Evidence map›Paper›PMID 28674134›Full record

SynthesisBMJ open2017

Test accuracy of drug and antibody assays for predicting response to antitumour necrosis factor treatment in Crohn's disease: a systematic review and meta-analysis.

Karoline Freeman, Sian Taylor-Phillips, Martin Connock, Rachel Court, Alexander Tsertsvadze, Deepson Shyangdan, Peter Auguste, Hema Mistry, Ramesh Arasaradnam, Paul Sutcliffe and 1 more

Open access · goldAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed, 2 pooled it
2.4field-weighted citation impact, top 11% 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.

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

9 citing papers in PubMed, 2 syntheses or guidelines pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Observational
  4. Article
  5. Article
  6. Immunogenicity of biologic agents in rheumatology.Nature reviews. Rheumatology · 2021
    Review
  7. Review
  8. Article
  9. 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

11 authors at 2 institutions in 1 country.

Karoline FreemanWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Sian Taylor-PhillipsWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Martin ConnockWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Rachel CourtWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Alexander TsertsvadzeWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Deepson ShyangdanWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Peter AugusteWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Hema MistryWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Ramesh ArasaradnamWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Paul SutcliffeWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
Aileen ClarkeWarwick Medical School, University of Warwick, Coventry, Warwickshire, UK.
University of Warwick · GBUniversity Hospital Coventry · GB

Funding

Department of Health CDF-2016-09-018
6 · The paper itself

Abstract

objectiveTo present meta-analytic test accuracy estimates of levels of antitumour necrosis factor (anti-TNF) and antibodies to anti-TNF to predict loss of response or lack of regaining response in patients with anti-TNF managed Crohn's disease.

methodsMEDLINE, Embase, the Cochrane Library and Science Citation Index were searched from inception to October/November 2014 to identify studies which reported 2×2 table data of the association between levels of anti-TNF or its antibodies and clinical status. Hierarchical/bivariate meta-analysis was undertaken with the user-written 'metandi' package of Harbord and Whiting using Stata V.11 software, for infliximab, adalimumab,anti-infliximab and anti-adalimumab levels as predictors of loss of response. Prevalence of Crohn's disease in included studies was meta-analysed using a random effects model in MetaAnalyst software to calculate positive and negative predictive values. The search was updated in January 2017.

results31 studies were included in the review. Studies were heterogeneous with respect to the type of test used, criteria for establishing response and loss of response, population examined and results. Meta-analytic summary point estimates for sensitivity and specificity were 65.7% and 80.6% for infliximab trough levels and 56% and 79% for antibodies to infliximab, respectively. Pooled results for adalimumab trough levels and antibodies to adalimumab were similar. Pooled positive and negative predictive values ranged between 70% and 80% implying that between 20% and 30% of both positive and negative test results may be incorrect in predicting loss of response.

conclusionThe available evidence suggests that these tests have modest predictive accuracy for clinical status; direct test accuracy comparisons in the same population are needed. More clinical trial evidence from test-treat studies is required before the clinical utility of the tests can be reliably evaluated.

Indexed as

AdalimumabAntibodiesCrohn DiseaseHumansInfliximabPredictive Value of TestsTreatment OutcomeTumor Necrosis Factor-alphaAdalimumabAntibodiesInfliximabTumor Necrosis Factor-alphaanti-TNFCrohn diseasemeta-analysispredictive valuesensitivityspecificity

Identifiers

PMID28674134
PMCPMC5734585
OpenAlexW2615523787

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.