EBLM の進め方と問題点−系統的レビューを中心に−(6)

特別発言
−高感度 CRP 系統的再評価における問題点−

竹　村　　　譲*1　石　田　　　博*2
　　　　　　　　　　　　　　　　　　　　　　
Special Comments−Problems in Systematic Review for Diagnostic Accuracy
of High-Sensitivity C-Reactive Protein Assay in Neonatal Infection−

Yuzuru TAKEMURA, MD*1 and Haku ISHIDA, MD*2

We conducted a systematic review for the diagnostic accuracy of high-sensitivity C-reactive protein assay for neonatal infection. In total, 558 relevant published reports were found in a search of MEDLINE and Igaku-Chuo-Shi. With our inclusion and exclusion criteria, we finally selected 30 primary studies for meta-analysis. We critically appraised the quality of selected clinical studies and then extracted sensitivity and specificity data from each article for meta-analysis. There was only one article that fulfilled our three major standards for quality assessment(rank A; high-quality), while 19 studies which fulfilled only one criterion were assigned to rank C(low-quality). Most studies neither took careful consideration of the blindness against the results of the index test nor described this methodological standard. Lack of qualified primary studies may have had substantial influence on the summary estimates. Insufficient number of primary studies for meta-analysis and their unsatisfactory quality would be improved by the addition of supplemental results retrieved from raw data, which the authors of clinical studies did not present in their articles.
[Rinsho Byori 51 : 696〜699, 2003]

*1Department of Laboratory Medicine, National Defense Medical College, Tokorozawa, 359-8513

【Key Words】systematic review(系統的再評価)，primary clinical studies(一次臨床研究)，critical appraisal(批判的吟味)，quality assessment(質の評価)，raw data(生データ)

*1防衛医科大学校検査部(〒359-8513 所沢市並木3-2)
*2山口大学医学部附属病院医療情報部(〒755-8505 宇部市南小串1-1-1)

E-mail :yutakemu@interlink.or.jp