Evidence map›Paper›PMID 27377905›Full record

SynthesisKnee surgery, sports traumatology, arthroscopy : official journal of the ESSKA2016

Accuracy of diagnostic tests for prosthetic joint infection: a systematic review.

Sufian S Ahmad, Ahmed Shaker, Mo Saffarini, Antonia F Chen, Michael T Hirschmann, Sandro Kohl

Abstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in Knee surgery, sports traumatology, arthroscopy : official journal of the ESSKA, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 4 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

34 citing papers in PubMed, 4 syntheses or guidelines pooled it.

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  17. The Role of Nuclear Medicine Imaging withDiagnostics (Basel, Switzerland) · 2022
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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

6 authors.

Sufian S AhmadDepartment of Orthopaedic Surgery, Bern University Hospital, Inselspital, Bern, Switzerland. Sufian.ahmad@insel.ch.
Ahmed ShakerDepartment of Orthopaedic Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.
Mo SaffariniDepartment of Medical Research, Alliance Scientifique SAS, Lyon, France.
Antonia F ChenRothman Institute, Thomas Jefferson University Hospital, Philadelphia, Pennsylvania, USA.
Michael T HirschmannDepartment of Orthopaedic Surgery and Traumatology, Kantonsspital Baselland-Bruderholz, Basel, Switzerland.
Sandro KohlDepartment of Orthopaedic Surgery, Bern University Hospital, Inselspital, Bern, Switzerland.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThere are few evidence-based recommendations on the most effective methods for diagnosing prosthetic joint infections (PJIs), and the potency of tests in relation to each other also remains vague. This systematic review aimed to (1) identify systematic reviews reporting accuracies of available approaches for diagnosing PJI, (2) critically appraise their quality and bias, and (3) compare the available approaches in terms of accuracy for diagnosing PJI.

methodsPubMed and EMBASE databases were searched for meta-analyses reporting accuracies of different diagnostic modalities for PJIs. Thirteen systematic reviews met the inclusion and exclusion criteria, and their data were extracted and tabulated by two reviewers in duplicate and independent manners.

resultsThe 13 articles reported diagnostic accuracy from 278 clinical studies comprising 27,754 patients and evaluating 13 diagnostic tests grouped into 7 broad categories. Implant sonication had the highest positive likelihood ratio (17.2), followed by bacteriology (15.3) and synovial fluid differentiated cytology (13.3). The highest negative likelihood ratio was for interleukin (IL)-6 serum marker (0.03) followed by synovial fluid cytology and differentiation (0.12 and 0.13, respectively).

conclusionThe diagnostic tests that are most likely to rule out PJI include serum IL-6, serum C-reactive protein, and synovial fluid cytology. On the other hand, the diagnostic test that is most likely to confirm PJI is implant sonication. Nuclear imaging showed low overall accuracy as diagnostic tests for PJI. The findings of this study could enable clinicians to confirm or rule out PJIs using the most accurate, rapid, least invasive, and cost-effective tools available, thereby enabling fast treatment before formation of resistant biofilms and degradation of patient conditions. LEVEL OF EVIDENCE: Systematic review, Level IV.

Indexed as

Arthroplasty, ReplacementBacterial Typing TechniquesC-Reactive ProteinHumansInterleukin-6Joint ProsthesisLikelihood FunctionsProsthesis-Related InfectionsSynovial FluidC-Reactive ProteinIL6 protein, humanInterleukin-6DiagnosisDiagnostic accuracyJoint infectionPJIProsthetic joint infection

Identifiers

PMID27377905

What OpenQuestion holds

Textmetadata
Read underepoch 390

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.