A124 THE DIAGNOSTIC ACCURACY OF BLOOD AND TISSUE-BASED TESTS FOR CYTOMEGALOVIRUS REACTIVATION IN INFLAMMATORY BOWEL DISEASE: A SYSTEMATIC REVIEW AND META-ANALYSIS
Bibliographic record
Abstract
Several diagnostic techniques exist to detect cytomegalovirus (CMV) reactivation in inflammatory bowel disease (IBD). The accuracy of these tests compared to one another remains poorly defined. As such, the aim of this study was to compare the sensitivity and specificity of diagnostic tests for CMV reactivation in IBD. Multiple electronic databases were searched through July 2015 for cross-sectional and cohort studies comparing the accuracy (sensitivity and specificity) of at least two diagnostic tests for CMV reactivation in IBD. Initially, the accuracy of blood-based tests (whole blood PCR (bPCR) or pp65 antigenemia assay) was determined using tissue-based tests (tissue PCR (tPCR), immunohistochemistry (IHC) or hemotoxylin and eosin (H&E)) as the reference standard. Next the accuracy of individual tissue-based tests was assessed. Weighted summary estimates were determined by bivariate analysis, with random-effects or fixed-effects modelling when appropriate. Individual study quality was assessed by the QUADAS-2 tool. Twelve studies compared blood-based tests (6 by bPCR, 5 by pp65, 1 by both) with tissue-based tests. The overall sensitivity and specificity of blood-based tests was 65% (95% CI, 31–99%) and 92% (95% CI, 89–96%) respectively. The sensitivity of bPCR was 63% (95% CI, 51–76%), and the sensitivity of pp65 antigenemia was 39% (95% CI, 27–52%). Eight studies compared histopathology (5 by H&E and 4 by IHC) with tPCR. The sensitivity of H&E was 6.2% (95% CI, 2.2–16.3%), and the sensitivity of IHC was 28.3% (95% CI, 12.2–52.8%) when compared to tPCR as the reference standard. Specificity was high for H&E (98.1%; 95% CI, 94.2–99.4%), and IHC (98.0%; 95% CI, 92.2–99.5%). Studies were limited by low study quality and in the ability to compare clinically relevant CMV reactivation. Our study demonstrates that blood-based tests and H&E are insensitive markers for CMV reactivation in IBD and should not be used as sole diagnostic tests. None
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.018 | 0.056 |
| Meta-epidemiology (narrow) | 0.003 | 0.002 |
| Meta-epidemiology (broad) | 0.015 | 0.039 |
| Bibliometrics | 0.010 | 0.010 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.004 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".