1 / 16

The Use of Inflammatory Biomarkers in the Diagnosis of Asthma – a systematic review –

The Use of Inflammatory Biomarkers in the Diagnosis of Asthma – a systematic review –. Introdução à Medicina 2006/2007 Class 3, First Year João Almeida Lopes Fonseca Altamiro Manuel Rodrigues da Costa Pereira. Summary. Introduction Current Tests Inflammatory Biomarkers Aim Methods

hedia
Download Presentation

The Use of Inflammatory Biomarkers in the Diagnosis of Asthma – a systematic review –

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. The Use of Inflammatory Biomarkers in the Diagnosis of Asthma– a systematic review – Introdução à Medicina 2006/2007 Class 3, First Year João Almeida Lopes Fonseca Altamiro Manuel Rodrigues da Costa Pereira

  2. Summary • Introduction • Current Tests • Inflammatory Biomarkers • Aim • Methods • Study Design • First Queries • Data source • Study Selection • Quality Criteria • Statistical Analysis • Flow Chart • Gantt chart

  3. Introduction • Asthma is an inflammatory disorder. • Asthma diagnosis: • Mostly based on the clinical observation complemented with lung function tests. • Bronchodilatation and hiperreactivity tests (methacholine). • Bronchial biopsy. • There is growing interest in exhaled nitric oxide (Fe(NO)) and induced sputum eosinophilia.

  4. Introduction Current Tests Tests Parameters GINA. 2006 Nov Dundas I. Thorax. 2005 Jan Busse WW. Am J Respir Crit Care Med.2005 Oct

  5. Introduction Inflammatory Biomarkers Tests Parameters Lemiere Cet al. Can J Physiol Pharmacol. 2006 Jan Joos GF et al.Curr Opin Pharmacol. 2003 Jun Dinakar C et al. Curr Allergy Asthma Rep. 2004 Nov Kim CK et al. Ann Allergy Asthma Immunol. 2004 Aug

  6. Introduction Aim To evaluate the sensitivityand the specificity of Fe(NO) and induced sputum eosinophilia in asthma diagnosis.

  7. Methods Study Design A meta-analysis of the published studies on the sensitivity and specificity of measurements of Fe(NO)andinduced sputum eosinophilia.

  8. Methods First Queries • Inflammatory Biomarkers in diagnosing asthma Without limits - 7 results (4 revision articles) • Biological Markers[MeSH] AND Asthma[MeSH] AND Nitric Oxide[MeSH] AND Diagnosis[MeSH] Limits: English, Portuguese, Clinical Trial 29 results (without limits - 126 results (33 revision articles))

  9. Methods First Queries • Diagnosis[MeSH] AND Eosinophil[MeSH] AND Asthma[MeSH] AND Biological Markers[MeSH] Limits: English, Portuguese, Clinical Trial, Randomized Controlled Trial 42 results (0 revision articles) (without limits - 236 results (20 revision articles)) • asthm* AND diagnos* AND sputum AND eosinophil Limits: English, Portuguese, Clinical Trial, Humans 59 results (0 revision articles) (without limits - 294 results; 36 revision articles)

  10. Methods Data source Research was made using Medline,Scopus and references of used articles. • Query was: ((Asthma[MeSH] OR Asthma OR Asthm*) AND ((Nitric Oxide[MeSH] OR feno OR ENO OR exhaled air) OR ((Eosinophil* OR Eosinophil[MeSH] OR eosinophilia[MeSH]) AND(Sputum[MeSH] OR Sputum))) AND ((sensitiv*[Title/Abstract] OR sensitivity and specificity[MeSH Terms] OR diagnos*[Title/Abstract] OR diagnosis[MeSH:noexp] OR diagnostic * [MeSH:noexp] OR diagnosis,differential[MeSH:noexp] OR diagnosis[Subheading:noexp] OR (Diagnosis[MeSH] OR Diagnosis OR Diagnos*)))

  11. Methods Study Selection • Six groups of two reviewers - titles/abstracts • Five groups of two reviewers - full text • Articles atributted randomly. • Checked inclusion and exclusion criteria to select the articles • 1st stage: titles/abstracts • 2nd stage: full text. • Non-agreementsolved by: • Consensus or • A third reviewer (a specialist in the field).

  12. Inclusion criteria Asthma diagnosis in adults or children. Assessing Fe(NO) or induced sputum eosinophilia. Reports the sensitivity and specificity of inflammatory biomarkers. Explains the way the diagnosis was done (diagnostic criteria). Exclusion criteria Not in English, Portuguese, French or Spanish. Published before 1991. The sensitivity and specificity of inflammatory biomarkers cannot be determined with the article data. Full text article not accessible (not available via Medline, Scopus, FMUP library or request to authors). Methods Study Selection

  13. Methods Quality Criteria • The articles included were evaluated regarding their methodological quality using a scale based on STARD. • http://www.consort-statement.org/stardstatement.htm

  14. Methods Statistical Analysis • Meta-Disc 1.4 and/or SPSS 14.0 - Relevant information extracted from the chosen articles was registered. • Main parameters - Sensitivity and Specifity of inflammatory biomarkers: • Nitric oxide • Eosinophils • Kappa Statistics -compares the agreement against that which might be expected by chance.

  15. Flow chart

  16. Gantt chart

More Related