Davis Cody, Immormino Jenna, Higgins Brendan M, Clark Kyle, Engebose Samuel, Garcia Alessandra N, Cook Chad E
Division of Physical Therapy, Duke University, Durham, USA.
Department of Orthopaedic Surgery, Division of Physical Therapy, Duke University, Durham, USA.
Shoulder Elbow. 2019 Oct;11(5):321-331. doi: 10.1177/1758573218811656. Epub 2018 Nov 19.
The Active Compression Test has been proposed to have high diagnostic accuracy for superior labrum anterior to posterior tears. The aim of this systematic review was to compile the available evidence for this test and evaluate its diagnostic accuracy.
The databases PubMed, Embase, Cochrane, CINAHL, and SCOPUS were searched for case control, diagnostic studies that evaluated the Active Compression Test between 1999 (date of test introduction) and February 2018. Two independent review authors screened the search results, assessed the risk of bias using QUADAS-2, and extracted the data.
Eighteen studies (pooled sample = 3091) were included in this review. Twelve out of 18 studies either had high or unclear risk of bias (66.6%). Results from the pooled analysis of all 18 studies provided that the Active Compression Test is more sensitive (71.5: 95% CI = 68.8, 74.0) than specific (51.9: 95% CI = 50.7, 53.1) and only marginally influenced posttest probability from a pretest probability of 31.7-40.72% with a positive finding and a pretest probability of 31.7-20.33% with a negative finding.
The Active Compression Test has both limited screening and confirmation ability; therefore, we do not advocate for its use in clinical decision making.
主动压缩试验被认为对上盂唇前后向撕裂具有较高的诊断准确性。本系统评价的目的是汇总该试验的现有证据并评估其诊断准确性。
检索PubMed、Embase、Cochrane、CINAHL和SCOPUS数据库，查找1999年（该试验引入日期）至2018年2月间评估主动压缩试验的病例对照诊断研究。两位独立的综述作者筛选检索结果，使用QUADAS-2评估偏倚风险，并提取数据。
本综述纳入了18项研究（合并样本量=3091）。18项研究中有12项存在高或不清楚的偏倚风险（66.6%）。对所有18项研究的汇总分析结果表明，主动压缩试验的敏感性（71.5：95%CI=68.8，74.0）高于特异性（51.9：95%CI=50.7，53.1），阳性结果时仅略微影响从31.7 - 40.72%的验前概率到验后概率，阴性结果时从31.7 - 20.33%的验前概率到验后概率。
主动压缩试验的筛查和确诊能力均有限；因此，我们不主张在临床决策中使用该试验。
