短波长自动视野计对原发性青光眼诊断效能的Meta分析

目的以标准自动视野计的异常检测结果和／或眼底改变为金标准，对短波长自动视野计(SWAP)诊断原发性青光眼的文献进行Meta分析，评价SWAP的临床诊断效能。设计基于文献检索的Meta分析研究。对象电子检索MEDLINE、EMBASE、Cochrane Library、BIOSIS、Previews、HMIC、IPA、OVID循证医学数据库、中国期刊网专题全文数据库、中国生物医学文献数据库、维普中文科技期刊数据库、中国医学学术会议论文、中国优秀硕博士论文数据库、超星数字图书馆、书生之家数字图书馆；手工检索国内外相关教科书、杂志、会议论文等及其参考文献。方法检索上述文献。根据Cochrane协作网推荐的诊断试验纳入标准筛选文献，并对纳入文献进行质量评估，提取纳入研究的特征信息。数据分析采用Meta Test version0．6软件，检验异质性，并根据检验结果选择相应的效应模型进行Meta分析，绘制汇总受试者工作特征曲线(SROC)、计算曲线下面积并进行敏感性分析。主要指标敏感性、特异性及相应的95％可信区间(95％CI)、SROC曲线下面积。结果共检索到相关文献136篇，5篇英文文献(7个研究)符合纳入标准，研究对象共514例。SWAP诊断原发性青光眼的敏感性范围为0．39-0．94，特异性范围为0．83～1．00。纳入研究不存在异质性。按照固定效应模型计算汇总敏感性、特异性分别为0．64(95％CI0．49-0．78)、0．90(95％CI0．85-0．93)。SROC曲线下面积为92．48％。纳入文献稳定性好。结论纳入的文献具有较高质量，Meta分析显示，SWAP诊断原发性青光眼的效能较高，但还需要高质量的前瞻性研究作进一步分析。

Meta-analysis of diagnostic capability of SWAP for glaucoma

Objective To assess the overall diagnostic capabilities of short-wavelength automated perimetry(SWAP)in patients of primary glaucoma with standard automated perimetry(SAP) andor optic disc appearance as the gold standard.Design Meta analysis based on the reference searching.Participants A comprehensive electric search in MEDLINE,EMBASE,Cochrane Library,BIOSIS,Previews,HMIC,IPA,OVID,CNKI,CBMdisc,VIP information,CMCC,CCPD,SSreader,21dmedia and a manual search in related textbooks,journals,congress articles and their references at home and abroad were performed to identify relevant English and Chinese language articles.Methods Search the according references by means of electric searching and manual searching in different database or materials.Criteria for inclusion and exclusion were established according to validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests.Then quality of the included articles was assessed and characteristics were extracted.Statistical analysis was performed with Meta Test version 0.6 software.Heterogeneity of the included articles was tested,which was used to select appropriate effect model to calculate pooled weighted sensitivity and specificity.Summary Receiver Operating Characteristic(SROC)curve was performed and the area under the curve(AUC)was calculated.Finally,sensitivity analysis was performed.Main Outcome Measures Sensitivity,specificity,the according confidence intervals(CI) and the area under the curve (AUC) of SROC.Results Seven studies of 136 retrieved articles were included,with a total of 514 patients.The reported sensitivity of SWAP ranged from 0.39 to 0.94,and specificity from 0.83 to 1.00.The pooled weighted sensitivity and specificity for SWAP with 95% confidence intervals(95%CI) after correction for standard error were 0.64 (0.49-0.78),0.90 (0.85-0.93),respectively.The AUC of SROC was 92.48%.Sensitivity analysis demonstrated no disproportionate influences of individual study.Conclusion The included articles are of good quality and SWAP can be a highly efficient diagnostic test for primary glaucoma based on Meta-analysis.