HSROC统计模型对超声诊断颞下颌关节盘前移位的Meta分析

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1、万方数据温州医科大学硕士学位论文ThediagnosticvalueofHigh·-ResolutionUltrasonographyfordetectionofanteriorDiscdisplacementofthe1'emporomandibularJoint：AMeta—analysisemployingtheHSRoCstatisticalmodelAbstractobjective：Toassessthediagnosticvalueofhigh—resolutionultrasonography(HR·us)indetectionofanteriordisc

2、displacement(ADD)ofthetemporomandibularjoint(TMJ)·Weperformedastatisticallyrigorousmeta-analysisusingaHierarchicalSummaryReceiverOperatingCharacteristic(HSROC)model．Methods：WesearchedforrelevanttrialsreportedinMEDLINE(1966一February2014)，theChineseNationalKnowledgeInfrastructureDatabase(19

3、94-February2014)，theChineseBiomedicalLiteratureDatabase(1978-February2014)，andEMbase(1974．February2014)．Wealsosearchedmanually．TworeviewersevaluatedthequalityofretrievedtrialdatausingtheQualityAssessmentofDiagnosticAccuracyStudies(QUADAS)evaluationcriterion．Datawereextractedandcross—check

4、ed，andameta．analysisperformedusingaHSROC(HierarchicalSummaryReceiverOperatingCharacteristiclmodel．TheclinicalutilityofresultswasestimatedusingtheFagan’SNomogramofBayes’theory．AlldatawereevaluatedusingStatal2．0software．Results：Atotalof1reportsfeaturing1,096subjectswasincludedinanalysis．All

5、dealtwiththeutilityofHR．US(high．resolutionultrasonography)intermsofdiagnosisofanteriordiscdisplacementwithreduction(ADDWR)andanteriordiscdisplacementwithoutreduction(ADDWoR)．ForADDWR(anteriordiscdisplacementwithreduction)，theweightedsensitivityandspecificitywere0．83(95％CI，0．78·0．88)andO．8

6、5(95％C1，0．76．0．92)respectively．Thelambdavaluewas3．41(95％CI，2．37．4．461andtheFagan’SNomogrampre—testprobability58％withapositivelikelihoodratio皿R)of6．01．Thepositivepost-testprobabilitywas89％withanegativelikelihoodratioof0．20．Thepost—testprobabilitywasminus21％；thepositiveincreaseindiagnosticu

7、tility31％：andthenegativedecrementinthatvalue4万方数据37％．TheuseofHR-US(high．resolutionultrasonography)todiagnoseADDWoRranteriordiscdisplacementwithoutreduction)wasassociatedwithweightedsensitivityandspecificityvaluesof0．72(95％CI，0．59-0．81)and0．90(95％CI，0．86．0．93)．respec