BACKGROUND Non-invasive criteria are needed for Crohn’s disease(CD)diagnosis,with several biomarkers being tested.Results of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic au...BACKGROUND Non-invasive criteria are needed for Crohn’s disease(CD)diagnosis,with several biomarkers being tested.Results of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic autoantibodies-to-glycoprotein-2(anti-GP2)tests for the diagnosis of CD appear promising.AIM To systematically review and meta-analyze evidence on the diagnostic accuracy of anti-GP2 tests in patients with suspected/confirmed CD.METHODS An electronic search was conducted on PubMed,Cochrane-CENTRAL and grey literature(CRD42019125947).The structured research question in PICPTR format was“Population”including patients with symptoms akin to CD,the“Index test”being anti-GP2 testing,the“Comparator”involved standard CD diagnosis,the“Purpose of test”being diagnostic,“Target disorder”was CD,and the“Reference standard”included standard clinical,radiological,endoscopical,and histological CD diagnostic criteria.Quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and hierarchical models were employed to synthesize the data.RESULTS Out of 722 studies retrieved,15 were meta-analyzed.Thirteen studies had industry-related conflicts-of-interest,and most included healthy donors as controls(spectrum bias).For the combination of IgA and/or IgG anti-GP2 test,the summary sensitivity was 20%(95%confidence interval:10%-29%)at a median specificity of 97%.If the test was applied in 10000 suspected patients,9669 would be true negatives and in 26,the diagnosis would be missed.In this hypothetical cohort,the anti-GP2 would fail to produce a diagnosis for 81.3%of the positive cases.Low summary points of sensitivity and high specificity were estimated for the IgG or IgA anti-GP2 test.Analogous results were observed when the analyses were restricted using specific cut-offs,or when ulcerative colitis patients were used as comparators.CONCLUSION Anti-GP2 tests demonstrate low sensitivity and high specificity.These results indicate that caution is required before relying on its 展开更多
基金教育部人文社会科学研究规划基金项目"资本成本价值创造与我国国企EVA考核研究"(批准号10YJA630146)+2 种基金国家社会科学基金项目"资本成本约束可持续分红与国有企业价值创造"(批准号11BGL026)北京市属高等学校高层次人才引进与培养计划项目(The Importation and Development of HighCaliber Talents Project of Beijing Municipal Institutions)之青年拔尖人才项目"基于资本成本锚定效应的公司财务政策优化研究"
文摘BACKGROUND Non-invasive criteria are needed for Crohn’s disease(CD)diagnosis,with several biomarkers being tested.Results of individual diagnostic test accuracy studies assessing the diagnostic value of pancreatic autoantibodies-to-glycoprotein-2(anti-GP2)tests for the diagnosis of CD appear promising.AIM To systematically review and meta-analyze evidence on the diagnostic accuracy of anti-GP2 tests in patients with suspected/confirmed CD.METHODS An electronic search was conducted on PubMed,Cochrane-CENTRAL and grey literature(CRD42019125947).The structured research question in PICPTR format was“Population”including patients with symptoms akin to CD,the“Index test”being anti-GP2 testing,the“Comparator”involved standard CD diagnosis,the“Purpose of test”being diagnostic,“Target disorder”was CD,and the“Reference standard”included standard clinical,radiological,endoscopical,and histological CD diagnostic criteria.Quality was assessed with the Quality Assessment of Diagnostic Accuracy Studies-2 tool and hierarchical models were employed to synthesize the data.RESULTS Out of 722 studies retrieved,15 were meta-analyzed.Thirteen studies had industry-related conflicts-of-interest,and most included healthy donors as controls(spectrum bias).For the combination of IgA and/or IgG anti-GP2 test,the summary sensitivity was 20%(95%confidence interval:10%-29%)at a median specificity of 97%.If the test was applied in 10000 suspected patients,9669 would be true negatives and in 26,the diagnosis would be missed.In this hypothetical cohort,the anti-GP2 would fail to produce a diagnosis for 81.3%of the positive cases.Low summary points of sensitivity and high specificity were estimated for the IgG or IgA anti-GP2 test.Analogous results were observed when the analyses were restricted using specific cut-offs,or when ulcerative colitis patients were used as comparators.CONCLUSION Anti-GP2 tests demonstrate low sensitivity and high specificity.These results indicate that caution is required before relying on its
