Table 7.
Summary of SEN, SPE, PLR, NLR, DS, DOR, and AUC values for AE assay
| Subgroup | N | SEN (95% CI) | SPE (95% CI) | PLR (95% CI) | NLR (95% CI) | DS (95% CI) | DOR (95% CI) | AUC (95% CI) | P a | |
|---|---|---|---|---|---|---|---|---|---|---|
| Overall | 12 | 0.57 (0.41–0.71) | 0.85 (0.73–0.93) | 3.91 (2.31–6.61) |
0.50 (0.37–0.68) |
2.05 (1.43–2.67) | 7.78 (4.19–14.46) | 0.78 (0.74–0.81) | ||
| Outlier excluded | 11 | 0.51 (0.39–0.62) | 0.88 (0.79–0.94) | 4.22 (2.42–7.36) |
0.56 (0.45–0.69) |
2.02 (1.37–2.67) | 7.53 (3.92–14.47) | 0.73 (0.69–0.77) | ||
| Storage method | ||||||||||
| Cryopreservation | 1 | 0.51 | 0.51 | 1.06 | 0.95 | −c | 1.12 | – | < 0.001 | |
| Fresh | 11 | 0.60 (0.41–0.76) | 0.87 (0.77–0.93) | 4.64 (3.04–7.08) | 0.46 (0.32–0.68) | 2.30 (1.80–2.80) | 9.99 (6.05–16.49) | 0.83 (0.80–0.86) | ||
| Preparation method | ||||||||||
| No preparation | 6 | 0.72 (0.50–0.87) | 0.80 (0.59–0.92) | 3.68 (1.90–7.13) | 0.35 (0.21–0.59) | 2.36 (1.71–3.01) | 10.56 (5.51–20.26) | 0.83 (0.79–0.86) | 0.006 | |
| Swim up | 4b | 0.38 (0.24–0.54) | 0.86 (0.49–0.97) | 2.63 (0.75–9.18) | 0.73 (0.62–0.85) | 1.29 (− 0.06–2.63) | 3.62 (0.94–13.90) | 0.51 (0.47–0.56) | ||
| Discontinuous gradient | 4 | 0.46 (0.28–0.65) | 0.90 (0.87–0.93) | 4.83 (2.64–8.83) | 0.60 (0.41–0.87) | 2.09 (1.14–3.04) | 8.08 (3.13–20.88) | 0.90 (0.87–0.92) | ||
| FR cut-off value combined with AE assay method | ||||||||||
| < 50% | Spectrophotometry | NC | ||||||||
| Spectrophotometry/BAPNA | 4b | 0.63 (0.48–0.76) | 0.87 (0.60–0.97) | 4.96 (1.51–16.37) | 0.42 (0.32–0.57) | 2.46 (1.24–3.67) | 11.68 (3.47–39.36) | 0.75 (0.71–0.79) | ||
| Substrate assay | ||||||||||
| Acrosin target with gelatine substrate assay | 1 | 0.50 | 0.93 | 7.00 | 0.54 | – | 13.00 | 0.80d | ||
| ≤ 50% | Substrate assay | |||||||||
| Acrosin target with gelatine substrate assay | 1 | 0.26 | 0.97 | 9.64 | 0.76 | – | 12.63 | – | ||
| = 0% | Fluorometry | |||||||||
| PAb-acrosin | 1 | 0.63 | 0.92 | 9.23 | 0.39 | – | 23.87 | – | ||
| PAb-hyaluronidase | 1 | 0.23 | 0.90 | 2.29 | 0.86 | – | 2.68 | – | ||
| MAb 4D4-proacrosin | 1 | 0.40 | 0.96 | 10.00 | 0.63 | – | 16.00 | 0.71d | ||
| Spectrophotometry | ||||||||||
| Spectrophotometry/BAPNA | 4 | 0.78 (0.38–0.95) | 0.63 (0.40–0.81) | 2.11 (1.25–3.55) | 0.35 (0.11–1.18) | 1.78 (0.29–3.27) | 5.94 (1.34–26.34) | 0.74 (0.70–0.78) | ||
| Accu-sperm Spectrophotometry/BAPNA |
1 | 0.61 | 0.84 | 3.90 | 0.46 | – | 8.4 | – | ||
SEN sensitivity, SPE specificity, PLR positive likelihood ratio, NLR negative likelihood ratio, DS diagnostic score, DOR diagnostic odds ratio, AUC area under the summary receiver operating characteristic curve, CI confidence interval, NC not compared
aComparison between subgroups with the Q test for heterogeneity
bConverted number = actual number × 2. Studies were duplicated for numbers ≥ 2 and < 4, based on the computation of bivariate mixed effects regression model for the lowest threshold of 4 studies
cNot calculated in original data or not reported
dCoordinates in scatter plots were converted with the Engauge digitizer to calculate AUC