Evidence map›Paper›PMID 23334663›Full record

SynthesisEuropean journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology2013

The use of procalcitonin in the diagnosis of bone and joint infection: a systemic review and meta-analysis.

C-J Shen, M-S Wu, K-H Lin, W-L Lin, H-C Chen, J-Y Wu, M C-H Lee, C-C Lee

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 22 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
22citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

22 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Review
  5. Review
  6. Article
  7. Article
  8. Review
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Review
  16. A Real Pain: Diagnostic Quandaries and Septic Arthritis.Journal of clinical microbiology · 2018
    Review
  17. A Case of Acute Osteomyelitis: An Update on Diagnosis and Treatment.International journal of environmental research and public health · 2016
    Review
  18. Article
  19. Review
  20. Procalcitonin: present and future.Irish journal of medical science · 2015
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

C-J ShenDepartment of Emergency Medicine, Chang Gung Memorial Hospital, Keelung, Taiwan.
M-S Wu
K-H Lin
W-L Lin
H-C Chen
J-Y Wu
M C-H Lee
C-C Lee

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Only a few studies have investigated the use of PCT in the diagnosis of bone and joint infection, and these studies have had relatively small sample sizes. We performed a systematic review and meta-analysis of the diagnostic performance of serum procalcitonin (PCT) in the identification of osteomyelitis and septic arthritis in patients who present with fever and orthopedic symptoms. EMBASE, MEDLINE, and Cochrane databases and the reference lists of relevant articles were searched, with no language restrictions, through February 2012. All original studies that reported the use of serum PCT alone or in comparison with other biomarkers for diagnosis of osteomyelitis and septic arthritis were included. Seven studies qualified for inclusion. These studies enrolled a total of 583 patients with suspected bone or joint infection, 131 of whom had confirmed osteomyelitis or septic arthritis. Analysis of the PCT data indicated a bivariate pooled sensitivity of 0.67 (95 % CI: 0.37-0.88), specificity of 0.90 (95 % CI: 0.78-0.96), a positive likelihood ratio (LR+) of 6.48 (95 % CI: 2.28-14.6), and a negative likelihood ratio (LR-) of 0.37 (95 % CI: 0.16-0.84). Use of a lower PCT cut-off value (0.2-0.3 ng/mL) improved the LR + to 6.66 and the LR- to 0.15. Analysis of the three studies that also measured serum C-reactive protein (CRP) indicated that CRP had an LR + of 1.39 (95 % CI: 1.17-1.65) and an LR- of 0.40 (95 % CI: 0.12-1.36). Our results indicate that PCT may be more suitable as an aid for rule-in diagnosis rather than for exclusion of septic arthritis or osteomyelitis and that use of a lower cut-off value for serum PCT may improve its diagnostic performance.

Indexed as

Arthritis, InfectiousCalcitoninCalcitonin Gene-Related PeptideHumansOdds RatioOsteomyelitisProtein PrecursorsROC CurveCALCA protein, humanCalcitoninCalcitonin Gene-Related PeptideProtein Precursors

Identifiers

PMID23334663

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.