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Presepsin as a diagnostic marker for sepsis: evidence from a bivariate meta-analysis.

Tong X, Cao Y, Yu M, Han C - Ther Clin Risk Manag (2015)

Bottom Line: The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.83 (95% confidence interval [CI] 0.77-0.88), 0.81 (95% CI 0.74-0.87), 4.43 (95% CI 3.05-6.43), 0.21 (95% CI 0.14-0.30), and 21.56 (95% CI 10.59-43.88), respectively.The area under the curve was 0.89 (95% CI 0.86-0.92).No publication bias was identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.

ABSTRACT

Background: The diagnosis of sepsis remains a clinical challenge. Many studies suggest that presepsin plays a role in diagnosing sepsis, but the results remain controversial. This study aimed to identify the overall diagnostic accuracy of presepsin for sepsis through meta-analysis.

Methods: A systematic literature search was performed in PubMed and EMBASE to identify studies evaluating the diagnostic accuracy of presepsin in sepsis patients. Data were retrieved and the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were calculated. A summary receiver operating characteristic curve and area under curve (AUC) were used to evaluate the overall diagnostic performance. The statistical analysis was performed using Stata 12.0 and Meta-DiSc 1.4 software.

Results: Eleven publications with 3,106 subjects were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.83 (95% confidence interval [CI] 0.77-0.88), 0.81 (95% CI 0.74-0.87), 4.43 (95% CI 3.05-6.43), 0.21 (95% CI 0.14-0.30), and 21.56 (95% CI 10.59-43.88), respectively. The area under the curve was 0.89 (95% CI 0.86-0.92). Estimated positive and negative post-probability values for a sepsis prevalence of 20% were 53% and 5%, respectively. No publication bias was identified.

Conclusion: Based on currently available evidence, presepsin may have a valuable role in the diagnosis of sepsis, and its results should be interpreted carefully in the context of clinical condition and traditional markers.

No MeSH data available.


Related in: MedlinePlus

Fagan’s nomogram for likelihood ratios and pre-test and post-test probabilities when using presepsin measurements to diagnose sepsis.
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f4-tcrm-11-1027: Fagan’s nomogram for likelihood ratios and pre-test and post-test probabilities when using presepsin measurements to diagnose sepsis.

Mentions: Figure 3 gives the SROC curve for the included studies, and shows a plot of the rate of true positives as a function of the rate of false positives for the individual studies. The AUC was 0.89 (95% CI 0.86–0.92), indicating a good discriminatory ability of presepsin measurement for sepsis. Fagan’s nomogram for likelihood ratios indicates that using presepsin to diagnose sepsis increased the post-probability to 53% when the results were positive and reduced the post-probability to 5% when the results were negative (Figure 4).


Presepsin as a diagnostic marker for sepsis: evidence from a bivariate meta-analysis.

Tong X, Cao Y, Yu M, Han C - Ther Clin Risk Manag (2015)

Fagan’s nomogram for likelihood ratios and pre-test and post-test probabilities when using presepsin measurements to diagnose sepsis.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4494627&req=5

f4-tcrm-11-1027: Fagan’s nomogram for likelihood ratios and pre-test and post-test probabilities when using presepsin measurements to diagnose sepsis.
Mentions: Figure 3 gives the SROC curve for the included studies, and shows a plot of the rate of true positives as a function of the rate of false positives for the individual studies. The AUC was 0.89 (95% CI 0.86–0.92), indicating a good discriminatory ability of presepsin measurement for sepsis. Fagan’s nomogram for likelihood ratios indicates that using presepsin to diagnose sepsis increased the post-probability to 53% when the results were positive and reduced the post-probability to 5% when the results were negative (Figure 4).

Bottom Line: The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.83 (95% confidence interval [CI] 0.77-0.88), 0.81 (95% CI 0.74-0.87), 4.43 (95% CI 3.05-6.43), 0.21 (95% CI 0.14-0.30), and 21.56 (95% CI 10.59-43.88), respectively.The area under the curve was 0.89 (95% CI 0.86-0.92).No publication bias was identified.

View Article: PubMed Central - PubMed

Affiliation: Department of Laboratory Medicine, China-Japan Friendship Hospital, Beijing, People's Republic of China.

ABSTRACT

Background: The diagnosis of sepsis remains a clinical challenge. Many studies suggest that presepsin plays a role in diagnosing sepsis, but the results remain controversial. This study aimed to identify the overall diagnostic accuracy of presepsin for sepsis through meta-analysis.

Methods: A systematic literature search was performed in PubMed and EMBASE to identify studies evaluating the diagnostic accuracy of presepsin in sepsis patients. Data were retrieved and the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) were calculated. A summary receiver operating characteristic curve and area under curve (AUC) were used to evaluate the overall diagnostic performance. The statistical analysis was performed using Stata 12.0 and Meta-DiSc 1.4 software.

Results: Eleven publications with 3,106 subjects were included in the meta-analysis. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and DOR were 0.83 (95% confidence interval [CI] 0.77-0.88), 0.81 (95% CI 0.74-0.87), 4.43 (95% CI 3.05-6.43), 0.21 (95% CI 0.14-0.30), and 21.56 (95% CI 10.59-43.88), respectively. The area under the curve was 0.89 (95% CI 0.86-0.92). Estimated positive and negative post-probability values for a sepsis prevalence of 20% were 53% and 5%, respectively. No publication bias was identified.

Conclusion: Based on currently available evidence, presepsin may have a valuable role in the diagnosis of sepsis, and its results should be interpreted carefully in the context of clinical condition and traditional markers.

No MeSH data available.


Related in: MedlinePlus