Le Roux Pierre-Yves, Robin Philippe, Tromeur Cécile, Davis Alexandra, Robert-Ebadi Helia, Carrier Marc, Couturaud Francis, Le Gal Grégoire, Salaun Pierre-Yves
Service de médecine nucléaire, CHRU de Brest, EA3878 (GETBO), Université de Brest, Brest, France.
Department of Medicine, Ottawa Hospital Research Institute, University of Ottawa, Ottawa, Ontario, Canada.
BMJ Open. 2018 Apr 21;8(4):e022024. doi: 10.1136/bmjopen-2018-022024.
Single photon emission computed tomography ventilation/perfusion (SPECT V/Q) imaging has many proponents within the nuclear medicine community and has already largely replaced planar V/Q scintigraphy in daily practice for the diagnosis of pulmonary embolism (PE). However, the test is still described in clinical guidelines as an experimental test because of insufficient evidence.
We will conduct a systematic review and a meta-analysis of diagnostic accuracy and management outcome studies involving patients evaluated with V/Q SPECT for suspected acute PE. We will search from inception to 19 December 2017 MEDLINE, Embase and the Cochrane Central Register of Controlled Trials for diagnostic accuracy studies, randomised controlled trials and observational cohort studies. Two reviewers will conduct all screening and data collection independently. The methodological quality and risk of bias of eligible studies will be carefully and rigorously assessed using the Quality Assessment of Diagnostic Accuracy Studies-2, the Cochrane Collaboration's tool and the Risk Of Bias In Non-randomised Studies - of Interventions (ROBINS-I) tools. The primary outcomes will be sensitivity, specificity and likelihood ratios of V/Q SPECT for the diagnosis of acute PE. The secondary outcomes will be the rate of venous thromboembolism during a 3-month follow-up period in patients left untreated after a negative diagnostic work-up based on SPECT V/Q.
This study of secondary data does not require ethics approval. It will be presented internationally and published in the peer-reviewed literature.
CRD42018084095.
单光子发射计算机断层扫描通气/灌注（SPECT V/Q）成像在核医学领域有众多支持者，在日常实践中已在很大程度上取代了平面V/Q闪烁扫描术用于诊断肺栓塞（PE）。然而，由于证据不足，该检查在临床指南中仍被描述为一项试验性检查。
我们将对涉及用V/Q SPECT评估疑似急性PE患者的诊断准确性和管理结果研究进行系统评价和荟萃分析。我们将检索从创刊至2017年12月19日的MEDLINE、Embase和Cochrane对照试验中央注册库，查找诊断准确性研究、随机对照试验和观察性队列研究。两名评价者将独立进行所有筛选和数据收集工作。将使用诊断准确性研究质量评估-2、Cochrane协作组工具以及非随机干预性研究的偏倚风险（ROBINS-I）工具，仔细且严格地评估合格研究的方法学质量和偏倚风险。主要结局将是V/Q SPECT诊断急性PE的敏感性、特异性和似然比。次要结局将是基于SPECT V/Q的阴性诊断检查后未接受治疗的患者在3个月随访期内静脉血栓栓塞的发生率。
这项对二手数据的研究无需伦理批准。研究结果将在国际上进行展示，并发表在同行评审的文献中。
PROSPERO注册号：CRD42018084095。
