page 21 and 22: Table 48 Characteristics of test ac
Page 23 and 24: labour. Literature was identified f
Page 25 and 26: 8) strategies needs to be explored.
Page 27 and 28: morbidities, which often lengthen h
Page 29 and 30: anticipating a normal course of pre
Page 31 and 32: The second population of interest i
Page 33 and 34: Chapter 3 Methods Protocol developm
Page 35 and 36: stage process using predefined and
Page 37 and 38: Table 1 List of tests that purporte
Page 39: corresponding authors so that only
Page 43 and 44: Figure 3 Identification of test acc
Page 45 and 46: with one previous spontaneous prete
Page 47 and 48: Figure 6 Plot of sensitivity agains
Page 49 and 50: predicting spontaneous preterm birt
Page 51 and 52: Figure 9 Forest plots of likelihood
Page 53 and 54: within 7-10 days of testing in addi
Page 55 and 56: Figure 10 Methodological quality of
Page 57 and 58: Figure 13 Plot of sensitivity again
Page 63 and 64: Cervico-vaginal prolactin During pr
Page 69 and 70: women had reported spontaneous pret
Page 75 and 76: Serum α-fetoprotein (MSAFP) A high
Page 81 and 82: Accuracy of maternal serum relaxin
Page 85 and 86: Only two studies used the same thre
Page 87 and 88: β-human chorionic gonadotrophin (
Page 89 and 90: showed asymmetry indicating presenc
Page 91 and 92:
Figure 42 Forest plots of likelihoo
Page 93 and 94:
Estriol Estriol is produced by both
Page 95 and 96:
Figure 46 Methodological quality of
Page 97 and 98:
Page 99 and 100:
while for symptomatic women with th
Page 101 and 102:
Page 103 and 104:
Page 105 and 106:
Interleukin-6 (IL6) Interleukin 6 (
Page 107 and 108:
Page 109 and 110:
epresented the largest higher quali
Page 111 and 112:
Page 113 and 114:
Figure 57 Plot of sensitivity again
Page 115 and 116:
two-weekly interval. For symptomati
Page 117 and 118:
Page 119 and 120:
Matrix metalloproteases-9 (MMP-9) D
Page 121 and 122:
Page 123 and 124:
All but one study assessed women’
Page 125 and 126:
Page 127 and 128:
Asymptomatic bacteriuria assessment
Page 129 and 130:
Page 131 and 132:
Page 133 and 134:
Gram staining using Spiegel’s 232
Page 135 and 136:
Page 137 and 138:
Page 139 and 140:
Mammary stimulation test Antenatal
Page 141 and 142:
Uterine activity monitoring Presenc
Page 143 and 144:
Accuracy of uterine activity monito
Page 145 and 146:
Rheobase Rheobase in the context of
Page 147 and 148:
Absence of fetal breathing movement
Page 149 and 150:
Page 151 and 152:
Cervical ultrasound assessment Ante
Page 153 and 154:
Page 155 and 156:
Accuracy of cervical length and fun
Page 157 and 158:
Page 159 and 160:
Page 161 and 162:
Page 163 and 164:
gestation or birth with 48 hours of
Page 165 and 166:
The main accuracy results are summa
Page 167 and 168:
Figure 100 Summary forest plots of
Page 169 and 170:
Screening typically involves use of
Page 171 and 172:
Table 3 Summary of tests’ accurac
Page 173 and 174:
Table 5 Summary of tests’ accurac
Page 175 and 176:
Chapter 6 Discussion Methodological
Page 177 and 178:
completely as would have been desir
Page 179 and 180:
antenatal women population, using a
Page 181 and 182:
final common pathway of spontaneous
Page 183 and 184:
effectiveness), there are no practi
Page 185 and 186:
Recommendations for research • Ne
Page 187 and 188:
modelling project should make provi
Page 189 and 190:
188
Page 191 and 192:
Appendix II - Search strategies MED
Page 193 and 194:
111. (premature adj3 rupture adj3 m
Page 195 and 196:
92. Granuloma Inguinale/ 93. mycopl
Page 197 and 198:
s (oncofetal or c-reactive)(w)(prot
Page 199 and 200:
s (uterine or antepartum)(3w)(hemor
Page 201 and 202:
interpregnancy and interval* or occ
Page 203 and 204:
((((physical next exam) or (physica
Page 205 and 206:
Appendix IV - Characteristics and r
Page 207 and 208:
Table 12 Characteristics of test ac
Page 209 and 210:
Table 13 Individual accuracy result
Page 211 and 212:
Table 14 Characteristic of studies
Page 213 and 214:
Symptomatic Luzzi 110 2003 133 Coho
Page 215 and 216:
Peaceman 79 1997 725 Cohort Prospec
Page 217 and 218:
Rozenberg 128 1997 76 Calda 120 199
Page 220 and 221:
Page 222 and 223:
Page 224 and 225:
Elizur 144 2005 35 Cohort Prospecti
Page 226 and 227:
Table 21 Characteristics of the inc
Page 228 and 229:
Page 230 and 231:
Table 23 Characteristics of studies
Page 232 and 233:
Page 234 and 235:
Page 236 and 237:
Liu 183 1999 USA 72 Case-control Re
Page 238 and 239:
Page 240 and 241:
Page 242 and 243:
*TP = true positive, FP = false pos
Page 244 and 245:
Page 246 and 247:
Silver 219 1993 USA 29 Cohort Prosp
Page 248 and 249:
Turhan 230 2000 Turkey 82 Cohort Pr
Page 250 and 251:
34 weeks Rizzo 1 217 18 0 34 40 0.3
Page 252 and 253:
Page 254 and 255:
Page 256 and 257:
Page 258 and 259:
Stuart 273 1965 UK 817 Case-control
Page 260 and 261:
Page 262 and 263:
Page 264 and 265:
Helou, 1996 292 Israel Cohort Blind
Page 266 and 267:
Krohn, 1991 302 USA Prospective Tes
Page 268 and 269:
Holst 232 Spiegel 9 3 13 24 0.41 0.
Page 270 and 271:
Page 272 and 273:
Page 274 and 275:
Castle 312 1983 English Cohort Pros
Page 276 and 277:
Page 278 and 279:
Page 280 and 281:
Page 282 and 283:
Page 284 and 285:
Page 286 and 287:
Page 288 and 289:
Another method for assessing hetero
Page 290 and 291:
Publications directly contributing
Page 292 and 293:
15. Martin JA, Hamilton BE, Sutton
Page 294 and 295:
44. Honest H, Bachmann LM, Knox EM,
Page 296 and 297:
72. Parikh MN,.Mehta AC. Internal c
Page 298 and 299:
99. Vercoustre L, Sotter S, Bouige
Page 300 and 301:
126. Pieta-Dolinska A, Jaczewski B,
Page 302 and 303:
preterm delivery but not with fetal
Page 304 and 305:
and activin A in maternal serum: pr
Page 306 and 307:
199. Foulon W, Van Liedekerke D, De
Page 308 and 309:
223. Kurkinen-Raty M, Ruokonen A, V
Page 310 and 311:
249. Radnai M, Gorzo I, Nagy E, Urb
Page 312 and 313:
281. Spiegel CA, Amsel R, Eschenbac
Page 314 and 315:
307. Guinn DA, Wigton TR, James JA,
Page 316 and 317:
334. Daskalakis G, Thomakos N, Hatz
show all

Chapter 4 Results - etheses Repository

Create successful ePaper yourself

Delete template?

Save as template?