TABLE 5A.
PICO question 1A: Should EUS be used to diagnose choledocholithiasis in low to intermediate risk of disease?
| No. of studies and patients |
Factors that may decrease certainty of evidence |
Effect per 1000 patients tested |
|||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|
| Outcome | study design |
Risk of bias |
Indirectness | Inconsistency | Imprecision | Publication bias |
Pretest probability of 5% |
Pretest probability of 20% |
Pretest probability of 50% |
Test accuracy | |
| True positives (patients with [target condition]) | 5 studies 272 patients | Cross-sectional (cohort type accuracy study) | Not serious | Not serious | Serious* | Serious† | None | 49 (46-50) | 194 (182-198) | 485 (455-495) | ⊕⊕○○ LOW |
| False negatives (patients incorrectly classified as not having [target condition]) | 1 (0-4) | 6 (2-18) | 15 (5-45) | ||||||||
| True negatives (patients without [target condition]) | 5 studies 272 patients | Cross-sectional (cohort type accuracy study) | Not serious | Not serious | Serious* | Serious† | None | 855 (789-893) | 720 (664-752) | 450 (415-470) | ⊕⊕○○ LOW |
| False positives (patients incorrectly classified as having [target condition]) | 95 (57-161) | 80 (48-136) | 50 (30-85) | ||||||||
*
We rated down for inconsistency because the confidence intervals did not overlap and the I2 for EUS specificity was 54.2%.
†
We rated down for imprecision because of wide confidence intervals.