Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis
Objectives There is a controversy on the diagnostic reliability and accuracy of synovial fluid α‐defensin in periprosthetic joint infection (PJI). We performed this meta‐analysis to evaluate the diagnostic accuracy of the α‐defensin lateral flow test in PJI. Methods PubMed, Embase, and the Cochrane...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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Wiley
2021-05-01
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| Series: | Orthopaedic Surgery |
| Subjects: | |
| Online Access: | https://doi.org/10.1111/os.12966 |
| _version_ | 1819081248097697792 |
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| author | Yu‐qing Zeng Shu Deng Xing‐yang Zhu Xiao‐bo Sun Wen‐jun Feng Jian‐chun Zeng Hai‐tao Zhang Yi‐rong Zeng |
| author_facet | Yu‐qing Zeng Shu Deng Xing‐yang Zhu Xiao‐bo Sun Wen‐jun Feng Jian‐chun Zeng Hai‐tao Zhang Yi‐rong Zeng |
| author_sort | Yu‐qing Zeng |
| collection | DOAJ |
| description | Objectives There is a controversy on the diagnostic reliability and accuracy of synovial fluid α‐defensin in periprosthetic joint infection (PJI). We performed this meta‐analysis to evaluate the diagnostic accuracy of the α‐defensin lateral flow test in PJI. Methods PubMed, Embase, and the Cochrane library were systematically searched, and articles (up to January 2020) on the diagnosis of hip and knee PJIs using the α‐defensin Synovasure lateral flow test were included. The diagnostic accuracy of the α‐defensin lateral flow test in PJI was evaluated using meta‐analysis. The pooled sensitivity, specificity, accuracy, positive and negative likelihood ratio, diagnostic odds ratio, and post‐test probabilities were calculated. Results Seventeen studies including 1443 cases were included. Meta‐analysis showed the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and a diagnostic odds ratio was 0.83 (95% CI 0.77, 0.88), 0.95 (95% CI 0.93, 0.97), 16.86 (95% CI 11.67, 24.37), 0.17 (95% CI 0.13, 0.24) and 85.30 (95% CI 47.76, 152.35), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.97 (95% CI 0.95, 0.98). Subgroup analysis also confirmed the high efficiency of α‐defensin Synovasure lateral flow test in diagnosing PJIs, irrespective of ethnicity. Fagan's nomogram analysis there was a high positive post‐test probability of 94% and a low negative post‐test probability of 15%. Conclusions We indicated that the α‐defensin lateral flow test had a high accuracy for diagnosing PJI. Large‐scale studies are needed to validate its significance in PJI diagnosis. |
| first_indexed | 2024-12-21T19:57:45Z |
| format | Article |
| id | doaj.art-3298cad1acaa4d428b75869a22913348 |
| institution | Directory Open Access Journal |
| issn | 1757-7853 1757-7861 |
| language | English |
| last_indexed | 2024-12-21T19:57:45Z |
| publishDate | 2021-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Orthopaedic Surgery |
| spelling | doaj.art-3298cad1acaa4d428b75869a229133482022-12-21T18:52:02ZengWileyOrthopaedic Surgery1757-78531757-78612021-05-0113370871810.1111/os.12966Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysisYu‐qing Zeng0Shu Deng1Xing‐yang Zhu2Xiao‐bo Sun3Wen‐jun Feng4Jian‐chun Zeng5Hai‐tao Zhang6Yi‐rong Zeng7The First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Hematology The First Affiliated Hospital of Zhejiang Chinese Medical University Hangzhou ChinaThe First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaThe First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaThe First Clinical Medical College Guangzhou University of Chinese Medicine Guangzhou ChinaDepartment of Orthopaedics The First Affiliated Hospital of Guangzhou University of Chinese Medicine Guangzhou ChinaObjectives There is a controversy on the diagnostic reliability and accuracy of synovial fluid α‐defensin in periprosthetic joint infection (PJI). We performed this meta‐analysis to evaluate the diagnostic accuracy of the α‐defensin lateral flow test in PJI. Methods PubMed, Embase, and the Cochrane library were systematically searched, and articles (up to January 2020) on the diagnosis of hip and knee PJIs using the α‐defensin Synovasure lateral flow test were included. The diagnostic accuracy of the α‐defensin lateral flow test in PJI was evaluated using meta‐analysis. The pooled sensitivity, specificity, accuracy, positive and negative likelihood ratio, diagnostic odds ratio, and post‐test probabilities were calculated. Results Seventeen studies including 1443 cases were included. Meta‐analysis showed the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and a diagnostic odds ratio was 0.83 (95% CI 0.77, 0.88), 0.95 (95% CI 0.93, 0.97), 16.86 (95% CI 11.67, 24.37), 0.17 (95% CI 0.13, 0.24) and 85.30 (95% CI 47.76, 152.35), respectively. The area under the hierarchical summary receiver operating characteristic curve was 0.97 (95% CI 0.95, 0.98). Subgroup analysis also confirmed the high efficiency of α‐defensin Synovasure lateral flow test in diagnosing PJIs, irrespective of ethnicity. Fagan's nomogram analysis there was a high positive post‐test probability of 94% and a low negative post‐test probability of 15%. Conclusions We indicated that the α‐defensin lateral flow test had a high accuracy for diagnosing PJI. Large‐scale studies are needed to validate its significance in PJI diagnosis.https://doi.org/10.1111/os.12966ArthroplastyPeriprosthetic joint infectionSystematic reviewα‐defensin lateral flow test |
| spellingShingle | Yu‐qing Zeng Shu Deng Xing‐yang Zhu Xiao‐bo Sun Wen‐jun Feng Jian‐chun Zeng Hai‐tao Zhang Yi‐rong Zeng Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis Orthopaedic Surgery Arthroplasty Periprosthetic joint infection Systematic review α‐defensin lateral flow test |
| title | Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis |
| title_full | Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis |
| title_fullStr | Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis |
| title_full_unstemmed | Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis |
| title_short | Diagnostic Accuracy of the Synovial Fluid α‐Defensin Lateral Flow Test in Periprosthetic Joint Infection: A Meta‐analysis |
| title_sort | diagnostic accuracy of the synovial fluid α defensin lateral flow test in periprosthetic joint infection a meta analysis |
| topic | Arthroplasty Periprosthetic joint infection Systematic review α‐defensin lateral flow test |
| url | https://doi.org/10.1111/os.12966 |
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