Evidence map›Paper›PMID 36157929›Full record

SynthesisWorld journal of gastroenterology2022

Use of shear wave elastography for the diagnosis and follow-up of biliary atresia: A meta-analysis.

Ellen S Wagner, Hussien Ahmed H Abdelgawad, Meghan Landry, Belal Asfour, Mark B Slidell, Ruba Azzam

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in World journal of gastroenterology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
11citing papers in PubMed, 2 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

11 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  3. Review
  4. Article
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  6. Article
  7. Biliary atresia.Nature reviews. Disease primers · 2024
    Review
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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.

Ellen S WagnerPediatric Gastroenterology, Hepatology, and Nutrition, The University of Chicago Medicine, Comer Children' s Hospital, Chicago, IL 60637, United States.
Hussien Ahmed H AbdelgawadDepartment of Medicine, Zagazig University, Zagazig 44511, Egypt, Egypt.
Meghan LandryDepartment of Pediatrics, The University of Chicago Medicine, Comer Children' s Hospital, Chicago, IL 60637, United States.
Belal AsfourGraduate School of Professional Education-Biomedical Informatics, University of Chicago, Chicago, IL 60637, United States.
Mark B SlidellDepartment of Surgery, The University of Chicago Medicine, Comer Children' s Hospital, Chicago, IL 60637, United States.
Ruba AzzamPediatric Gastroenterology, Hepatology, and Nutrition, The University of Chicago Medicine, Comer Children' s Hospital, Chicago, IL 60637, United States. razzam@peds.bsd.uchicago.edu.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundTimely differentiation of biliary atresia (BA) from other infantile cholestatic diseases can impact patient outcomes. Additionally, non-invasive staging of fibrosis after Kasai hepatoportoenterostomy has not been widely standardized. Shear wave elastography is an ultrasound modality that detects changes in tissue stiffness. The authors propose that the utility of elastography in BA can be elucidated through meta-analysis of existing studies.

aimTo assess the utility of elastography in: (1) BA diagnosis, and (2) post-Kasai fibrosis surveillance.

methodsA literature search identified articles that evaluated elastography for BA diagnosis and for post-Kasai follow-up. Twenty studies met criteria for meta-analysis: Eleven for diagnosis and nine for follow-up post-Kasai. Estimated diagnostic odds ratio (DOR), sensitivity, and specificity of elastography were calculated through a random-effects model using Meta-DiSc software.

resultsMean liver stiffness in BA infants at diagnosis was significantly higher than in non-BA, with overall DOR 24.61, sensitivity 83%, and specificity 79%. Post-Kasai, mean liver stiffness was significantly higher in BA patients with varices than in patients without, with DOR 16.36, sensitivity 85%, and specificity 76%. Elastography differentiated stage F4 fibrosis from F0-F3 with DOR of 70.03, sensitivity 96%, and specificity 89%. Elastography also differentiated F3-F4 fibrosis from F0-F2 with DOR of 24.68, sensitivity 85%, and specificity 81%.

conclusionElastography has potential as a non-invasive modality for BA diagnosis and surveillance post-Kasai. This paper's limitations include inter-study method heterogeneity and small sample sizes. Future, standardized, multi-center studies are recommended.

Indexed as

Biliary AtresiaElasticity Imaging TechniquesFibrosisFollow-Up StudiesHumansInfantLiverLiver CirrhosisPortoenterostomy, HepaticBiliary atresiaCholestasisElasticity imaging techniquesEsophageal and gastric varicesFibrosisHepatic portoenterostomy

Identifiers

PMID36157929
PMCPMC9476882

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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.