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. 2015 Feb 16;2015(2):CD010438. doi: 10.1002/14651858.CD010438.pub2

Summary of findings'. 'Summary of findings table.

What is the test accuracy of thromboelastography (TEG) and rotational thromboelastometry (ROTEM) for trauma‑induced coagulopathy (TIC) in adult trauma patients with bleeding?
Patients Adult trauma patients with bleeding at risk of TIC
Prior testing None
Setting Hospital; civilian or military
Index tests Tests of global haemostatic function especially thromboelastography (TEG) and rotational thromboelastometry (ROTEM).
Any device output measure considered
Reference standard
  • Prothrombin ratio or International Normailsed ratio 1.2 or greater

  • Prothrombin ratio or International Normailsed ratio 1.5 or greater

Study design Cross‐sectional or case‐control test accuracy studies; all included studies were cross‐sectional
Test No of participants
(no. of studies)
Accuracy
(sensitivity (95% CI))
Accuracy
(specificity (95% CI))
Risk of bias Implications
ROTEM EXTEM Clot amplitude 5 minutes (CA5) 409 (2) Davenport 2011a: 70% (47,87)
Woolley 2012: 96% (88,100)
Davenport 2011a: 86% (82,90)
Woolley 2012: 58% (44,72)
High Accuracy estimates potentially misleading
ROTEM EXTEM Clot amplitude 10 minutes (CA10) 109 (1) 100% (94,100) 70% (56,82) High Accuracy estimates potentially misleading
ROTEM EXTEM Clot amplitude 15 minutes (CA15) 88 (1) 88% (69,97) 100% (94,100) High Accuracy estimates potentially misleading

Concerns about risk of bias arose from consideration of the index test and the reference standard