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• W2108013152 abstract "Bronchial asthma is a chronic inflammatory disorder of the airways, in which many cells, and cellular elements play a role. It is a problem worldwide, with an estimated 300 million individuals affected and 15 million disability-adjusted life years lost annually. 1 Although asthma was regarded as an untreatable disease earlier, the global initiative for asthma 2 (GINA) has emphasized that asthma can be controlled by standard management. Accordingly, accurate diagnosis and appropriate surveillance would be the prerequisite. Currently, the diagnosis of asthma is based on the clinical, or pulmonary function parameters, which cannot effectively guide the therapy. 2 With the unveiling of airway inflammation mechanisms, the methods to monitor airway inflammation have been viewed as complementary to the conventional tools in the diagnostic process. Several ways are now available to collect samples from the lower airways for studying features of airway inflammation. Among them, sputum induction has a great advantage due to its non-invasive manner. In addition, it can provide more direct and additional information on the current inflammatory status of the airways, 3 and guide the treatment with corticosteroids to reduce exacerbation rates. Therefore, induced sputum eosinophil count would become a promising novel diagnostic tool for asthma. It is now necessary to evaluate the accuracy of this technique due to the unsettled value of its diagnostic accuracy. We conducted a systematic review, and meta-analysis of published studies where the induced sputum eosinophil count was adopted for detecting asthma. This meta-analysis was performed between July 2009 and November 2009 at the West China Hospital, Sichuan, P. R. China. A comprehensive search was carried out using PubMed, Ovid, EMBASE,VIP,CNKI and CBMdisc to identify relevant studies published before November 2009. Some additional published, unpublished, and ongoing studies were also identified by manual review. Inclusion criteria included induced sputum eosinophil count for diagnosing bronchial asthma, comparison of induced sputum result with pulmonary function parameters as reference standard (according to GINA, the diagnosis of asthma should be based on the presence of one of the following items: spirometry, airway responsiveness, and peak expiratory flow [PEF] variability) and the numbers used to calculate sensitivity and specificity were reported. Secondary literature, and animal studies were excluded during the process. Two reviewers independently completed screening, study selection, and data extraction. Disagreements were resolved by discussion. Study quality was assessed using the quality assessment of diagnostic accuracy studies (QUADAS). Meta-analysis was undertaken with Meta-Disc statistical software. 4 The heterogeneity caused by threshold effect was explored through spearman correlation analysis. Heterogeneity other than threshold effect was tested with chi-square test, and Cochran’s Q-test. The effect model was adopted according to the extent of heterogeneity. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio were calculated, and summary receiver operating characteristic (SROC) curves were performed. Finally, we conducted sensitivity analysis to assess whether changing the inclusion criteria influenced the results. A p-value less than 0.05 was considered significant. All our data analysis was undertaken with Meta-Disc statistical software. In total, 9 studies including 659 patients were appropriate for the meta-analysis. The statistical results show the spearman correlation coefficient was -0.583 (p=0.09). The x 2 value of sensitivity, and specificity was 31.18 (p=0.0001), and 19.31 (p=0.0133). The Cochran’s Q value of positive likelihood ratio was 21.97 (p=0.005), negative likelihood ratio was 49.99 (p=0.0000), and diagnostic odds ratio was 31.45 (p=0.0001). Then, random effect model was selected to calculate the diagnostic parameters. The pooled sensitivity was 0.80 (95% confidence interval (CI): 0.75, 0.84), specificity was 0.90 (95% CI: 0.87, 0.93), positive likelihood ratio was 7.03 (95% CI: 3.78, 13.08), negative likelihood ratio was 0.23 (95% CI: 0.14, 0.39), and diagnostic odds ratio was 4.36 (95% CI: 12.59, 93.79). The" @default.
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• W2108013152 date "2010-06-01" @default.
• W2108013152 modified "2023-09-23" @default.
• W2108013152 title "Induced sputum eosinophil count for the diagnosis of bronchial asthma." @default.
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