甲状腺超声影像报告和数据系统对甲状腺结节诊断价值的Meta分析

发布时间：2018-02-01 18:01

本文关键词： Meta分析甲状腺影像报告和数据系统诊断价值超声检查甲状腺结节　出处：《苏州大学》2015年硕士论文　论文类型：学位论文

【摘要】：目的:分析评价甲状腺超声影像报告和数据系统(thyroid imaging reporting and data system,TI-RADS)对甲状腺良性和恶性结节的鉴别诊断价值。方法:系统检索1994年4月-2015年4月期间外文数据库ISI Web of Science、Pubmed、MEDLINE和EMBASE,中文数据库CNKI、CBM、VIP和万方数据库,收集TI-RADS对判断甲状腺结节良性和恶性的诊断性试验。纳入公开发表的设计严谨、方法可靠的诊断性研究,并且其结果均可直接提供或者通过间接计算得到真阳性、假阳性、假阴性和真阴性的例数,同时对纳入的研究文献采用诊断性试验质量评价(Quality Assessment of Diagnostic Accuracy Studies,QUADAS)量表进行质量评价。本论文所有的研究分析均采用MetaDiSc1.4软件和STATA12.0软件,分别分析合并的灵敏度、特异度、阳性似然比、阴性似然比、诊断比值比(diagnostic odds ratio,DOR)及其95%CI作为合并效应量;绘制汇总受试者工作特征曲线(summary receiver operating characteristic curve,SROC),计算曲线下面积(area under the curve,AUC)与Q~龵指数。同时进行Meta回归分析和亚组分析研究文献间异质性的来源。最后利用Deek图和Deek’s检验来综合评价研究文献的发表偏倚。结果:本次Meta分析共纳入6篇文献,涉及甲状腺结节共8799个。Meta分析结果显示,TI-RADS诊断甲状腺良性和恶性结节的合并敏感度、合并特异度、合并阳性似然比、合并阴性似然比及合并DOR依次为0.82(95%CI:0.81-0.84)、0.69(95%CI:0.68-0.70)、4.18(95%CI:2.63-6.67)、0.15(95%CI:0.07-0.30)、29.59(95%CI:12.34-70.94);SROC曲线下面积为0.920(Q龵=0.853)。结论:在甲状腺结节的超声检查中,TI-RADS对甲状腺结节良性和恶性分类具有较好的应用价值。
[Abstract]:Objective: to analyze and evaluate the thyroid imaging reporting and data system. TI-RADS). Methods: the foreign language database ISI Web of Science from April 1994 to April 2015 was searched systematically. Pubmedus MEDLINE and EMBASE, Chinese database CNKICIM VIP and Wanfang database. To collect TI-RADS diagnostic tests for the diagnosis of benign and malignant thyroid nodules, and to include published diagnostic studies with rigorous design and reliable methods. And the results can be directly provided or indirectly calculated to obtain true positive, false positive, false negative and true negative cases. At the same time, the quality evaluation of diagnostic test was used for the included research literature (. Quality Assessment of Diagnostic Accuracy Studies. The QUADASS scale was used to evaluate the quality. MetaDiSc1.4 software and STATA12.0 software were used to analyze the sensitivity and specificity of this study. The positive likelihood ratio, the negative likelihood ratio, the diagnostic odds ratio and 95 CI were used as the combined effect. Summary receiver operating characteristic curvec. Area under the curve area under the curveAUC) and QN? Index. At the same time, Meta regression analysis and subgroup analysis were used to study the origin of the heterogeneity of literature. Finally, the Deek map and Deek's test were used to evaluate the publication bias of the research literature. Six articles were included in this Meta analysis. The results of Meta-analysis showed that TI-RADS in the diagnosis of benign and malignant thyroid nodules had a combined sensitivity, specificity and positive likelihood ratio. The combined negative likelihood ratio and the combined DOR were 0.82-0.84% CI: 0.81-0.84% 0.6995% CI: 0.68-0.70). 4.18 I / I 2.63-6.67 I / I: 0.07-0.30 I / I: 0.07-0.30 / 29.59 / 95 CI: 12.34-70.94; The area under the SROC curve is 0.920? Conclusion: TI-RADS has a good value in the classification of benign and malignant thyroid nodules.
【学位授予单位】：苏州大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R445.1;R581.3

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