Assessing the Diagnostic Accuracy of Immunodiagnostic Techniques in the Diagnosis of Schistosomiasis Japonica: a Meta-analysis
|School||Huazhong University of Science and Technology|
|Course||Epidemiology and Biostatistics,|
|Keywords||Schistosomiasis japonica Diagnostic accuracy Enzyme - linked immunosorbent assay The indirect hemagglutination set test meta-analysis|
Objective: immunological diagnostic tests have been widely used in on-site diagnosis of schistosomiasis, in previous studies, however, have not yet estimate and compare the accuracy of diagnostic tests. In this study, a meta-analysis, system retrieved schistosomiasis diagnostic test results, quantitative integrated to obtain the effect of the immunological detection test for schistosomiasis japonica exact diagnosis, provide the basis for better choice for the future diagnosis of schistosomiasis . Method: the systematic and comprehensive searching Pubmed, Web of Science (SCI), the China Academic Journal (CNKI), Proquest, the Cochrane Library, [such as databases, published literature on Schistosoma japonicum serological diagnostic tests by two bit investigators independently extracted and organize data, extract valid data. Using SAS 9.1 statistical analysis, namely the use of the SROC law, the sensitivity and specificity of the bivariate model analysis of the results were analyzed, and the results of the two methods of calculation. Excel 2003 draw charts, funnel plot analysis of publication bias. Results: 16 studies met the inclusion criteria, the final entry into the study. Meta-analysis of the results show robust method indirect hemagglutination test sensitivity to 0.721, odds ratio 8.689,95% odds ratio confidence interval of (7.67,9.84); enzyme-linked immunosorbent assay sensitivity 0.633, odds ratio 3.691,95% odds ratio confidence interval of (3.02,4.52). IHA sensitivity than ELISA, but the Z-test results show that the two methods still can not believe that these two methods in the diagnosis of schistosomiasis japonica significant differences (P gt; 0.05). Bivariate model of sensitivity and specificity analysis showed an IHA sensitivity of 0.81, 95% confidence interval of (0.69,0.89), mean specificity of 0.67, 95% confidence interval (0.55,0.78); ELISA sensitivity mean 0.82, 95% confidence interval of (0.66,0.92), mean specificity of 0.48, 95% confidence interval (0.33,0.63); IHA diagnostic advantages than the mean of 9.95% confidence interval (4,21), ELISA diagnostic odds than the average of 4,95% confidence interval (3,7). IHA method sensitivity and similar ELISA method sensitivity, specificity higher than ELISA. Mixed model results show no statistically significant mean difference of IHA and ELISA sensitivity, the mean specificity as well as DOR mean no significant difference between Conclusion: In this study, using the the SROC method and two-variable model analysis to evaluate the results of IHA and ELISA diagnostic results found that the conclusions of the two statistical methods similar, but the the bivariate method can be respectively derived sensitivity, specificity and DOR's mean and confidence interval, bivariate method can be seen as the improvement and expansion of the SROC method. Studies have shown that the two kinds of schistosome immunology diagnostic tests (indirect hemagglutination test and enzyme-linked immunosorbent assay) sensitivity were higher accuracy is also better, indirect hemagglutination test is better than the enzyme-linked immunosorbent assay, but the statistical results display the difference is not significant. Comprehensive comparison of the two immunological diagnosis of schistosomiasis japonica have certain diagnostic value, can be used for on-site diagnosis of schistosomiasis. IHA and ELISA have their own characteristics, specific conditions should be used to treat, according to local conditions.