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Voiding cystourethrography as a predictor of reflux nephropathy in children with urinary-tract infection. For dipsticks measuring urinary leukocyte esterase 14 studies [ 2028343643565760636672849495 ] and for dipsticks for the presence of either nitrite or leukocyte esterase 15 studies [ 19 – 2128345660636684 – 869294 – 96 ], no items showed strong evidence of an association with the DOR in the weighted analysis. For dipstick to detect urinary nitrite 23 studies [ 20262834364041435254 – 576063667274848893 – 95 ], the weighted analysis found that studies reporting that clinical review bias had been avoided had a DOR 4.

Abstract Background The use of systematic literature review to inform evidence based practice in diagnostics is rapidly expanding. Diagnostic value of symptoms and clean-voided urine specimen in childhood urinary tract infection. We hypothesised that the components of methodological quality affecting results were likely to differ between the three sections of the review. Were withdrawals from the study explained?

A number of the items found to be associated with test performance related to specific test methodologies e. Tests used to localise infection spanned both categories.

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How does study quality affect the results of a diagnostic meta-analysis?

Urinary glucose unreliable as test for urinary tract infection in infancy. Without significant improvements in the reporting of sxamen studies, progress in this area will be limited.

Ultrasound and plain X-ray screening in bacteerioscopico urinary tract infection. Statistical Methods in Medical Research. Annals of tropical paediatrics. This method has two advantages over the standard methods: This meant that further analysis to investigate heterogeneity could only be undertaken using a subset of studies, and that the findings are open to various interpretations.

Is the time period between reference standard and index test short enough to be reasonably sure that the target condition did not change between the two tests?

Comparison of echo-enhanced ultrasound with fluoroscopic MCU for the detection of vesicoureteral reflux in neonates. The QUADAS tool facilitates systematic evaluation of the quality of diagnostic accuracy studies, and was specifically developed for use in systematic reviews of diagnostic tests [ 12 ].

Did patients receive the same reference standard regardless of the index test result? Canadian Medical Association Journal. Often factors that lead to an increase in sensitivity will lead to a decrease in specificity and vice versa.

Systematic reviews in healthcare: Table 4 Results of the regression analysis for microscopy for the diagnosis of UTI. Appropriate methods for rigorous evaluation of diagnostic technologies have been well established [ 1 – 5 ]. The detection of reflux nephropathy in infants by 99mtechnetium dimercaptosuccinic acid studies.


Comparison of ultrasound examination bacterioscopici intravenous urography after a urinary tract infection. Detection of low-grade vesicoureteral reflux in children by color Doppler imaging mode. Were the same clinical data available when test results were interpreted as would be available when the test is used in practice? They also read and approved the final manuscript.

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Lindsell D, Moncrieff M. The common practice of using summary quality scores in systematic reviews has been widely debated elsewhere [ – ]. As with studies of the diagnosis of UTI, reporting of clinical review bias, handling of uninterpretable results, and withdrawals from the study was poor. Does urinary tract ultrasonography at hospitalization for acute pyelonephritis predict vesicoureteral reflux? As in all previous groups, studies also provided very little information on whether appropriate clinical information was available when test results were interpreted, how uninterpretable results were handled, and whether there were any withdrawals from the study and if so whether all withdrawals were accounted for.

Were hacterioscopico reference standard results interpreted without knowledge of the results of the index test?