Evidence map›Paper›PMID 27903285›Full record

ArticleSystematic reviews2016

Prognostic biomarkers to identify patients destined to develop severe Crohn's disease who may benefit from early biological therapy: protocol for a systematic review, meta-analysis and external validation.

Steve Halligan, Darren Boone, Gauraang Bhatnagar, Tariq Ahmad, Stuart Bloom, Manuel Rodriguez-Justo, Stuart A Taylor, Susan Mallett

Abstract read
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In one paragraph

Article in Systematic reviews, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Review
  3. Article
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.

Steve HalliganCentre for Medical Imaging, UCL, 3rd Floor East, 250 Euston Road, London, NW1 2PG, UK. s.halligan@ucl.ac.uk.ORCID 0000-0003-0632-5108
Darren BooneDepartment of Radiology, Colchester Hospital University NHS Foundation Trust, Colchester General Hospital, Turner Road, Colchester, Essex, CO4 5JL, UK.
Gauraang BhatnagarCentre for Medical Imaging, UCL, 3rd Floor East, 250 Euston Road, London, NW1 2PG, UK.
Tariq AhmadDepartment of Gastroenterology, Royal Devon and Exeter NHS Foundation Trust, Barrack Road, Exeter, EX2 5DW, UK.
Stuart BloomDepartment of Gastroenterology, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
Manuel Rodriguez-JustoDepartment of Histopathology, University College Hospital, 235 Euston Road, London, NW1 2BU, UK.
Stuart A TaylorCentre for Medical Imaging, UCL, 3rd Floor East, 250 Euston Road, London, NW1 2PG, UK.
Susan MallettSchool of Health and Population Sciences, University of Birmingham, Edgbaston, Birmingham, B15 2TT, UK.

Funding

Department of Health HTA/14/210/07
6 · The paper itself

Abstract

backgroundIt is believed increasingly that patients with severe Crohn's disease are best treated early with biological therapy, which may ameliorate subsequent disease course and diminish long-term complications. However, we cannot predict currently which new presentations of Crohn's disease are destined to develop severe disease so treatment cannot be targeted to the most appropriate patients. Accordingly, via systematic review and meta-analysis we aim to identify if biomarkers of disease activity are able to predict development of severe disease. METHODS/

designWe will search the primary literature and conference proceedings for studies of biomarkers of all types including clinical, endoscopic, radiological, faecal, urinary, serological, genetic, and histological. Precise definition of "severe" disease is elusive so we will include sensitivity analysis to account for different definitions. We will use the CHARMS checklist to frame our question and to extract data. We will extract the study design, setting, participant characteristics, biomarker(s) investigated, and study outcomes. Bias will be assessed via the PROBAST tool. We will present the results using narrative and graphical methods. We will present the summary by meta-analysis where there are sufficient studies with reasonable homogeneity, using methods appropriate to the type of data extracted. Heterogeneity will be presented via Forest and ROC plots. DISCUSSION: If this systematic review and meta-analysis identifies biomarkers that appear sufficiently predictive for subsequent severe disease course, we aim to combine them in a predictive model, followed by external validation using individual patient data. A predictive model able to identify new presentations of Crohn's disease destined to develop severe disease subsequently would have considerable clinical utility for patient management. SYSTEMATIC REVIEW REGISTRATION: PROSPERO CRD42016029363 .

Indexed as

BiomarkersSecondary PreventionBiological TherapyCrohn DiseaseHumansMeta-Analysis as TopicPrognosisSystematic Reviews as TopicBiomarkersBiological markersBiomarkersCrohn’s diseaseDiagnostic accuracyMeta-analysisPredictionPrognosisReview, systematic

Identifiers

PMID27903285
PMCPMC5131410

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Registered trials

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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.