Evidence map›Paper›PMID 29294147›Full record

SynthesisInternational orthopaedics2018

Diagnostic accuracy of interleukin-6 and procalcitonin in patients with periprosthetic joint infection: a systematic review and meta-analysis.

Jung-Ro Yoon, Se-Hyun Yang, Young-Soo Shin

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International orthopaedics, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 29 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
29citing papers in PubMed, 4 pooled it
9.7field-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.

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

29 citing papers in PubMed, 4 syntheses or guidelines pooled it, 65 citations in OpenAlex.

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  12. Procalcitonin as a Predictor of Septic Knee Arthritis: A Retrospective Cohort Study.Journal of the American Academy of Orthopaedic Surgeons. Global research & reviews · 2023
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  14. Phage Therapy for Limb-threatening Prosthetic Knee Klebsiella pneumoniae Infection: Case Report and In Vitro Characterization of Anti-biofilm Activity.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2021
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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

3 authors at 1 institution in 1 country.

Jung-Ro YoonDepartment of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-Gu, Seoul, 134-791, Republic of Korea.
Se-Hyun YangDepartment of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-Gu, Seoul, 134-791, Republic of Korea.
Young-Soo ShinDepartment of Orthopaedic Surgery, Veterans Health Service Medical Center, 61 Jinhwangdoro-gil, Gangdong-Gu, Seoul, 134-791, Republic of Korea. sysoo3180@naver.com.ORCID 0000-0003-1030-9979
Veterans Health Service Medical Center · KR

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeMany studies have found associations between laboratory biomarkers and periprosthetic joint infection (PJI), but it remains unclear whether these biomarkers are clinically useful in ruling out PJI. This meta-analysis compared the performance of interleukin-6 (IL-6) versus procalcitonin (PCT) for the diagnosis of PJI.

methodsIn this meta-analysis, we reviewed studies that evaluated IL-6 or/and PCT as a diagnostic biomarker for PJI and provided sufficient data to permit sensitivity and specificity analyses for each test. The major databases MEDLINE, EMBASE, the Cochrane Library, Web of Science, and SCOPUS were searched for appropriate studies from the earliest available date of indexing through February 28, 2017. No restrictions were placed on language of publication.

resultsWe identified 18 studies encompassing a total of 1,835 subjects; 16 studies reported on IL-6 and 6 studies reported on PCT. The area under the curve (AUC) was 0.93 (95% CI, 0.91-0.95) for IL-6 and 0.83 (95% CI, 0.79-0.86) for PCT. The pooled sensitivity was 0.83 (95% CI, 0.74-0.89) for IL-6 and 0.58 (95% CI, 0.31-0.81) for PCT. The pooled specificity was 0.91 (95% CI, 0.84-0.95) for IL-6 and 0.95 (95% CI, 0.63-1.00) for PCT. Both the IL-6 and PCT tests had a high positive likelihood ratio (LR); 9.3 (95% CI, 5.3-16.2) and 12.4 (95% CI, 1.7-89.8), respectively, making them excellent rule-in tests for the diagnosis of PJI. The pooled negative LR for IL-6 was 0.19 (95% CI, 0.12-0.29), making it suitable as a rule-out test, whereas the pooled negative LR for PCT was 0.44 (95% CI, 0.25-0.78), making it unsuitable as a rule-out diagnostic tool.

conclusionsBased on the results of the present meta-analysis, IL-6 has higher diagnostic value than PCT for the diagnosis of PJI. Moreover, the specificity of the IL-6 test is higher than its sensitivity. Conversely, PCT is not recommended for use as a rule-out diagnostic tool.

Indexed as

AgedArthritis, InfectiousBiomarkersFemaleHumansInterleukin-6MaleMiddle AgedProcalcitoninProsthesis-Related InfectionsSensitivity and SpecificityBiomarkersInterleukin-6ProcalcitoninDiagnosisInterleukin-6Meta-analysisProcalcitonin

Identifiers

PMID29294147
OpenAlexW2781571003

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.