Systematic review, meta-analysis and economic modelling of ...

DOI: 10.3310/hta17010 Health Technology Assessment 2013 Vol. 17 No. 1Representative spectrum?Acceptable reference standard?Acceptable delay between tests?Partial verification avoided?Differential verification avoided?Incorporation avoided?Reference standard results blinded?Index test results blinded?Body 2011 57 ++++++–+Cete 2010 58 ++++++??Charpentier 2010 59 ++++++++Di Serio 2005 63 ??+?++??Ecollan 2007 64 ++++++??Garcia-Valdecasas 2011 49 ++?+++++Haltern 2010 67 ++++++??Hjortshoj 2010 68 ++++++??Ilva 2009 50 ++++++??LeFevre 2007 72 ??++++++Li 2010 73 ++++++++Liao 2009 74 +??++?––Mad 2007 75 +??++?++McCann 2008 76 +++++?++Mion 2007 77 –+++?+??Naroo 2009 78 ++++++++Valle 2007 82 +?+++++?FIGURE 14 Quality assessment of diagnostic studies of H-FABP.test characteristics. Reporting of exclusion criteria was variable and some studies excluded patients withdiagnostic ECG changes. The prevalence of MI was generally high and varied from 18% to 73%. Themedian time from symptom onset to sampling varied from 2.2 to 7.8 hours. There was no consistencyin the diagnostic threshold used. It ranged from 51 to 150 µg/l and 5 out of 13 studies used differentthresholds for men and women, whereas 8 out of 13 studies used the same threshold. Several studies usedrelatively high thresholds for positivity for the reference standard troponin or did not report the timing ofsampling or the assay used.Quality assessment of diagnostic studies of myoglobinFigure 21 shows the quality assessments for studies of myoglobin, whereas Figure 22 shows themethodological quality summary. The quality assessment of acceptability of the reference standard waslimited to whether or not the reference standard criteria were reported clearly and met the universal© Queen’s Printer and Controller of HMSO 2013. This work was produced by Goodacre et al. under the terms of a commissioning contract issued by the Secretary of Statefor Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journalsprovided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should beaddressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton SciencePark, Southampton SO16 7NS, UK.39