Diagnostic accuracy of imaging devices in glaucoma: A meta-analysis

被引:22
作者
Fallon, Monica [1 ,2 ]
Valero, Oliver [3 ]
Pazos, Marta [2 ,4 ]
Anton, Alfonso [2 ,4 ,5 ,6 ,7 ]
机构
[1] Univ Autonoma Barcelona, Dept Pediat Obstet Gynecol & Prevent Med, Barcelona, Spain
[2] Hosp Esperanca Parc Salut Mar, Ophthalmol Dept, Barcelona, Spain
[3] Univ Autonoma Barcelona, Stat Dept, Serv Estadist, Barcelona, Spain
[4] IMIM, Dept Med, Barcelona, Spain
[5] ICR, Glaucoma Dept, Barcelona, Spain
[6] ICR, Res Dept, Barcelona, Spain
[7] Univ Int Catalunya, Res Line Epidemiol & Hlth Serv, Barcelona, Spain
关键词
glaucoma; biomedical enhancement; meta-analysis; diagnostic imaging; optic nerve; OPTICAL COHERENCE TOMOGRAPHY; NERVE-FIBER LAYER; MOORFIELDS REGRESSION-ANALYSIS; SCANNING-LASER-OPHTHALMOSCOPY; DOMAIN; ONSET; RATIO;
D O I
10.1016/j.survophthal.2017.01.001
中图分类号
R77 [眼科学];
学科分类号
100212 ;
摘要
Imaging devices such as the Heidelberg retinal tomograph-3 (HRT3), scanning laser polarimetry (GDx), and optical coherence tomography (OCT) play an important role in glaucoma diagnosis. A systematic search for evidence-based data was performed for prospective studies evaluating the diagnostic accuracy of HRT3, GDx, and OCT. The diagnostic odds ratio (DOR) was calculated. To compare the accuracy among instruments and parameters, a meta-analysis considering the hierarchical summary receiver-operating characteristic model was performed. The risk of bias was assessed using quality assessment of diagnostic accuracy studies, version 2. Studies in the context of screening programs were used for qualitative analysis. Eighty-six articles were included. The DOR values were 29.5 for OCT, 18.6 for GDx, and 13.9 for HRT. The heterogeneity analysis demonstrated statistically a significant influence of degree of damage and ethnicity. Studies analyzing patients with earlier glaucoma showed poorer results. The risk of bias was high for patient selection. Screening studies showed lower sensitivity values and similar specificity values when compared with those included in the meta-analysis. The classification capabilities of GDx, HRT, and OCT were high and similar across the 3 instruments. The highest estimated DOR was obtained with OCT. Diagnostic accuracy could be overestimated in studies including prediagnosed groups of subjects. (C) 2017 Elsevier Inc. All rights reserved.
引用
收藏
页码:446 / 461
页数:16
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