A Systematic Review of Screening Tests for Chronic Kidney Disease: An Accuracy Analysis

Abstract

This systematic review was conducted to assess the diagnostic accuracy of chronic kidney disease screening tests in the general population. MEDLINE, EMBASE, Web of Science, Scopus, The Cochrane Library and ProQuest databases were searched for English-language publications up to November 2016. Two reviewers independently screened studies and extracted study data in standardized tables. Methodological quality was assessed using the QUADAS-2 tool. Sensitivity and specificity of all available screening methods were identified through included studies. Ten out of 1349 screened records included for final analysis. Sensitivities of the dipstick test with a cutoff value of trace were ranged from 37.1% to 69.4% and specificities from 93.7% to 97.3% for the detection of ACR>30 mg/g. The diagnostic sensitivities of the UAC>10 mg/dL testing was shown to vary from 40% to 87%, and specificities ranged from 75% to 96%. While the sensitivities of ACR were fluctuating between 74% and 90%, likewise the specificities were between 77% and 88%. Sensitivities for C-G, Grubb and Larsson equations were 98.9%, 86.2%, and 70.1% respectively. In the meantime the study showed specificities of 84.8%, 84.2% and 90.5% respectively for these equations. Individual studies were highly heterogeneous in terms of target populations, type of screening tests, thresholds used to detect CKD and variations in design. Results pointed to the superiority of UAC and dipstick over the other tests in terms of all parameters involved. The diversity of methods and thresholds for detection of CKD, necessitate considering the cost parameter along with the effectiveness of tests to scale-up an efficient strategy. [GMJ.2020;9:e1573]

Paper spray mass spectrometry combined with machine learning as a rapid diagnostic for chronic kidney disease

“…Nevertheless, these results provide evidence that PS-MS generated data has the potential to be used as a diagnostic tool for CKD: current screening tests based on ACR values provide sensitivity of 74-90% and specificity of 77-88%. 48 Since PS-MS in negative mode provided better clinical performance values, the next step aimed to tentatively identify the negative ion mode features (m/z) selected by random forest that contributed most to the classification model. It is important to note that chemical information for the m/z features is not implicitly necessary for the proposed technique to be used as a diagnostic tool.…”

“…Nevertheless, these results provide evidence that PS-MS generated data has the potential to be used as a diagnostic tool for CKD: current screening tests based on ACR values provide sensitivity of 74–90% and specificity of 77–88%. 48…”

The Effectiveness of Fluoride Varnish and Fissure Sealant in Elementary School Children: A Systematic Review and Meta-Analysis

“…The TREND statement has a 22-item (57 sub-item) checklist specifically developed to guide standardized reporting of nonrandomized-controlled trials. In these reviews, studies from different dimensions such as Sequence generation, allocation concealment, blinding, incomplete outcome data, and selective outcome reporting and other sources of bias were examined ( 20 – 24 ).…”

Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method

“…The same operator on each sample performed both dipstick and microscopic analysis. Positive dipstick or positive microscopy was defined if one or more parameters met the threshold for positivity (Table 1) 1,2,[12][13][14][15][16][17][18][19][20][21][22][23][24] , giving each sample a classification for dipstick (positive or negative) and microscopic (positive or negative) analysis. The dipstick analysis was considered the index test and the microscopic analysis as the reference standard.…”