A Meta-Analysis of Diagnostic Test Accuracy (DTA) of the Endoscopic Ultrasound (EUS) and Magnetic Resonance Cholangiopancreatography (MRCP) in Detecting Choledocholithiasis
Bibliographic record
Abstract
Introduction: Published reports provide a wide range of sensitivity and specificity for EUS and MRCP in the diagnosis of the choledocholithiasis. However, a proper meta-analysis of DTA is lacking. Here, we aimed at determining and comparing the diagnostic accuracy of EUS and MRCP in detecting choledocholithiasis using appropriate methodology recommended by the Cochrane group. Methods: A comprehensive electronic literature search up to March 2016 was done by two reviewers for prospective cohort studies comparing EUS and MRCP to the gold standard in detecting choledocholithiasis. The gold standard was considered endoscopic retrograde cholangiopancreatography (ERCP), intra-operative cholangiography (IOC) or clinical follow up >3 months for negative cases. There was no restriction in terms of language, location or quality sof the studies. Abstracts, unpublished data, studies with insufficient data and pediatric studies were excluded. Quality of the included studies was measured using QUADAS-2 tool. Data analysis was done using DerSimonian Laird method (random effects model) on intention-to-treat data. Mantel-Haenszel or the DerSimonian Laird methods to estimate the overall diagnostic Odds Ratio (DOR) and hence to determine the best-fitting receiver operating characteristics (ROC) curve. Symmetrical ROC (sROC) was developed and area under curve (AUC) was calculated. Results: A total of five out of fourteen studies were included. Three studies were from Europe, one from Japan and one from the US. All studies had low risk of bias. The pooled sensitivity, specificity, DOR and AUC for EUS were 96.6(91.4-99.1)%, 89.7(83.3-94.3)%, 0.9771, 162.5(54.0-489.3), and 0.977 (SE:0.011,Q:0.932), respectively. The pooled sensitivity, specificity, DOR and AUC for MRCP were 87.1(79.6-92.6)%, 92.5(86.9-96.2)%, 79.0(23.8-262.2) and 0.95.2 (SE:0.027; Q:0.89), respectively. The difference between the AUC of diagnostic accuracy of EUS and MRCP was 0.0248 (SE:0.015) arithmetically in favor of EUS but it was not significantly different (p:0.10, two-tailed). Conclusion: Both EUS and MRCP provide very good diagnostic accuracy in detecting choledocholithiasis with slight arithmetical superiority with EUS. Individual participant data and meta-regression analyses may identify the characters that may benefit from one modality or the other.Figure 1Figure 2
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 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 teacher head, 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".