A systematic review and meta-analysis comparing the diagnostic accuracy of initial RT-PCR and CT scan in suspected COVID-19 patients.
A systematic review and meta-analysis comparing the diagnostic accuracy of initial RT-PCR and CT scan in suspected COVID-19 patients.
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DOI：
10.1259/bjr.20201039
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发表时间：
2021-03-01
期刊：
影响因子：
--
通讯作者：
Rea P
中科院分区：
文献类型：
--
作者：
Mair MD;Hussain M;Siddiqui S;Das S;Baker A;Conboy P;Valsamakis T;Uddin J;Rea P
进行系统评价和荟萃分析，以比较 CT 和初始逆转录聚合酶链反应 (RT-PCR) 检测 COVID-19 感染的诊断准确性。我们检索了 PubMed、EMBASE 和 EMCARE 三个数据库，以确定报告 2019 年 12 月至 2020 年 5 月期间 CT 和 RT-PCR 在检测 COVID-19 感染方面的诊断准确性的研究。为了准确比较，仅纳入那些同时接受 CT 和 RT-PCR 的患者的研究。使用双变量随机效应模型计算两项测试的汇总诊断准确性。根据纳入标准，最终分析中仅纳入了由 1834 名患者组成的 11 项研究，这些研究报告了同一组患者中 CT 和 RT-PCR 的诊断准确性。 CT 扫描的灵敏度估计范围为 0.69 至 1.00，RT-PCR 的灵敏度估计范围为 0.47 至 1.00。 CT 和 RT-PCR 的敏感性汇总估计值分别为 0.91 [95% CI (0.84–0.97)] 和 0.84 [95% CI (0.71–0.94)]。在亚组分析中，CT 和 RT-PCR 的汇总敏感性分别为 0.95 [95% CI (0.88–0.98)] 和 0.91 [95% CI (0.80–0.96)，p = o.ooo1]。 CT 和 RT-PCR 的汇总特异性分别为 0.31 [95% CI (0.035–0.84)] 和 1.00 [95% CI (0.96–1.00)]。 CT 在检测 COVID-19 感染方面比 RT-PCR 更敏感，但特异性很低。由于CT扫描的结果可以快速获得，因此它可以用作有阳性接触史或流行病学史的患者的辅助初步诊断测试。
To perform a systematic review and meta-analysis to compare the diagnostic accuracy of CT and initial reverse transcriptase polymerase chain reaction (RT-PCR) for detecting COVID-19 infection. We searched three databases, PubMed, EMBASE, and EMCARE, to identify studies reporting diagnostic accuracy of both CT and RT-PCR in detecting COVID-19 infection between December 2019 and May 2020. For accurate comparison, only those studies that had patients undergoing both CT and RT-PCR were included. Pooled diagnostic accuracy of both the tests was calculated by using a bivariate random effects model. Based on inclusion criteria, only 11 studies consisting of 1834 patients were included in the final analysis that reported diagnostic accuracy of both CT and RT-PCR, in the same set of patients. Sensitivity estimates for CT scan ranged from 0.69 to 1.00 and for RT-PCR varied ranging from 0.47 to 1.00. The pooled estimates of sensitivity for CT and RT-PCR were 0.91 [95% CI (0.84–0.97)] and 0.84 [95% CI (0.71–0.94)], respectively. On subgroup analysis, pooled sensitivity of CT and RT-PCR was 0.95 [95% CI (0.88–0.98)] and 0.91 [95% CI (0.80–0.96), p = o.ooo1]. The pooled specificity of CT and RT-PCR was 0.31 [95% CI (0.035–0.84)] and 1.00 [95% CI (0.96–1.00)]. CT is more sensitive than RT-PCR in detecting COVID-19 infection, but has a very low specificity. Since the results of a CT scan are available quickly, it can be used as an adjunctive initial diagnostic test for patients with a history of positive contact or epidemiological history.
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