SynthesisClinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association2018
Diagnostic Performance of Measurement of Fecal Elastase-1 in Detection of Exocrine Pancreatic Insufficiency: Systematic Review and Meta-analysis.
Synthesis in Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05480241 (Impact of Exocrine Pancreatic Insufficiency Associated With Acute Pancreatitis and Pancreatic Enzyme Replacement Therapy on Gut Microbiota, Immunological Changes and Quality of Life), which is not on this map. Cited by 85 papers, 9 of them syntheses that pooled it.
What it found
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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.
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.
Impact of Exocrine Pancreatic Insufficiency Associated With Acute Pancreatitis and Pancreatic Enzyme Replacement Therapy on Gut Microbiota, Immunological Changes and Quality of Life
Who cites it
85 citing papers in PubMed, 9 syntheses or guidelines pooled it, 211 citations in OpenAlex.
- Incidence of Secondary Pancreatic Exocrine Insufficiency after Metabolic Bariatric Surgery: a Systematic Review and Meta-Analysis.Obesity surgery · 2026Pooled it
- Diagnostic Accuracy of Fecal Elastase-1 Test for Pancreatic Exocrine Insufficiency: A Systematic Review and Meta-Analysis.United European gastroenterology journal · 2025Pooled it
- Pancreatic Enzyme Replacement Therapy in Pancreatic Exocrine Insufficiency-Real-World's Dosing and Effectiveness: A Systematic Review.Digestive diseases and sciences · 2025Pooled it
- European Consensus on Malabsorption-UEG & SIGE, LGA, SPG, SRGH, CGS, ESPCG, EAGEN, ESPEN, and ESPGHAN. Part 1: Definitions, Clinical Phenotypes, and Diagnostic Testing for Malabsorption.United European gastroenterology journal · 2025Guideline
- European guidelines for the diagnosis and treatment of pancreatic exocrine insufficiency: UEG, EPC, EDS, ESPEN, ESPGHAN, ESDO, and ESPCG evidence-based recommendations.United European gastroenterology journal · 2025Guideline
- Clinical Efficacy and Safety of Treatments for Exocrine Pancreatic Insufficiency: A Systematic Literature Review.Digestion · 2025Pooled it
- Exocrine Pancreatic Insufficiency Is Common in Celiac Disease: A Systematic Review and Meta-Analysis.Digestive diseases and sciences · 2023Pooled it
- Timing of pancreatic enzyme replacement therapy (PERT) in cystic fibrosis.The Cochrane database of systematic reviews · 2021Pooled it
- Differential diagnosis of diarrhoea in patients with neuroendocrine tumours: A systematic review.World journal of gastroenterology · 2020Pooled it
- [When the intestine swallows the pounds].Innere Medizin (Heidelberg, Germany) · 2026Article
- Unique causes of exocrine pancreatic insufficiency: When to consider pancreatic enzyme supplementation: A narrative review.Nutrition in clinical practice : official publication of the American Society for Parenteral and Enteral Nutrition · 2026Review
- Dietary Patterns Following an Episode of Acute Pancreatitis: A Post Hoc Analysis From the PAPPEI Multicenter, Prospective Study.Pancreas · 2026Article
- Study Design Considerations for the Evaluation of Pancreatic Enzyme Replacement Therapy (PERT) Products in People with Cystic Fibrosis: An Update.Clinical therapeutics · 2026Review
- High Frequency of Pancreatic Exocrine Insufficiency Among Patients with Abdominal Pain, Bloating, and Malodorous Flatus: Hidden Pancreatic InsufficiencyThe Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Article
- Utility of Fecal Elastase-1 in Estimating Exocrine Pancreatic Function in Cystic Fibrosis: A Scoping Review.Pediatric pulmonology · 2026Article
- Clinical Practice Update on the Evaluation, Diagnosis, and Management of Pancreatic Exocrine Insufficiency: Expert Review.The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology · 2026Review
- Low Fecal Elastase-1: A Non-negligible Factor in Functional Dyspepsia Patients.Digestive diseases and sciences · 2026Article
- Disparities in the diagnosis and management of exocrine pancreatic insufficiency in resectable vs metastatic pancreatic cancer.The oncologist · 2026Article
- The prevalence of exocrine pancreatic insufficiency in diabetes mellitus - a multicentre study.Przeglad gastroenterologiczny · 2026Article
- Pancreatic Exocrine Insufficiency After Metabolic and Bariatric Surgery.Digestive diseases and sciences · 2026Review
25 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
5 authors at 3 institutions in 1 country.
Funding
Abstract
BACKGROUND &
aimsTests to quantify fecal levels of chymotrypsin like elastase family member 3 (CELA3 or elastase-1) in feces are widely used to identify patients with exocrine pancreatic insufficiency (EPI). However, the diagnostic accuracy of this test, an ELISA, is not clear. We performed a systematic review and meta-analysis to determine the accuracy of measurement of fecal elastase-1 in detection of EPI.
methodsWe searched PubMed, Embase, and reference lists for articles through November 2016 describing studies that compared fecal level of elastase-1 with results from a reference standard, direct method (secretin stimulation test), or indirect method (measurement of fecal fat) for detection of EPI. Sensitivity and specificity values were pooled statistically using bivariate diagnostic meta-analysis.
resultsWe included total of 428 cases of EPI and 673 individuals without EPI (controls), from 14 studies, in the meta-analysis. The assay for elastase-1, compared to secretin stimulation test, identified patients with pancreatic insufficiency with a pooled sensitivity value of 0.77 (95% CI, 0.58-0.89) and specificity value of 0.88 (95% CI, 0.78-0.93). In an analysis of 345 cases of EPI and 312 controls, from 6 studies, the fecal elastase-1 assay identified patients with EPI with a pooled sensitivity value of 0.96 (95% CI, 0.79-0.99) and specificity value of 0.88 (95% CI, 0.59-0.97), compared to quantitative fecal fat estimation. In patients with low pre-test probability of EPI (5%), the fecal elastase-1 assay would have a false-negative rate of 1.1% and a false-positive rate of 11%, indicating a high yield in ruling out EPI but not in detection of EPI. In contrast, in patients with high pre-test probability of EPI (40%), approximately 10% of patients with EPI would be missed (false negatives).
conclusionsIn a systematic review and meta-analysis of studies that compared fecal level of elastase-1 for detection of EPI, we found that normal level of elastase-1 (above 200 mcg/g) can rule out EPI in patients with a low probability of this disorder (such as those with irritable bowel syndrome with diarrhea). However, in these patients, an abnormal level of elastase-1 (below 200 mcg/g) has a high false-positive rate.
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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.