Author/Authors :
Keshvari-Shad, Fatemeh Department of Health Economics - School of Management and Medical Informatics - Tabriz University of Medical Sceinecs, Tabriz, Iran , Hajebrahimi, Sakineh Urology Department - Research Center for Evidence Based Medicine - Faculty of Medicine - Tabriz University of Medical Sciences, Tabriz, Iran , Laguna Pes, Maria Pilar Department of Urology - Istanbul Medipol University, Istanbul, Turkey , Mahboub-Ahari, Alireza Department of Health Economics - Iranian Evidence-Based Medicine Center of Excellence - School of Management and Medical Informatics - Tabriz University of Medical Sciences, Tabriz, Iran , Nouri, Mohammad Department of Biochemistry and Clinical Laboratories - Tabriz University of Medical Sciences, Tabriz, Iran , Seyednejad, Farshad Department of Radiation Oncology - Tabriz Medical University, Tabriz, Iran , Yousefi, Mahmood Department of Health Economics - Iranian Center of Excellence in Health Management - School of Management and Medical Informatics - Tabriz University of Medical Sciences, Tabriz, Iran
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.
Keywords :
Chronic Kidney Disease , Screening , Sensitivity , Specificity , Systematic Review
