Summary of findings'. 'Summary of findings Table.
| General information | ||
| General issue | What is the diagnostic performance of endoscopic ultrasound (EUS) in assessing disease stage in people with gastric carcinoma ? | |
| Specific questions | What is the diagnostic performance of EUS in assessing primary tumor depth ? | Superficial (T1 ‐ T2) versus advanced (T3 ‐ T4) tumors |
| Early (T1) versus muscular (T2) tumors | ||
| Mucosal (T1a) versus submucosal (T1b) tumors | ||
| What is the diagnostic performance of EUS in assessing regional lymph node status ? | Non‐metastatic (N0) versus metastatic (N+) lymph nodes | |
| Patients | Patients diagnosed with gastric carcinoma | |
| Settings | Pre‐treatment evaluation of disease stage | |
| Index tests | Endoscopic ultrasound (EUS) | |
| Reference standard | Histology of surgical or endoscopic specimen | |
| Importance | Choosing best treatment or treatment sequence of gastric carcinoma | |
| Studies | 66 studies enrolling 7747 patients | |
| Quality concerns | Overall judgement | Good quality |
| Applicability concerns | None | |
| Patient selection bias | None | |
| Index test interpretation bias | High risk: 5 studies | |
| Reference test interpretation bias | None | |
| Flow and timing selection bias | High risk: 2 studies Unclear risk: 2 studies |
|
| T1 ‐ T2 versus T3 ‐ T4 tumors | ||
| Studies | 50 (patients enrolled: 4397) | |
| Summary results | Sensitivity: 0.86 (95% CI: 0.81 to 0.90). Specificity: 0.90 (95% CI: 0.87 to 0.93) | |
| Consequences | In a hypothetical cohort of 1000 patients (T1 ‐ T2 prevalence: 50%) | Correctly classified: 880 |
| Overstaged: 70 | ||
| Understaged: 50 | ||
| T1 versus T2 tumors | ||
| Studies | 46 (patients enrolled: 2742) | |
| Summary results | Sensitivity: 0.85 (95% CI: 0.78 to 0.91). Specificity: 0.90 (95% CI: 0.85 to 0.93) | |
| Consequences | In a hypothetical cohort of 1000 patients (T1 prevalence: 70%) | Correctly classified: 865 |
| Overstaged: 105 | ||
| Understaged: 30 | ||
| T1a versus T1b tumors | ||
| Studies | 20 (patients enrolled: 3321) | |
| Summary results | Sensitivity: 0.87 (95% CI: 0.81 to 0.92). Specificity: 0.75 (95% CI: 0.62 to 0.84) | |
| Consequences | In a hypothetical cohort of 1000 patients (T1a prevalence: 70%) | Correctly classified: 834 |
| Overstaged: 91 | ||
| Understaged: 75 | ||
| N0 versus N+ tumors | ||
| Studies | 44 (patients enrolled: 3573) | |
| Summary results | Sensitivity: 0.83 (95% CI: 0.79 to 0.87). Specificity: 0.67 (95% CI: 0.61 to 0.72) | |
| Consequences | In a hypothetical cohort of 1000 patients (N+ prevalence: 50%) | Correctly classified: 750 |
| Overstaged: 85 | ||
| Understaged: 165 | ||