Department of Pediatrics, University of Calgary, Calgary, Alberta, Canada.
Faculty of Medicine and Dentistry, University of Alberta, Edmonton, Alberta, Canada.
BMJ Open. 2019 Mar 7;9(3):e025950. doi: 10.1136/bmjopen-2018-025950.
Rapid detection of Shiga toxin-producing (STEC) enables appropriate treatment. Numerous commercially available molecular tests exist, but they vary in clinical performance. This systematic review aims to synthesise available evidence to compare the clinical performance of enzyme immunoassay (EIA) and nucleic acid amplification tests (NAATs) for the detection of STEC.
The following databases will be searched employing a standardised search strategy: Medline, Embase, Cochrane CENTRAL Register of Controlled Trials, Cochrane Database of Systematic Reviews, PubMed, Scopus and Web of Science. Grey literature will be searched under advice from a medical librarian. Independent reviewers will screen titles, abstracts and full texts of retrieved studies for relevant studies. Data will be extracted independently by two reviewers, using a piloted template. Quality Assessment of Diagnostic Accuracy Studies-2 will be employed to assess the risk of bias of individual studies, and the quality of evidence will be assessed with the Grading of Recommendations Assessment, Development and Evaluation approach. A bivariate random-effects model will be used to meta-analyse the sensitivity and specificity of commercial STEC diagnostic tests, and a hierarchical summary receiver operator characteristic curve will be constructed. Studies of single test accuracy of EIA and NAATs and studies of comparative accuracy will be analysed separately.
Ethics approval was not required for this systematic review and meta-analysis. Findings will be disseminated in conferences, through a peer-reviewed journal and via personal interactions with relevant stakeholders.
CRD42018099119.
快速检测产志贺毒素的大肠杆菌(STEC)可实现针对性治疗。目前已有许多商业化的分子检测方法,但它们在临床性能方面存在差异。本系统评价旨在综合现有证据,比较酶免疫分析(EIA)和核酸扩增检测(NAAT)用于检测 STEC 的临床性能。
将采用标准化搜索策略在以下数据库中进行搜索:Medline、Embase、Cochrane 对照试验中心注册库、Cochrane 系统评价数据库、PubMed、Scopus 和 Web of Science。根据医学图书馆员的建议,将在灰色文献中进行搜索。独立评审员将筛选检索研究的标题、摘要和全文,以获取相关研究。将由两名评审员独立使用经过试点的模板提取数据。将使用诊断准确性研究的质量评估-2 来评估个体研究的偏倚风险,并使用推荐评估、制定和评估方法评估证据质量。将采用双变量随机效应模型对商业 STEC 诊断检测的敏感性和特异性进行荟萃分析,并构建分层综合接收者操作特征曲线。将分别分析 EIA 和 NAAT 的单一检测准确性研究和比较准确性研究。
本系统评价和荟萃分析不需要伦理批准。研究结果将通过会议、同行评议期刊以及与相关利益相关者的个人互动进行传播。
PROSPERO 注册号:CRD42018099119。