Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy

Intraoperative parathyroid hormone (iPTH) monitoring is standard-of-care in the surgical management of hyperparathyroidism. It involves real-time determination of circulating PTH levels to guide parathyroid gland excision. There exists several iPTH monitoring criteria, such as the Miami criteria, an...

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Main Authors: Phillip Staibano, Kevin Um, Sheila Yu, Mohit Bhandari, Michael K. Gupta, Michael Au, JEM (Ted) Young, Han Zhang
Format: Article
Language:English
Published: Frontiers Media S.A. 2024-01-01
Series:Frontiers in Surgery
Subjects:
Online Access:https://www.frontiersin.org/articles/10.3389/fsurg.2023.1298611/full
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author Phillip Staibano
Kevin Um
Sheila Yu
Mohit Bhandari
Michael K. Gupta
Michael Au
JEM (Ted) Young
Han Zhang
author_facet Phillip Staibano
Kevin Um
Sheila Yu
Mohit Bhandari
Michael K. Gupta
Michael Au
JEM (Ted) Young
Han Zhang
author_sort Phillip Staibano
collection DOAJ
description Intraoperative parathyroid hormone (iPTH) monitoring is standard-of-care in the surgical management of hyperparathyroidism. It involves real-time determination of circulating PTH levels to guide parathyroid gland excision. There exists several iPTH monitoring criteria, such as the Miami criteria, and a lack of standardization in the timing of post-parathyroid gland excision samples. We present a protocol of a systematic review and network meta-analysis of diagnostic test accuracy to identify the iPTH criteria and post-gland excision timepoint that best predicts surgical cure in hyperparathyroidism. The database search strategy will be developed in conjunction with a librarian specialist. We will perform a search of Medline (Ovid), EMBASE (Ovid), CINAHL, Cochrane Collaboration, and Web of Science from 1990–present. Studies will be eligible if they include adult patients diagnosed with hyperparathyroidism who undergo parathyroidectomy with iPTH monitoring. We will only include studies that report diagnostic test properties for iPTH criteria and/or post-excision sampling timepoints. All screening, full-text review, data extraction, and critical appraisal will be performed in duplicate. Critical appraisal will be performed using QUADAS-2 instrument. A descriptive analysis will present study and critical appraisal characteristics. We will perform evaluation of between-study heterogeneity using I2 and Cochrane Q and where applicable, we will perform sensitivity analysis. Our network meta-analysis will include Bayesian hierarchical framework with random effects using multiple models. Ethics approval is not required. This proposed systematic review will utilize a novel Bayesian network meta-analysis model to help standardize iPTH monitoring in hyperparathyroidism, thereby optimizing patient outcomes and healthcare expenditures.
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spelling doaj.art-5d3ab56251af43cb8d00898cc1e8a0d02024-01-04T04:20:43ZengFrontiers Media S.A.Frontiers in Surgery2296-875X2024-01-011010.3389/fsurg.2023.12986111298611Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracyPhillip Staibano0Kevin Um1Sheila Yu2Mohit Bhandari3Michael K. Gupta4Michael Au5JEM (Ted) Young6Han Zhang7Division of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaDepartment of Medicine, McMaster University, Hamilton, ON, CanadaDivision of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaDepartment of Surgery, McMaster University, Hamilton, ON, CanadaDivision of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaDivision of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaDivision of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaDivision of Otolaryngology–Head and Neck Surgery, Department of Surgery, McMaster University, Hamilton, ON, CanadaIntraoperative parathyroid hormone (iPTH) monitoring is standard-of-care in the surgical management of hyperparathyroidism. It involves real-time determination of circulating PTH levels to guide parathyroid gland excision. There exists several iPTH monitoring criteria, such as the Miami criteria, and a lack of standardization in the timing of post-parathyroid gland excision samples. We present a protocol of a systematic review and network meta-analysis of diagnostic test accuracy to identify the iPTH criteria and post-gland excision timepoint that best predicts surgical cure in hyperparathyroidism. The database search strategy will be developed in conjunction with a librarian specialist. We will perform a search of Medline (Ovid), EMBASE (Ovid), CINAHL, Cochrane Collaboration, and Web of Science from 1990–present. Studies will be eligible if they include adult patients diagnosed with hyperparathyroidism who undergo parathyroidectomy with iPTH monitoring. We will only include studies that report diagnostic test properties for iPTH criteria and/or post-excision sampling timepoints. All screening, full-text review, data extraction, and critical appraisal will be performed in duplicate. Critical appraisal will be performed using QUADAS-2 instrument. A descriptive analysis will present study and critical appraisal characteristics. We will perform evaluation of between-study heterogeneity using I2 and Cochrane Q and where applicable, we will perform sensitivity analysis. Our network meta-analysis will include Bayesian hierarchical framework with random effects using multiple models. Ethics approval is not required. This proposed systematic review will utilize a novel Bayesian network meta-analysis model to help standardize iPTH monitoring in hyperparathyroidism, thereby optimizing patient outcomes and healthcare expenditures.https://www.frontiersin.org/articles/10.3389/fsurg.2023.1298611/fullparathyroidhyperparathyroidismnetwork meta-analysissurgeryintraoperative parathyroid hormone (PTH) assay
spellingShingle Phillip Staibano
Kevin Um
Sheila Yu
Mohit Bhandari
Michael K. Gupta
Michael Au
JEM (Ted) Young
Han Zhang
Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
Frontiers in Surgery
parathyroid
hyperparathyroidism
network meta-analysis
surgery
intraoperative parathyroid hormone (PTH) assay
title Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
title_full Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
title_fullStr Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
title_full_unstemmed Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
title_short Intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism: a protocol for a network meta-analysis of diagnostic test accuracy
title_sort intraoperative parathyroid hormone monitoring in parathyroidectomy for hyperparathyroidism a protocol for a network meta analysis of diagnostic test accuracy
topic parathyroid
hyperparathyroidism
network meta-analysis
surgery
intraoperative parathyroid hormone (PTH) assay
url https://www.frontiersin.org/articles/10.3389/fsurg.2023.1298611/full
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