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The diagnostic value of high-resolution ultrasonography for detecting of anterior disc displacement of temporomandibular joint: a meta-analysis by HSROC statistical model
DONG Xiao-yu, ZHU Zu-feng, ZHANG Xin-li, HE Shuai
2014, 12 (3):
266-272.
PURPOSE: To assess the diagnostic value of high-resolution ultrasonography for detecting anterior disc displacement of temporomandibular joint using HSROC statistical model. METHODS: The relevant trials were searched in the databases of PubMed (1966-2013.9), CNKI(1994-2013.9), CBM(1978-2013.9), Embase(1974-2013.9), VIP(1994-2013.9) database and manual searching was also conducted, two reviewers evaluated the quality of the included trials according to the QUADAS evaluation criterion, the data was extracted and then cross-checked, meta-analysis was conducted by HSROC statistical model, the clinical utility of the results was estimated according to the Fagan’s Nomogram of Bayes'theory. All the included data was analyzed using Stata12.0 software package. RESULTS: Twelve literatures and 1137 subjects were included. The results of HR-US in diagnosis of ADDWR were: the weighted sensitivity and specificity were 0.84 (95%CI=0.76-0.90) and 0.87 (95%CI=0.77-0.93), beta=0.33 (95%CI=0.15-0.81), Z=0.135, P=0.179>0.1, Lambda=3.65 (95%CI=2.53-4.77), fagan pre-test probability =58%, +LR=6.7, positive post-test probability=90%, -LR=0.17, negative post-test probability=20%; The results of HR-US in diagnosis of ADDWoR were: weighted sensitivity and specificity were 0.76 (95%CI=0.61-0.86)and 0.92 (95%CI=0.87-0.95), beta=-0.41 (95%CI=-1.17-0.35), Z=-1.05, P=0.294>0.1, Lambda=3.99 (95%CI=2.71-5.27), fagan pre-test probability =38%,+LR=9.8,positive post-test probability =83%,-LR=0.25, negative post-test probability=16%. CONCLUSIONS: HR-US had good performance in the diagnosis of ADD, it is of superior diagnostic value in detecting ADDWR than ADDWoR, and it can be used as a new clinical diagnosis method for rapid diagnosis of ADD. Supported by Medical Research Projects of Nanjing Military Command, PLA (06MA151, 20080987, Y07010, 11Z007).
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