AIM: Although absolute values for C-reactive protein (CRP) and procalcitonin (PCT) are well known to predict sepsis, it remains unclear how their diagnostic value in major burn patients as metabolic changes in burn patient mimic signs and symptoms for sepsis. This paper attempts to clarify these points for both of the markers.
METHODS: A comprehensive literature search of PubMed, Scopus, DOAJ, Web of Science, and the Cochrane Library databases for studies published up to June 1, 2020, that evaluated PCT and/or CRP as a marker for diagnosing sepsis in burn patients was conducted. Review Manager 5.3 was used to analyze the data.
RESULTS: A total of 11 literatures were obtained. The combined sensitivity and specificity for PCT as assessed by meta-analysis were 88% and 89%, respectively. The combined sensitivity and specificity of CRP were described as 85.5% and 57.5%, respectively. Meta-analysis cannot be performed for CRP parameters because there are only two literatures that include CRP diagnostic test values.
DISCUSSION: PCT and CRP have additional diagnostic value for sepsis in patients with major burns. The pooled sensitivity and specificity of PCT are excellent. Although the difference in sensitivity between PCT and CRP is not very large, there are distinct differences in specificity. A low CRP specificity value will show many “false positives” when CRP is used as a biomarker.
CONCLUSION: PCT provides a better diagnostic value than CRP in cases of sepsis in major burn patients. More study on combination of biomarker, clinical presentation, and microbial culture for diagnosing sepsis are needed. Further large-scale research with cohort or case control design should be done.
Aim: To assess M2BPGi serum performance compared to liver biopsy in diagnosisng liver fibrosisMethod: Literature search using Pubmed®, Ebsco®, ProQuest®, Scopus®, Clinical Key databases, and the Cochrane Library® yield four relevant and full-text articles. The four articles were critically appraised for its validity, importance, and applicability.Results: Sensitivity and specificity in all four studies showed that M2BPGi serum was inadequate to ruling in and ruling out the diagnosis of liver fibrosis in chronic hepatitis B patients. The difference in M2BPGi cut-off value to determine the stage of fibrosis in each study makes this value cannot be used as an accurate standard to determine the advanced stage (F≥3) of liver fibrosis. On the other hand, M2BPGi serum combined with other tests are known to improve the diagnostic accuracy.Conclusion: MBP2Gi serum cannot be used as a diagnostic modality for detecting liver fibrosis in chronic hepatitis B patients.
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