Evidence map›Paper›PMID 25732419›Full record

SynthesisThe American journal of gastroenterology2015

A meta-analysis of the utility of C-reactive protein, erythrocyte sedimentation rate, fecal calprotectin, and fecal lactoferrin to exclude inflammatory bowel disease in adults with IBS.

Stacy B Menees, Corey Powell, Jacob Kurlander, Akash Goel, William D Chey

2 registry-linked trialsAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in The American journal of gastroenterology, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 2 registered trials, which are not on this map. Cited by 152 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
152citing papers in PubMed, 8 pooled it
24.5field-weighted citation impact, top 1% of its field
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.

NCT04491799 completednot on this mapstarted 2019, after this paper: background citation

Fecal Calprotectin Level in Differentiating Between Inflammatory and Non-inflammatory Diarrhea in Patients With Nosocomial Diarrhea

TypeobservationalSponsorMahidol UniversityRan2019 to 2020Enrolled135ConditionsDiarrhea, CalprotectinArmsFecal calprotectin
NCT07103772 naenrolling by invitationnot on this mapstarted 2024, after this paper: background citation

Effect of Consuming a Nutraceutical Composition Based on Pineapple and Natural Extracts on Signs and Symptoms in Adult Patients With Irritable Bowel Syndrome

TypeinterventionalSponsorUniversidad Autonoma de Nuevo LeonRan2024 to 2026Enrolled94ConditionsIrritable Bowel Syndrome, Irritable Bowel Syndrome With Diarrhea, Irritable Bowel Syndrome With Constipation, Irritable Bowel Syndrome MixedArmsAnaná
3 · Its place in the literature

Who cites it

152 citing papers in PubMed, 8 syntheses or guidelines pooled it, 383 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
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  5. Guideline
  6. Pooled it
  7. Pooled it
  8. ACG Clinical Guideline: Management of Crohn's Disease in Adults.The American journal of gastroenterology · 2018
    Guideline
  9. Trial
  10. Irritable bowel syndrome.Nature reviews. Disease primers · 2026
    Review
  11. Article
  12. Article
  13. Article
  14. Review
  15. Article
  16. Article
  17. Article
  18. Review
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  20. Article

92 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

5 authors at 3 institutions in 1 country.

Stacy B MeneesDivision of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Corey PowellCenter for Statistical Consultation and Research (CSCAR), University of Michigan, Ann Arbor, Michigan, USA.
Jacob KurlanderDivision of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Akash GoelDivision of Internal Medicine, Columbia University, New York Presbyterian, New York, New York, USA.
William D CheyDivision of Gastroenterology, University of Michigan Health System, Ann Arbor, Michigan, USA.
Michigan Medicine · USUniversity of Michigan–Ann Arbor · USTexas Health Dallas · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesIrritable bowel syndrome (IBS) is viewed as a diagnosis of exclusion by most providers. The aim of our study was to perform a systematic review and meta-analysis to evaluate the utility of C-reactive protein (CRP), erythrocyte sedimentation rate (ESR), fecal calprotectin, and fecal lactoferrin to distinguish between patients with IBS and inflammatory bowel disease (IBD) and healthy controls (HCs).

methodsA systematic online database search was performed. Included studies were prospective, adult, diagnostic cohort studies with any of the four tests. The means and s.d. values of biomarker logarithms were estimated based on studies that gave medians and either confidence intervals for the median, interquartile ranges, or ranges. We used a Naive Bayes approach to estimate the probability of being a HC, having IBS, or having IBD based on the biomarker values.

resultsSystematic review identified 1,252 citations. After cross-referencing medical subject headings, detailed evaluation identified 140 potentially relevant journal articles/abstracts for CRP, ESR, calprotectin, and lactoferrin of which 4, 4, 8, and 2 fulfilled our inclusion criteria, respectively. None of the biomarkers reliably distinguished between IBS and healthy controls. At a CRP level of ≤0.5 or calprotectin level of ≤40 μg/g, there was a ≤1% probability of having IBD. Individual analysis of ESR and lactoferrin had little clinical utility.

conclusionCRP and calprotectin of ≤0.5 or 40, respectively, essentially excludes IBD in patients with IBS symptoms. The addition of CRP and calprotectin to symptom-based criteria may improve the confident diagnosis of IBS.

Indexed as

Blood SedimentationAdultBiomarkersC-Reactive ProteinDiagnosis, DifferentialFecesHumansInflammatory Bowel DiseasesIrritable Bowel SyndromeLactoferrinLeukocyte L1 Antigen ComplexReproducibility of ResultsBiomarkersC-Reactive ProteinLactoferrinLeukocyte L1 Antigen Complex

Identifiers

PMID25732419
OpenAlexW2077187057

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

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.