Meta AnalysisID 2283
血清淀粉酶和脂肪酶及尿胰蛋白酶原和淀粉酶诊断急性胰腺炎，以及血清C反应蛋白、降钙素原和乳酸脱氢酶诊断胰腺坏死 [Cochrane方案]
CRD42016043861
Diagnosis of acute pancreatitis in people with acute epigastric or diffuse abdominal pain: to compare the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase, either alone or in
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Record Fields
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- Meta Analysis Id
- 2283
- Evidence Id
- 10841
- Core Evidence Id
- 10841
- Source Meta Analysis Id
- 2239
- Herb2 Meta Analysis Id
- HBMA002239
- Crd Id
- CRD42016043861
- Title
- Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis and serum C-reactive protein, procalcitonin and lactate dehydrogenase for the diagnosis of pancreatic necrosis [Cochrane Protocol]
- Review Question
- Diagnosis of acute pancreatitis in people with acute epigastric or diffuse abdominal pain: to compare the diagnostic accuracy of serum amylase, serum lipase, urinary trypsinogen-2, and urinary amylase, either alone or in combination, in the diagnosis of acute pancreatitis in patients with acute onset of a persistent, severe, epigastric pain or diffuse abdominal pain. Diagnosis of necrotising pancreatitis in people with established diagnosis of acute pancreatitis: to compare the diagnostic accuracy of CRP, procalcitonin, or LDH, either alone or in combination, in the diagnosis of necrotising pancreatitis in patients with acute pancreatitis and without organ failure. Secondary objective 1:Diagnosis of acute pancreatitis in people with acute epigastric or diffuse abdominal pain: if we identify heterogeneity, we plan to explore the following potential sources of heterogeneity: risk of bias, prospective or retrospective studies, publication status, previous history of acute pancreatitis, different aetiology for acute pancreatitis, presence of organ failure, average time to performance of the test, and different test manufacturers. Secondary objective 2:Diagnosis of necrotising pancreatitis in people with established diagnosis of acute pancreatitis: if we identify heterogeneity, we plan to explore the following potential sources of heterogeneity: risk of bias, prospective or retrospective studies, publication status, previous history of acute pancreatitis, different aetiology for acute pancreatitis, presence or absence of infection, pancreatic versus peripancreatic necrosis, average time to performance of the test, and different test manufacturers.
- Study Type Included
- We will include studies that evaluate the accuracy of the index tests mentioned above in the appropriate patient population (see below). We will include relevant studies irrespective of language or publication status, whether the data were collected prospectively or retrospectively, and whether there was a comparison between the tests. However, we will exclude case reports (that describe how the diagnosis of acute pancreatitis or acute necrotising pancreatitis was made on an individual patient or a group of patients and which do not provide sufficient diagnostic test accuracy data, i.e. true positive, false positive, false negative, and true negative). We will also exclude case-control studies because they are prone to bias (Whiting 2011).
- Condition Being Studied
- Acute pancreatitis in people with acute epigastric pain or diffuse abdominal pain, and acute necrotising pancreatitis in people with an established diagnosis of acute pancreatitis.
- Participant
- Diagnosis of acute pancreatitis in people with acute epigastric or diffuse abdominal pain Adult patients with acute epigastric or diffuse abdominal pain (with or without previous history of acute pancreatitis and with or without systemic signs and symptoms of acute pancreatitis), presenting within three days of the onset of symptoms, irrespective of the interval between onset of symptoms and the time at which the test was performed. Diagnosis of necrotising pancreatitis in people with established diagnosis of acute pancreatitis Adult patients with acute pancreatitis within 14 days of the onset of symptoms, irrespective of the interval between the onset of symptoms and the time at which the test was performed. The diagnosis of acute pancreatitis should have been made on the basis of the consensus conference definition (Banks 2013). Patients who have organ failure will be excluded, since all such patients undergo radiological investigations. We will also exclude patients in whom pancreatic necrosis has been diagnosed in the CT scan carried out to make a diagnosis of acute pancreatitis.
- Animal
- Human Disease Modelled
- Intervention
- Diagnosis of acute pancreatitis in people with acute epigastric or diffuse abdominal pain Serum amylase, serum lipase, urinary trypsinogen, and urinary amylase either alone or in combination. A variety of kits are available for measuring these tests. We will include the kits from all of the manufacturers, and will include studies irrespective of the threshold used. We will not include repeat tests (i.e. we will include the first test performed on initial assessment only). Diagnosis of necrotising pancreatitis in people with established diagnosis of acute pancreatitis Serum CRP, procalcitonin, and LDH either alone or in combination immediately prior to radiological investigation. A variety of kits are available for measuring these tests. We will include the kits from all of the manufacturers, and will include studies irrespective of the threshold used. We will include studies that report a single test and sequential tests of serum CRP, procalcitonin, and LDH. If the study reports sequential testing, we will consider progressive increase as positive index test irrespective of the degree of increase, and stationary or decrease in the levels as negative test.
- Comparator Control
- Specified above.
- Main Outcome
- Diagnostic test accuracy.
- Outcome Measure
- Additional Outcome
- None.
- Study Method
- Diagnostic, Systematic review
- Keyword
- Amylases; C-Reactive Protein; Calcitonin; Clinical Enzyme Tests; Diagnostic Techniques and Procedures; Diagnostic Techniques, Digestive System; Humans; L-Lactate Dehydrogenase; Lipase; Pancreatic Diseases; Pancreatitis; Trypsinogen
- Contact
- Kurinchi Selvan Gurusamy [email protected]
- Organisational Affiliation
- The Cochrane Collaboration http://www.cochrane.org/
- Funding Source
- None specified
- Other Selection Criteria
- Final Publication
- Same Topic Review
- Published Protocol
- Review Type
- Language
- English
- Country
- England
- Review Stage
- Review Ongoing
- First Submission Date
- Registration Date
- 2016-07-29
- Anticipated Start Date
- 2015-12-15
- Anticipated Completion Date
- 2017-12-15
- Title Cn
- 血清淀粉酶和脂肪酶及尿胰蛋白酶原和淀粉酶诊断急性胰腺炎，以及血清C反应蛋白、降钙素原和乳酸脱氢酶诊断胰腺坏死 [Cochrane方案]
- Title En
- Serum amylase and lipase and urinary trypsinogen and amylase for diagnosis of acute pancreatitis and serum C-reactive protein, procalcitonin and lactate dehydrogenase for the diagnosis of pancreatic necrosis [Cochrane Protocol]
- Bilingual Status
- complete