Telford Lisa H, Abdullahi Leila H, Ochodo Eleanor A, Zühlke Liesl J, Engel Mark E
Department of Medicine, Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Department of Paediatrics, Red Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
BMJ Open. 2018 Feb 10;8(2):e020140. doi: 10.1136/bmjopen-2017-020140.
Rheumatic heart disease (RHD) is a preventable and treatable chronic condition which persists in many developing countries largely affecting impoverished populations. Handheld echocardiography presents an opportunity to address the need for more cost-effective methods of diagnosing RHD in developing countries, where the disease continues to carry high rates of morbidity and mortality. Preliminary studies have demonstrated moderate sensitivity as well as high specificity and diagnostic odds for detecting RHD in asymptomatic patients. We describe a protocol for a systematic review on the diagnostic performance of handheld echocardiography compared to standard echocardiography using the 2012 World Heart Federation criteria for diagnosing subclinical RHD.
Electronic databases including PubMed, Scopus, Web of Science and EBSCOhost as well as reference lists and citations of relevant articles will be searched from 2012 to date using a predefined strategy incorporating a combination of Medical Subject Heading terms and keywords. The methodological validity and quality of studies deemed eligible for inclusion will be assessed against review specific Quality Assessment of Diagnostic Accuracy Studies 2 criteria and information on metrics of diagnostic accuracy and demographics extracted. Forest plots of sensitivity and specificity as well as scatter plots in receiver operating characteristic (ROC) space will be used to investigate heterogeneity. If possible, a meta-analysis will be conducted to produce summary results of sensitivity and specificity using the Hierarchical Summary ROC method. In addition, a sensitivity analysis will be conducted to investigate the effect of studies with a high risk of bias.
Ethics approval is not required for this systematic review of previously published literature. The planned review will provide a summary of the diagnostic accuracy of handheld echocardiography. Results may feed into evidence-based guidelines and should the findings of this review warrant a change in clinical practice, a summary report will be disseminated among leading clinicians and healthcare professionals in the field.
CRD42016051261.
风湿性心脏病（RHD）是一种可预防和治疗的慢性疾病，在许多发展中国家仍然存在，主要影响贫困人口。手持式超声心动图为满足发展中国家对更具成本效益的RHD诊断方法的需求提供了契机，在这些国家，该疾病的发病率和死亡率仍然很高。初步研究表明，手持式超声心动图在检测无症状患者的RHD方面具有中等敏感性以及高特异性和诊断比值。我们描述了一项系统评价方案，该方案根据2012年世界心脏联盟诊断亚临床RHD的标准，对比手持式超声心动图与标准超声心动图的诊断性能。
将使用预定义策略，结合医学主题词和关键词，检索2012年至今的电子数据库，包括PubMed、Scopus、科学网和EBSCOhost以及相关文章的参考文献列表和引用文献。将根据特定于综述的诊断准确性研究质量评估2标准，评估被认为符合纳入条件的研究的方法学有效性和质量，并提取诊断准确性指标和人口统计学信息。将使用敏感性和特异性的森林图以及受试者工作特征（ROC）空间中的散点图来研究异质性。如果可能，将使用分层汇总ROC方法进行荟萃分析，以得出敏感性和特异性的汇总结果。此外，将进行敏感性分析，以研究偏倚风险高的研究的影响。
对先前发表文献的这项系统评价无需伦理批准。计划进行的综述将提供手持式超声心动图诊断准确性的总结。结果可能会纳入循证指南，如果本综述的结果证明临床实践需要改变，将向该领域的主要临床医生和医疗保健专业人员传播一份总结报告。
PROSPERO注册号：CRD42016051261。
