个体患者数据系统评价和视神经鞘直径超声检测颅内压增高的荟萃分析：ONSD 研究组方案。
Individual patient data systematic review and meta-analysis of optic nerve sheath diameter ultrasonography for detecting raised intracranial pressure: protocol of the ONSD research group.
机构信息
Université Claude Bernard Lyon 1, 69003 Lyon, France.
出版信息
Syst Rev. 2013 Aug 6;2:62. doi: 10.1186/2046-4053-2-62.
BACKGROUND
The purpose of the optic nerve sheath diameter (ONSD) research group project is to establish an individual patient-level database from high quality studies of ONSD ultrasonography for the detection of raised intracranial pressure (ICP), and to perform a systematic review and an individual patient data meta-analysis (IPDMA), which will provide a cutoff value to help physicians making decisions and encourage further research. Previous meta-analyses were able to assess the diagnostic accuracy of ONSD ultrasonography in detecting raised ICP but failed to determine a precise cutoff value. Thus, the ONSD research group was founded to synthesize data from several recent studies on the subject and to provide evidence on the diagnostic accuracy of ONSD ultrasonography in detecting raised ICP.
METHODS
This IPDMA will be conducted in different phases. First, we will systematically search for eligible studies. To be eligible, studies must have compared ONSD ultrasonography to invasive intracranial devices, the current reference standard for diagnosing raised ICP. Subsequently, we will assess the quality of studies included based on the QUADAS-2 tool, and then collect and validate individual patient data. The objectives of the primary analyses will be to assess the diagnostic accuracy of ONSD ultrasonography and to determine a precise cutoff value for detecting raised ICP. Secondly, we will construct a logistic regression model to assess whether patient and study characteristics influence diagnostic accuracy.
DISCUSSION
We believe that this IPD MA will provide the most reliable basis for the assessment of diagnostic accuracy of ONSD ultrasonography for detecting raised ICP and to provide a cutoff value. We also hope that the creation of the ONSD research group will encourage further study.
TRIAL REGISTRATION
PROSPERO registration number: CRD42012003072.
背景
视神经鞘直径（ONSD）研究组项目的目的是从高质量的 ONSD 超声检测颅内压升高（ICP）的研究中建立一个个体患者水平的数据库，并进行系统评价和个体患者数据荟萃分析（IPDMA），这将提供一个截止值以帮助医生做出决策并鼓励进一步研究。以前的荟萃分析能够评估 ONSD 超声检测 ICP 升高的诊断准确性，但未能确定精确的截止值。因此，成立了 ONSD 研究组，以综合几个关于该主题的近期研究的数据，并提供关于 ONSD 超声检测 ICP 升高的诊断准确性的证据。
方法
本 IPDMA 将分阶段进行。首先，我们将系统地搜索合格的研究。要符合条件，研究必须将 ONSD 超声检查与侵入性颅内设备进行比较，后者是诊断 ICP 升高的当前参考标准。随后，我们将根据 QUADAS-2 工具评估纳入研究的质量，然后收集和验证个体患者数据。主要分析的目的将是评估 ONSD 超声检测 ICP 升高的诊断准确性并确定检测 ICP 升高的精确截止值。其次，我们将构建逻辑回归模型来评估患者和研究特征是否影响诊断准确性。
讨论
我们相信，本 IPDMA 将为评估 ONSD 超声检测 ICP 升高的诊断准确性并提供截止值提供最可靠的依据。我们还希望 ONSD 研究组的创建将鼓励进一步的研究。
试验注册
PROSPERO 注册号：CRD42012003072。
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