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• W1829320970 abstract "In clinically suspected scaphoid fractures, early diagnosis reduces the risk of non-union and minimises loss in productivity resulting from unnecessary cast immobilisation. Since initial radiographs do not exclude the possibility of a fracture, additional imaging is needed. Computed tomography (CT), magnetic resonance imaging (MRI) and bone scintigraphy (BS) are widely used to establish a definitive diagnosis, but there is uncertainty about the most appropriate method.The primary aim of this study is to identify the most suitable diagnostic imaging strategy for identifying clinically suspected fractures of the scaphoid bone in patients with normal radiographs. Therefore we looked at the diagnostic performance characteristics of the most used imaging modalities for this purpose: computed tomography, magnetic resonance imaging and bone scintigraphy.In July 2012, we searched the Cochrane Register of Diagnostic Test Accuracy Studies, MEDLINE, EMBASE, the Database of Abstracts of Reviews of Effects, the Cochrane Central Register of Controlled Trials, the NHS Economic Evaluation Database. In September 2012, we searched MEDION, ARIF, Current Controlled Trials, the World Health Organization (WHO) International Clinical Trials Registry Platform, conference proceedings and reference lists of all articles.We included all prospective or retrospective studies involving a consecutive series of patients of all ages that evaluated the accuracy of BS, CT or MRI, or any combination of these, for diagnosing suspected scaphoid fractures. We considered the use of one or two index tests or six-week follow-up radiographs as adequate reference standards.Two review authors independently screened titles and abstracts and assessed full-text reports of potentially eligible studies. The same authors extracted data from full-text reports and assessed methodological quality using the QUADAS checklist. For each index test, estimates of sensitivity and specificity from each study were plotted in ROC space; and forest plots were constructed for visual examination of variation in test accuracy. We performed meta-analyses using the HSROC model to produce summary estimates of sensitivity and specificity.We included 11 studies that looked at diagnostic accuracy of one or two index tests: four studies (277 suspected fractures) looked at CT, five studies (221 suspected fractures) looked at MRI and six studies (543 suspected fractures) looked at BS. Four of the studies made direct comparisons: two studies compared CT and MRI, one study compared CT and BS, and one study compared MRI and BS. Overall, the studies were of moderate to good quality, but relevant clinical information during evaluation of CT, MRI or BS was mostly unclear or unavailable.As few studies made direct comparisons between tests with the same participants, our results are based on data from indirect comparisons, which means that these results are more susceptible to bias due to confounding. Nonetheless, the direct comparisons showed similar patterns of differences in sensitivity and specificity as for the pooled indirect comparisons.Summary sensitivity and specificity of CT were 0.72 (95% confidence interval (CI) 0.36 to 0.92) and 0.99 (95% CI 0.71 to 1.00); for MRI, these were 0.88 (95% CI 0.64 to 0.97) and 1.00 (95% CI 0.38 to 1.00); for BS, these were 0.99 (95% CI 0.69 to 1.00) and 0.86 (95% CI 0.73 to 0.94). Indirect comparisons suggest that diagnostic accuracy of BS was significantly higher than CT and MRI; and CT and MRI have comparable diagnostic accuracy. The low prevalence of a true fracture among suspected fractures (median = 20%) means the lower specificity for BS is problematic. For example, in a cohort of 1000 patients, 112 will be over-treated when BS is used for diagnosis. If CT is used, only 8 will receive unnecessary treatment. In terms of missed fractures, BS will miss 2 fractures and CT will miss 56 fractures.Although quality of the included studies is moderate to good, findings are based on only 11 studies and the confidence intervals for the summary estimates are wide for all three tests. Well-designed direct comparison studies including CT, MRI and BS could give valuable additional information.Bone scintigraphy is statistically the best diagnostic modality to establish a definitive diagnosis in clinically suspected fractures when radiographs appear normal. However, physicians must keep in mind that BS is more invasive than the other modalities, with safety issues due to level of radiation exposure, as well as diagnostic delay of at least 72 hours. The number of overtreated patients is substantially lower with CT and MRI.Prior to performing comparative studies, there is a need to raise the initially detected prevalence of true fractures in order to reduce the effect of the relatively low specificity in daily practice. This can be achieved by improving clinical evaluation and initial radiographical assessment." @default.
• W1829320970 created "2016-06-24" @default.
• W1829320970 creator A5000192723 @default.
• W1829320970 creator A5030765772 @default.
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• W1829320970 creator A5039422690 @default.
• W1829320970 creator A5055866859 @default.
• W1829320970 creator A5075606139 @default.
• W1829320970 date "2015-06-05" @default.
• W1829320970 modified "2023-10-17" @default.
• W1829320970 title "Computed tomography versus magnetic resonance imaging versus bone scintigraphy for clinically suspected scaphoid fractures in patients with negative plain radiographs" @default.
• W1829320970 cites W157253676 @default.
• W1829320970 cites W1963859299 @default.
• W1829320970 cites W1969247465 @default.
• W1829320970 cites W1972466901 @default.
• W1829320970 cites W1973132152 @default.
• W1829320970 cites W1974760471 @default.
• W1829320970 cites W1978522025 @default.
• W1829320970 cites W1982254921 @default.
• W1829320970 cites W1988835037 @default.
• W1829320970 cites W1991550083 @default.
• W1829320970 cites W1993339050 @default.
• W1829320970 cites W1995978288 @default.
• W1829320970 cites W1996631639 @default.
• W1829320970 cites W1997316634 @default.
• W1829320970 cites W2008772884 @default.
• W1829320970 cites W2009495754 @default.
• W1829320970 cites W2011485447 @default.
• W1829320970 cites W2016947043 @default.
• W1829320970 cites W2018961956 @default.
• W1829320970 cites W2019327278 @default.
• W1829320970 cites W2021113829 @default.
• W1829320970 cites W2022682154 @default.
• W1829320970 cites W2026541793 @default.
• W1829320970 cites W2028677160 @default.
• W1829320970 cites W2029512557 @default.
• W1829320970 cites W2031390339 @default.
• W1829320970 cites W2031589895 @default.
• W1829320970 cites W2032634805 @default.
• W1829320970 cites W2033561286 @default.
• W1829320970 cites W2036211005 @default.
• W1829320970 cites W2041969074 @default.
• W1829320970 cites W2046204776 @default.
• W1829320970 cites W2046206113 @default.
• W1829320970 cites W2046822063 @default.
• W1829320970 cites W2048427052 @default.
• W1829320970 cites W2051064711 @default.
• W1829320970 cites W2051502628 @default.
• W1829320970 cites W2054060544 @default.
• W1829320970 cites W2055258676 @default.
• W1829320970 cites W2057475313 @default.
• W1829320970 cites W2061049789 @default.
• W1829320970 cites W2062029701 @default.
• W1829320970 cites W2065412675 @default.
• W1829320970 cites W2065477126 @default.
• W1829320970 cites W2067069142 @default.
• W1829320970 cites W2069263863 @default.
• W1829320970 cites W2073155895 @default.
• W1829320970 cites W2073512559 @default.
• W1829320970 cites W2074927557 @default.
• W1829320970 cites W2087479654 @default.
• W1829320970 cites W2087635247 @default.
• W1829320970 cites W2094513408 @default.
• W1829320970 cites W2099693918 @default.
• W1829320970 cites W2102146152 @default.
• W1829320970 cites W2104080412 @default.
• W1829320970 cites W2108100057 @default.
• W1829320970 cites W2113404529 @default.
• W1829320970 cites W2114427159 @default.
• W1829320970 cites W2121875129 @default.
• W1829320970 cites W2126511714 @default.
• W1829320970 cites W2126718057 @default.
• W1829320970 cites W2127368085 @default.
• W1829320970 cites W2131108685 @default.
• W1829320970 cites W2132877548 @default.
• W1829320970 cites W2136894645 @default.
• W1829320970 cites W2137328549 @default.
• W1829320970 cites W2138070895 @default.
• W1829320970 cites W2139587725 @default.
• W1829320970 cites W2144799185 @default.
• W1829320970 cites W2147493587 @default.
• W1829320970 cites W2149634843 @default.
• W1829320970 cites W2150879210 @default.
• W1829320970 cites W2154807527 @default.
• W1829320970 cites W2161741155 @default.
• W1829320970 cites W2167521589 @default.
• W1829320970 cites W2168218454 @default.
• W1829320970 cites W2169144122 @default.
• W1829320970 cites W2185467303 @default.
• W1829320970 cites W2213379284 @default.
• W1829320970 cites W2312872076 @default.
• W1829320970 cites W2323792914 @default.
• W1829320970 cites W2324949912 @default.
• W1829320970 cites W2328772780 @default.
• W1829320970 cites W2401999939 @default.
• W1829320970 cites W2403671976 @default.
• W1829320970 cites W2406904314 @default.
• W1829320970 cites W2409914034 @default.
• W1829320970 cites W2411447754 @default.

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