Scolaris Content Display Scolaris Content Display

Contenido relacionado

Ir a:

Revisiones y protocolos relacionados

Topics

Temas

PRISMA flow diagram outlining the study selection process.

Figuras y tablas -
Figure 1

PRISMA flow diagram outlining the study selection process.

Ir a la figura de la revisiónAbrir en una pestaña nueva

QUADAS‐2 risk of bias and applicability concerns graph including review authors' judgements about each domain presented as percentages across included studies.

Figuras y tablas -
Figure 2

QUADAS‐2 risk of bias and applicability concerns graph including review authors' judgements about each domain presented as percentages across included studies.

Ir a la figura de la revisiónAbrir en una pestaña nueva

QUADAS‐2 risk of bias and applicability concerns summary including review authors’ judgements about each domain for each included study.

Figuras y tablas -
Figure 3

QUADAS‐2 risk of bias and applicability concerns summary including review authors’ judgements about each domain for each included study.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing study level sensitivities and specificities that used an estimated fetal weight discordance (EFWD) of 20%.

Figuras y tablas -
Figure 4

A forest plot representing study level sensitivities and specificities that used an estimated fetal weight discordance (EFWD) of 20%.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary receiver operating characteristic plot of studies assessing the accuracy of ultrasound based on an estimated fetal weight discordance (EFWD) of 20%. Each study is represented as an ellipse with size of the ellipse adjusted to the sample size of the study. The filled circle represents the summary point indicating summary sensitivity and specificity of the meta‐analytic estimate. Dotted closed line represents 95% confidence region and the dashed line represents the 95% prediction region around the summary point.

Figuras y tablas -
Figure 5

Summary receiver operating characteristic plot of studies assessing the accuracy of ultrasound based on an estimated fetal weight discordance (EFWD) of 20%. Each study is represented as an ellipse with size of the ellipse adjusted to the sample size of the study. The filled circle represents the summary point indicating summary sensitivity and specificity of the meta‐analytic estimate. Dotted closed line represents 95% confidence region and the dashed line represents the 95% prediction region around the summary point.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing sensitivities and specificities of the studies that used ultrasound abdominal circumference to detect estimated fetal weight discordance (EFWD) of 20%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Figuras y tablas -
Figure 6

A forest plot representing sensitivities and specificities of the studies that used ultrasound abdominal circumference to detect estimated fetal weight discordance (EFWD) of 20%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing sensitivities and specificities of the studies that used femoral length by ultrasound to detect estimated fetal weight discordance (EFWD) of 20%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Figuras y tablas -
Figure 7

A forest plot representing sensitivities and specificities of the studies that used femoral length by ultrasound to detect estimated fetal weight discordance (EFWD) of 20%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing sensitivities and specificities of all the studies that used an estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Figuras y tablas -
Figure 8

A forest plot representing sensitivities and specificities of all the studies that used an estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Summary receiver operating characteristic plot of studies assessing the accuracy of ultrasound based on an estimated fetal weight discordance (EFWD) of 25%. Each study is represented as an ellipse with size of the ellipse adjusted to the sample size of the study. The filled circle represents the summary point indicating summary sensitivity and specificity of the meta‐analytic estimate. Dotted closed line represents 95% confidence region and the dashed line represents the 95% prediction region around the summary point.

Figuras y tablas -
Figure 9

Summary receiver operating characteristic plot of studies assessing the accuracy of ultrasound based on an estimated fetal weight discordance (EFWD) of 25%. Each study is represented as an ellipse with size of the ellipse adjusted to the sample size of the study. The filled circle represents the summary point indicating summary sensitivity and specificity of the meta‐analytic estimate. Dotted closed line represents 95% confidence region and the dashed line represents the 95% prediction region around the summary point.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing sensitivities and specificities of the studies that used ultrasound abdominal circumference to detect estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Figuras y tablas -
Figure 10

A forest plot representing sensitivities and specificities of the studies that used ultrasound abdominal circumference to detect estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

A forest plot representing sensitivities and specificities of the studies that used ultrasound femoral length to detect estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Figuras y tablas -
Figure 11

A forest plot representing sensitivities and specificities of the studies that used ultrasound femoral length to detect estimated fetal weight discordance (EFWD) of 25%. FN: false negative; FP: false positive; TN: true negative; TP: true positive.

Ir a la figura de la revisiónAbrir en una pestaña nueva

Cut‐off 20%

Figuras y tablas -
Test 1

Cut‐off 20%

Ir a la figura de la revisiónAbrir en una pestaña nueva

20% abdominal circumference

Figuras y tablas -
Test 2

20% abdominal circumference

Ir a la figura de la revisiónAbrir en una pestaña nueva

20% femur length

Figuras y tablas -
Test 3

20% femur length

Ir a la figura de la revisiónAbrir en una pestaña nueva

Cut‐off 25%

Figuras y tablas -
Test 4

Cut‐off 25%

Ir a la figura de la revisiónAbrir en una pestaña nueva

25% abdominal circumference

Figuras y tablas -
Test 5

25% abdominal circumference

Ir a la figura de la revisiónAbrir en una pestaña nueva

25% femur length

Figuras y tablas -
Test 6

25% femur length

Ir a la figura de la revisiónAbrir en una pestaña nueva
Summary of findings 1. Ultrasound for diagnosis of birth weight discordance in twin pregnancies at 20% cut‐off

Sensitivity

0.51 (95% CI 0.42 to 0.60)

Prevalencesa

18%

15%

28%

Specificity

0.91 (95% CI 0.89 to 0.93)

Outcome

No. of studies and

participants

Study design

Factors that may decrease certainty

Effect per 1000 women tested

Risk of bias

Indirectness

Inconsistency

Imprecision

Publication bias

Pretest probability of 18%

Pretest probability of 15%

Pretest probability of 28%

Test accuracy (certainty of the evidence)

True positives

(women with diagnosis of birth weight discordance)

22 studies,
1462 participants

Cohort‐type studies with delayed verification (cohort type accuracy study)

Very seriousb

Not serious

Very seriousc

Not serious

None

92 (76 to 108)

77 (63 to 90)

143 (118 to 168)

⊕⊝⊝⊝
Very lowd

False negatives

(women incorrectly classified as not having diagnosis of birth weight discordance)

88 (72 to 104)

73 (60 to 87)

137 (112 to 162)

True negatives
(women without diagnosis of birth weight discordance)

22 studies,

6453 participants

Cohort‐type studies with delayed verification (cohort type accuracy study)

Very seriousb

Not serious

Very seriousc

Not serious

None

746 (730 to 763)

774 (757 to 791)

655 (641 to 670)

⊕⊝⊝⊝
Very lowd

False positives
(women incorrectly classified as having diagnosis of birth weight discordance)

74 (57 to 90)

76 (59 to 93)

65 (50 to 79)

CI: confidence interval.
aThe prevalence used to represent the pretest probability are the median, first quartile and third quartile of the prevalences of included studies.
bIn more than 50% of the studies there were unclear statements regarding index test, use of proper reference standard and flow and timing elements; in 1/3 of the studies, it was unclear how the participants were selected.
cVery high unexplained heterogeneity in terms of sensitivity ranging from 0.16 to 1.00.
dGRADE certainty of evidence downgraded one level for risk of bias and two levels for inconsistency.

Figuras y tablas -
Summary of findings 1. Ultrasound for diagnosis of birth weight discordance in twin pregnancies at 20% cut‐off
Ir a la tabla de la revisión
Summary of findings 2. Ultrasound for diagnosis of birth weight discordance in twin pregnancies at 25% cut‐off

Sensitivity

0.46 (95% CI 0.26 to 0.66)

Prevalencesa

19%

9%

27%

Specificity

0.93 (95% CI 0.89 to 0.96)

Outcome

No. of studies and

participants

Study design

Factors that may decrease certainty

Effect per 1000 women tested

Risk of bias

Indirectness

Inconsistency

Imprecision

Publication bias

Pretest probability of 19%

Pretest probability of 9%

Pretest probability of 27%

Test accuracy (certainty of the evidence)

True positives

(women with diagnosis of birth weight discordance)

18 studies,
1679 participants

Cohort‐type studies with delayed verification (cohort type accuracy study)

Very seriousb

Not serious

Very seriousc

Not serious

None

87 (49 to 125)

41 (23 to 59)

124 (70 to 178)

⊕⊝⊝⊝
Very lowd

False negatives

(women incorrectly classified as not having diagnosis of birth weight discordance)

103 (65 to 141)

49 (31 to 67)

146 (92 to 200)

True negatives
(women without diagnosis of birth weight discordance)

18 studies
4792 participants

Cohort‐type studies with delayed verification (cohort type accuracy study)

Very seriousb

Not serious

Very seriousc

Not serious

None

753 (721 to 778)

846 (810 to 874)

679 (650 to 701)

⊕⊝⊝⊝
Very lowd

False positives
(women incorrectly classified as having diagnosis of birth weight discordance)

57 (32 to 89)

64 (36 to 100)

51 (29 to 80)

CI: confidence interval.
aThe prevalence used to represent the pretest probability are the median, first quartile and third quartile of the prevalences of included studies.
bAt least 50% of the studies had unclear statements regarding index test, use of proper reference standard and flow and timing elements.
cVery high unexplained heterogeneity in terms of sensitivity ranging from 0.1 to 1.00.
dGRADE certainty of evidence downgraded one level for risk of bias and two levels for inconsistency.

Figuras y tablas -
Summary of findings 2. Ultrasound for diagnosis of birth weight discordance in twin pregnancies at 25% cut‐off
Ir a la tabla de la revisión
Table 1. Meta‐analysis summary

Groups

No. of studies

Sensitivity (95% CI)

Specificity (95% CI)

LR+

LR–

BWD of 20%

22

0.51 (0.42 to 0.60)

0.91 (0.89 to 0.93)

5.9 (4.3 to 8.1)

0.53 (0.44 to 0.64)

EFWD by AC

7

0.57 (0.48 to 0.66)

0.84 (0.72 to 0.92)

3.6 (1.8 to 7.4)

0.51 (0.38 to 0.68)

EFWD by FL

7

0.60 (0.53 to 0.67)

0.87 (0.84 to 0.90)

4.6 (3.4 to 6.1)

0.46 (0.38 to 0.56)

BWD of 25%

18

0.46 (0.26 to 0.66)

0.93 (0.89 to 0.96)

6.7 (3.0 to 14.9)

0.58 (0.39 to 0.88)

EFWD by AC

7

0.42 (0.27 to 0.58)

0.88 (0.76 to 0.94)

3.3 (1.6 to 6.9)

0.67 (0.51 to 0.87)

EFWD by FL

4

0.55 (0.44 to 0.65)

0.91 (0.89 to 0.92)

5.8 (4.3 to 7.9)

0.50 (0.40 to 0.64)

AC: abdominal circumference; BWD: birth weight discordance; CI: confidence interval; EFWD: estimated fetal weight discordance; FL: femur length; LR+: likelihood ratio of a positive test; LR–: likelihood ratio of a negative test.

Figuras y tablas -
Table 1. Meta‐analysis summary
Ir a la tabla de la revisión
Table Tests. Data tables by test

Test

No. of studies

No. of participants

1 Cut‐off 20% Show forest plot

22

8005

2 20% abdominal circumference Show forest plot

7

2846

3 20% femur length Show forest plot

7

2791

4 Cut‐off 25% Show forest plot

18

6471

5 25% abdominal circumference Show forest plot

7

3614

6 25% femur length Show forest plot

4

2714
Figuras y tablas -
Table Tests. Data tables by test
Ir a la tabla de la revisión