Meta-analysis of diagnostic tests for acute sinusitis

被引:67
作者
Engels, EA
Terrin, N
Barza, M
Lau, J
机构
[1] Tufts Univ, Sch Med, New England Med Ctr, Dept Med,Div Clin Care Res, Boston, MA 02111 USA
[2] Tufts Univ, Sch Med, New England Med Ctr, Dept Med,Div Geog Med & Infect Dis, Boston, MA 02111 USA
[3] Tufts Univ, Sch Med, New England Med Ctr, Tupper Res Inst, Boston, MA 02111 USA
关键词
sinusitis; diagnostic tests; meta-analysis; receiver operator curve; radiography; clinical examination;
D O I
10.1016/S0895-4356(00)00209-2
中图分类号
R19 [保健组织与事业(卫生事业管理)];
学科分类号
摘要
To facilitate management of acute sinusitis, we conducted a meta-analysis of published studies comparing diagnostic tests for this disorder. Thirteen studies were identified through literature search. Based on sinus puncture/aspiration (considered most accurate), 49-83 % of symptomatic patients had acute sinusitis. Compared with puncture/aspiration, radiography offered moderate ability to diagnose sinusitis (summary receiver operator curve [SROC] area, 0.83). Using sinus opacity or fluid as the criterion for sinusitis, radiography had sensitivity of 0.73 and specificity of 0.80. Studies evaluating ultrasonography revealed substantial variation in test performance. The clinical evaluation, particularly risk scores formally incorporating history and physical examination findings, had moderate ability to identify patients with positive radiographs (SROC area, 0.74). Many studies were of poor quality, with inadequately described test methods and unblinded test interpretation. In conclusion, acute sinusitis is common among symptomatic patients. Radiography and clinical evaluation (especially risk scores) appear to provide useful information for diagnosis of sinusitis. (C) 2000 Elsevier Science Inc. All rights reserved.
引用
收藏
页码:852 / 862
页数:11
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