Accuracy of the COMPASS-CAT thrombosis risk assessment scale in predicting venous thromboembolism in cancer patients: a meta-analysis

ObjectiveThis systematic review aims to assess the accuracy of the COMPASS-CAT tool in predicting venous thromboembolism (VTE) among cancer patients.MethodsRelevant studies were searched in PubMed, Web of Science, The Cochrane Library, Embase, CINAHL, OVID, CBM, CNKI, WanFang Data, and VIP database from their inception up to April 19, 2023. The quality of studies was appraised using the diagnostic test accuracy study bias assessment tool (QUADAS-2). Quantitative analysis was performed using Stata MP 17.0.ResultsThirteen studies involving 8,665 patients were included. Meta-analysis indicated that the COMPASS-CAT score had a pooled sensitivity of 0.76 [95%CI (0.61, 0.86)], specificity of 0.67 [95%CI (0.52, 0.79)], positive likelihood ratio of 2.3 [95%CI (1.7, 3.1)], negative likelihood ratio of 0.36 [95%CI (0.23, 0.54)], diagnostic odds ratio of 6 [95%CI (4, 10)], and an area under the Summary Receiver Operating Characteristic (SROC) curve (AUC) of 0.77 [95%CI (0.74, 0.81)]. Funnel plots indicated no publication bias. Meta-regression and subgroup analysis suggested that country and diagnostic setting might be potential sources of heterogeneity. The sensitivity of the COMPASS-CAT assessment tool in international outpatient settings was 0.94 with an AUC of 0.86, while in domestic inpatient settings, the sensitivity was 0.65 with an AUC of 0.78.ConclusionThe COMPASS-CAT score had a certain diagnostic value for VTE in cancer patients and can effectively identify patients at risk of VTE. Most studies focus on patients with lung cancer. Future research should investigate more tumor types, and high-quality, large-sample, multi-center prospective studies on larger populations with cancers are warranted. The COMPASS-CAT thrombosis risk assessment model has been widely used to predict VTE risk in patients with solid tumors worldwide.This study conducted a meta-analysis of 13 articles, and the results showed that the COMPASS-CAT thrombosis risk assessment model can effectively identify patients at risk of VTE, with a pooled sensitivity of 0.76 and specificity of 0.67. The area under the ROC curve is 0.77, indicating that the scale has certain accuracy.It is helpful to select a suitable venous thrombosis risk assessment model for tumor patients. Accuracy of the COMPASS-CAT Thrombosis Risk Assessment Scale in Predicting Venous Thromboembolism in Cancer Patients: A Meta-Analysis.