Department of Surgery, Kuopio University Hospital and School of Medicine, University of Eastern Finland, Kuopio, Finland.
Molecular Oncology Research Center, Barretos Cancer Hospital, Barretos, Brazil.
Anticancer Res. 2021 Jun;41(6):3045-3054. doi: 10.21873/anticanres.15087.
BACKGROUND/AIM: Diagnostic scores (DSs) for confirmation of acute renal colic (ARCO) have rarely been evaluated.
A cohort of 1,333 patients with acute abdominal pain (AAP) were studied, including 59 patients with confirmed ARCO. The most significant diagnostic findings (in multivariate logistic regression analysis) were used to construct DS formulas for the diagnosis of ARCO. Meta-analytical techniques were used to detect the summary sensitivity and specificity estimates for each data set (clinical symptoms, signs and tests, as well as DS formulas).
In hierarchical summary receiver operating characteristic analysis (HSROC), the values for area under the curve (95% confidence interval) for i) clinical symptoms ii) signs and tests, and iii) DS were 0.650 (0.612-0.688), 0.724 (0.680-0.768) and 0.962 (0.940-0.984), respectively. In HSROC analysis of the area under the curve values, differences were significant between i) and iii) (p<0.0001) and between ii) and iii) (p<0.0001).
The present study is the first to provide evidence suggesting that the DS can be used for clinical confirmation of ARCO in patients with AAP, with a high diagnostic accuracy without radiological or laboratory analyses.
背景/目的：用于确诊急性肾绞痛（ARCO）的诊断评分（DS）很少得到评估。
研究了一组 1333 名患有急性腹痛（AAP）的患者，其中包括 59 名确诊为 ARCO 的患者。使用多变量逻辑回归分析中最显著的诊断发现，构建用于诊断 ARCO 的 DS 公式。使用荟萃分析技术检测每个数据集（临床症状、体征和检查以及 DS 公式）的综合敏感性和特异性估计值。
在分层汇总受试者工作特征分析（HSROC）中，曲线下面积（95%置信区间）的 i）临床症状 ii）体征和检查，以及 iii）DS 的值分别为 0.650（0.612-0.688）、0.724（0.680-0.768）和 0.962（0.940-0.984）。在 HSROC 分析中，曲线下面积值之间存在显著差异，i）与 iii）之间（p<0.0001）和 ii）与 iii）之间（p<0.0001）。
本研究首次提供了证据表明，DS 可用于临床确诊 AAP 患者的 ARCO，具有高诊断准确性，无需进行放射学或实验室分析。
