Summary of Glaucoma Diagnostic Testing Accuracy: An Evidence-Based Meta-Analysis.
Summary of Glaucoma Diagnostic Testing Accuracy: An Evidence-Based Meta-Analysis.
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DOI：
10.14740/jocmr2643w
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发表时间：
2016-09
期刊：
影响因子：
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通讯作者：
Hodge W
中科院分区：
文献类型：
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作者：
Ahmed S;Khan Z;Si F;Mao A;Pan I;Yazdi F;Tsertsvadze A;Hutnik C;Moher D;Tingey D;Trope GE;Damji KF;Tarride JE;Goeree R;Hodge W
新的青光眼诊断技术正在渗透临床护理，并正在迅速变化。对这些技术进行系统的回顾将有助于临床医生和决策者，并有助于确定需要解决的差距。本系统性综述研究了5种青光眼技术，并将其与青光眼检测的白色视野检查的白色金标准进行了比较。奥维德®接口：检索MEDLINE®（过程中和其他非索引引文）、EMBASE®、BIOSIS Previews®、CINAHL®、PubMed和科克伦图书馆。还进行了灰色文献检索。使用了技术专家小组、信息专家、系统评价方法专家和生物统计学家。创建PRISMA流程图，并进行随机效应荟萃分析。共筛选了2，474篇文章。发现倍频技术（FDT）的准确性最高（诊断比值比（DOR）：57.7），其次是蓝黄视野（DOR：46.7），光学相干断层扫描（OCT）（DOR：41.8），GDx（DOR：32.4）和海德堡视网膜断层扫描（HRT）（DOR：17.8）。最令人担忧的是，异质性检验均高于50%，这表明这些新技术中使用的截止值差异很大，并且在研究中不一致。青光眼含量专家需要为这些新技术建立统一的截止值，以便比较这些技术的研究可以得到更统一的解释。然而，目前的综合数据表明，在最新技术中，OCT具有最高的青光眼诊断准确性，其次是GDx，然后是HRT。
New glaucoma diagnostic technologies are penetrating clinical care and are changing rapidly. Having a systematic review of these technologies will help clinicians and decision makers and help identify gaps that need to be addressed. This systematic review studied five glaucoma technologies compared to the gold standard of white on white perimetry for glaucoma detection. OVID® interface: MEDLINE® (In-Process & Other Non-Indexed Citations), EMBASE®, BIOSIS Previews®, CINAHL®, PubMed, and the Cochrane Library were searched. A gray literature search was also performed. A technical expert panel, information specialists, systematic review method experts and biostatisticians were used. A PRISMA flow diagram was created and a random effect meta-analysis was performed. A total of 2,474 articles were screened. The greatest accuracy was found with frequency doubling technology (FDT) (diagnostic odds ratio (DOR): 57.7) followed by blue on yellow perimetry (DOR: 46.7), optical coherence tomography (OCT) (DOR: 41.8), GDx (DOR: 32.4) and Heidelberg retina tomography (HRT) (DOR: 17.8). Of greatest concern is that tests for heterogeneity were all above 50%, indicating that cutoffs used in these newer technologies were all very varied and not uniform across studies. Glaucoma content experts need to establish uniform cutoffs for these newer technologies, so that studies that compare these technologies can be interpreted more uniformly. Nevertheless, synthesized data at this time demonstrate that amongst the newest technologies, OCT has the highest glaucoma diagnostic accuracy followed by GDx and then HRT.