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Accuracy of Spleen Stiffness Measurement in Detection of Esophageal Varices in Patients With Chronic Liver Disease: Systematic Review and Meta-analysis 

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Presentation on theme: "Accuracy of Spleen Stiffness Measurement in Detection of Esophageal Varices in Patients With Chronic Liver Disease: Systematic Review and Meta-analysis "— Presentation transcript:

1 Accuracy of Spleen Stiffness Measurement in Detection of Esophageal Varices in Patients With Chronic Liver Disease: Systematic Review and Meta-analysis  Siddharth Singh, John E. Eaton, Mohammad H. Murad, Hironori Tanaka, Hiroko Iijima, Jayant A. Talwalkar  Clinical Gastroenterology and Hepatology  Volume 12, Issue 6, Pages e4 (June 2014) DOI: /j.cgh Copyright © 2014 AGA Institute Terms and Conditions

2 Figure 1 Flow diagram summarizing study identification and selection.
Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions

3 Figure 2 (A) Forest plots and meta-analyses of studies evaluating the sensitivity of SSM compared with EGD for the detection of any EVs in patients with chronic liver disease. (B) Forest plots and meta-analyses of studies evaluating the specificity of SSM compared with EGD for the detection of any EVs in patients with chronic liver disease. Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions

4 Figure 3 (A) Forest plots and meta-analyses of studies evaluating the sensitivity of SSM compared with EGD for the detection of clinically significant EVs in patients with chronic liver disease. (B) Forest plots and meta-analyses of studies evaluating the specificity of SSM compared with EGD for the detection of clinically significant EVs in patients with chronic liver disease. Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions

5 Supplementary Figure 1 Summary ROC curve for all 12 studies examining SSM compared with EGD for the detection of any EVs. SE, standard error. Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions

6 Supplementary Figure 2 Fagan nomogram estimating the post-test probability of EV, depending on the pretest clinical suspicion and results of spleen elastography. (A) With a pretest probability of EV of 25% (low clinical suspicion, as observed in patients with compensated cirrhosis), the post-test probability of EV, given a negative SSM (red), is 6%, and given a positive SSM (blue), is 53%. (B) With a pretest probability of EV of 50% (as observed in patients with decompensated cirrhosis), the post-test probability of EV, given a negative SSM (red), is 16%, and given a positive SSM (blue), is 78%. (C) With a hypothetical pretest probability of EV of 75%, the posttest probability of EV, given a negative SSM (red), is 36% and given a positive SSM (blue), is 91%. Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions

7 Supplementary Figure 3 Summary ROC curve for 9 studies examining SSM compared with EGD for the detection of clinically significant EVs. SE, standard error. Clinical Gastroenterology and Hepatology  , e4DOI: ( /j.cgh ) Copyright © 2014 AGA Institute Terms and Conditions


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