Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine
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Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine
Journal of Chongqing Medical UniversityVol. 40, Issue 10, Pages: 1275-1279(2015)
作者机构:
重庆医科大学公共卫生与管理学院卫生统计与信息管理教研室,重庆,400016
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Published:2015,
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Pu Yangyang, Peng Bin, Du Chengfeng, et al. Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine. [J]. Journal of Chongqing Medical University 40(10):1275-1279(2015)
DOI:
Pu Yangyang, Peng Bin, Du Chengfeng, et al. Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine. [J]. Journal of Chongqing Medical University 40(10):1275-1279(2015)DOI:
Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine
目的:基于Meta分析结果,运用综合受试者工作特征曲线技术(summary receiver operating characteristic,SROC)5种技术方法评价妊娠肝内胆汁淤积症(intrahepatic cholestasis of pregnancy,ICP)中总胆汁酸(total bile acid,TBA)的诊断价值。方法:检索中文数据库:中国生物医学文献数据库(CBM)、万方、CNKI;英文数据库:PubMed,HighWire,Ovid,the Cochrane Library,Google scholar research。文献搜索的截至日期为2015年5月。对所纳入的文献进行质量评价和数据提取后,利用Meta分析所收集的TBA的灵敏度、特异度等数据信息,运用双变量随机效应模型的SROC 5种方法:η on ξ、ξ on η、D on S、R&G(Rutter and Gatso-nis)、主轴法,应用SAS的MIXED和NLMIXED过程步得到参数,建立5种模型,评价TBA对ICP的诊断价值。结果:通过Meta分析检索步骤,最终纳入6篇文献,根据5种方法计算出诊断评价结果曲线下面积(area under curve,AUC)值显示:η on ξ:0.711,ξ on η:0.448;D on S:0.730;R&G:0.801;主轴法:0.703,提示TBA的诊断准确性较高,而5种技术方法的AUC和SROC图形结果显示:R&G评价TBA准确性的效果较其他方法更好。结论:TBA诊断ICP的准确性较好,但R&G的效果评价需进一步验证。
Abstract
Objective:To use 5 methods of summary receiver operating characteristic(SROC) to evaluate the diagnostic value of the total bile acid(TBA) in intrahepatic cholestasis of pregnancy(ICP) based on the Meta-analysis. Methods:Articles were identified from searches of PubMed,HighWire,Ovid,the Cochrane Library,Google scholar research,the Chinese National Knowledge Infras-tructure,WanFang Dissertation Database and Chinese Biological Medical. The retrieval time was conducted at May 2015. Bivariate random effect models:η on ξ,ξ on η,D on S,R&G(Rutter’s and Gatsonis),major axis,were used based on the information of sensitivity,specificity,etc. SAS MIXED and NLMIXED procedure was applied to build 5 kinds of model to evaluate the diagnostic value of total bile acid of intrahepatic cholestasis of pregnancy. Results:The results area under curve(AUC) of diagnostic evaluation showed that η on ξ:0.711,ξ on η:0.448,D on S:0.730,Rutter and Gatsonis(R&G):0.801,major axis:0.703,which indicated the di-agnostic accuracy of TBA was moderate,and 5 technical methods results of AUC and SROC curve showed that the effect of R&G was superior to other methods in evaluating the accuracy of TBA than. Conclusion:TBA is accurate when diagnosing intrahepatic choles-tasis of pregnancy,but the efficacy of R&G needs further consideration.
关键词
妊娠肝内胆汁淤积症总胆汁酸综合受试者工作特征曲线Meta分析
Keywords
intrahepatic cholestasis of pregnancytotal bile acidsummary receiver operating characteristicMeta-analysis