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Updated meta‐analysis on the diagnostic accuracy of serum anti‐Mullerian hormone in poly cystic ovary syndrome involving 13 509 subjects

机译:涉及13 509名受试者的血清抗苗勒管激素对多囊卵巢综合征诊断准确性的最新meta分析

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Abstract Aim To determine the diagnostic accuracy of anti‐Mullerian hormone (AMH) in the diagnosis of polycystic ovary syndrome (PCOS). Methods Two independent reviewers searched the electronic databases and search engines using PubMed, Cochrane library, and Google Scholar systematically to retrieve relevant articles published from inception to September 2021. The diagnostic efficacy of AMH was computed using the random‐effects model in terms of pooled sensitivity, specificity, and diagnostic odds ratio (DOR) with 95 confidence interval (CI). A meta‐regression and subgroup analysis were performed to check for any source which could explain possible heterogeneity. Risk of bias assessment was conducted using the QUADAS‐2 tool recommended by Cochrane Library. Results This meta‐analysis included a total of 41 studies involving 13?509 subjects. We observed promising pooled sensitivity 0.78 (95 CI 0.74 to 0.81), specificity 0.87 (95 CI 0.84 to 0.90), and diagnostic odds ratio (DOR) 24 (95 CI 15 to 37), for AMH in detecting PCOS and discriminatory power (summary receiver operating characteristic SROC curves, 0.89 95 CI 0.86–0.92). The most prominent bias was noted in the patient selection and index test assessment. Conclusions With the findings of this current meta‐analysis, we conclude serum AMH to be a promising biomarker for the diagnosis of PCOS, however, substantial heterogeneity among studies needs individual patient data analysis in order to identify an optimal cut‐off value and homogenous findings. Registration Number and Guidelines This meta‐analysis was performed according to constructed protocol registered in the PROSPERO database with registration number CRD42021246910.
机译:摘要 目的 探讨抗苗勒管激素(AMH)诊断多囊卵巢综合征(PCOS)的准确性。方法 2名独立评价员系统检索PubMed、Cochrane图书馆和Google Scholar电子数据库和搜索引擎,检索建库至2021年9月发表的相关文章。使用随机效应模型根据合并敏感性、特异性和诊断比值比 (DOR) 以及 95% 置信区间 (CI) 计算 AMH 的诊断效果。进行元回归和亚组分析,以检查任何可以解释可能的异质性的来源。使用Cochrane图书馆推荐的QUADAS-2工具进行偏倚风险评估。结果 本meta分析共纳入41项研究,涉及13?509名受试者。我们观察到AMH在检测PCOS和鉴别能力方面的合并敏感性为0.78(95%CI [0.74, 0.81])、特异性0.87(95%CI [0.84, 0.90])和诊断比值比(DOR)24(95%CI [15, 37])(汇总受试者工作特征[SROC]曲线,0.89 [95%CI 0.86-0.92])。在患者选择和指标测试评估中发现最突出的偏倚。结论 根据目前的荟萃分析结果,我们得出结论,血清 AMH 是诊断 PCOS 的有前途的生物标志物,然而,研究之间的大量异质性需要个体患者数据分析,以确定最佳临界值和同质性结果。注册号和指南 该荟萃分析是根据在PROSPERO数据库中注册的构建方案进行的,注册号为CRD42021246910。

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