Taylor Darlene, Lunny Carole, Wong Tom, Gilbert Mark, Li Neville, Lester Richard, Krajden Mel, Hoang Linda, Ogilvie Gina
BC Centre for Disease Control, 655 West 12th Avenue, Vancouver, BC V5Z 4R4, Canada.
Syst Rev. 2013 Oct 10;2:93. doi: 10.1186/2046-4053-2-93.
Three meta-analyses and one systematic review have been conducted on the question of whether self-collected specimens are as accurate as clinician-collected specimens for STI screening. However, these reviews predate 2007 and did not analyze rectal or pharyngeal collection sites. Currently, there is no consensus on which sampling method is the most effective for the diagnosis of genital chlamydia (CT), gonorrhea (GC) or human papillomavirus (HPV) infection. Our meta-analysis aims to be comprehensive in that it will examine the evidence of whether self-collected vaginal, urine, pharyngeal and rectal specimens provide as accurate a clinical diagnosis as clinician-collected samples (reference standard).
Eligible studies include both randomized and non-randomized controlled trials, pre- and post-test designs, and controlled observational studies.
The databases that will be searched include the Cochrane Database of Systematic Reviews, Web of Science, Database of Abstracts of Reviews of Effects (DARE), EMBASE and PubMed/Medline.
Data will be abstracted independently by two reviewers using a standardized pre-tested data abstraction form. Heterogeneity will be assessed using the Q2 test. Sensitivity and specificity estimates with 95% confidence intervals as well as negative and positive likelihood ratios will be pooled and weighted using random effects meta-analysis, if appropriate. A hierarchical summary receiver operating characteristics curve for self-collected specimens will be generated.
This synthesis involves a meta-analysis of self-collected samples (urine, vaginal, pharyngeal and rectal swabs) versus clinician-collected samples for the diagnosis of CT, GC and HPV, the most prevalent STIs. Our systematic review will allow patients, clinicians and researchers to determine the diagnostic accuracy of specimens collected by patients compared to those collected by clinicians in the detection of chlamydia, gonorrhea and HPV.
关于自我采集的标本在性传播感染（STI）筛查中是否与临床医生采集的标本一样准确，已经进行了三项荟萃分析和一项系统评价。然而，这些综述是在2007年之前进行的，并未分析直肠或咽部采集部位。目前，对于哪种采样方法对生殖器衣原体（CT）、淋病（GC）或人乳头瘤病毒（HPV）感染的诊断最有效尚无共识。我们的荟萃分析旨在全面，将研究自我采集的阴道、尿液、咽部和直肠标本是否能提供与临床医生采集的样本（参考标准）一样准确的临床诊断证据。
符合条件的研究包括随机和非随机对照试验、前后测试设计以及对照观察性研究。
将检索的数据库包括Cochrane系统评价数据库、科学网、效果综述摘要数据库（DARE）、EMBASE和PubMed/Medline。
两名评审员将使用标准化的预测试数据提取表独立提取数据。将使用Q2检验评估异质性。如果合适，将使用随机效应荟萃分析汇总和加权95%置信区间的敏感性和特异性估计值以及阴性和阳性似然比。将生成自我采集标本的分层汇总接受者操作特征曲线。
本综述涉及对自我采集的样本（尿液、阴道、咽部和直肠拭子）与临床医生采集的样本进行荟萃分析，以诊断最常见的性传播感染CT, GC和HPV。我们的系统评价将使患者、临床医生和研究人员能够确定患者采集的标本与临床医生采集的标本在检测衣原体、淋病和HPV方面的诊断准确性。
