Evidence map›Paper›PMID 38204852›Full record

ReviewCJC open2023

Diagnostic Accuracy of ECG to Detect Left Ventricular Hypertrophy in Patients with Left Bundle Branch Block: A Systematic Review and Meta-analysis.

Isabela A F de Souza, Eduardo M H Padrao, Isabela R Marques, Isabele A Miyawaki, José Eduardo Riceto Loyola Júnior, Vittoria Caporal S Moreira, Cintia Gomes, Caroliny H A Silva, Carson Oprysko, Augusto Barreto do Amaral Neto and 4 more

Open access · goldAbstract readReview
In one paragraph

Review in CJC open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
0.4field-weighted citation impact, top 33% 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

2 citing papers in PubMed, 2 citations in OpenAlex.

  1. Article
  2. Observational
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

14 authors at 11 institutions in 4 countries.

Isabela A F de SouzaFaculdade de Medicina de Petrópolis, Petrópolis, Rio de Janeiro, Brazil.
Eduardo M H PadraoDepartment of Pulmonary and Critical Care, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Isabela R MarquesUniversitat Internacional de Catalunya, Barcelona, Catalunya, Spain.
Isabele A MiyawakiUniversidade Federal do Paraná, Curitiba, Paraná, Brazil.
José Eduardo Riceto Loyola JúniorHospital Alemão Oswaldo Cruz, São Paulo, SP, Brazil.
Vittoria Caporal S MoreiraFaculdade Israelita de Ciências da Saúde Albert Einstein, São Paulo, SP, Brazil.
Cintia GomesUniversidade Federal de Santa Maria, Santa Maria, Rio Grande do Sul, Brazil.
Caroliny H A SilvaUniversidade Federal do Rio Grande do Norte, Natal, Rio Grande do Norte, Brazil.
Carson OpryskoDepartment of Internal Medicine, University of Connecticut, Farmington, Connecticut, USA.
Augusto Barreto do Amaral NetoCentral Montana Medical Center, Lewistown, Montana, USA.
Rhanderson CardosoBrigham and Women's Hospital, Harvard Medical School, Boston, Massachusetts, USA.
Nelson SamesianaInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, São Paulo, SP, Brazil.
Carlos Alberto PastoreInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, São Paulo, SP, Brazil.
Caio A M TavaresInstituto do Coracao (InCor), Hospital das Clinicas HCFMUSP, São Paulo, SP, Brazil.
Hospital do Coração · BRHospital Israelita Albert Einstein · BRUniversity of Connecticut · USBrigham and Women's Hospital · USCentral Maine Medical Center · USFaculdade de Medicina de Petrópolis · BRHospital Alemão Oswaldo Cruz · BRUniversidade Federal de Santa Maria · BRUniversidade Federal do Paraná · BRUniversidade Federal do Rio Grande do Norte · BRUniversitat Internacional de Catalunya · ES

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Background: Electrocardiographic (ECG) criteria to detect left ventricular hypertrophy (LVH) in patients with left bundle branch block (LBBB) remain under debate. We conducted a systematic review and meta-analysis to evaluate the diagnostic accuracy of different ECG criteria for diagnosing LVH in patients with LBBB. Methods: We searched PubMed, Embase, Cochrane, and LILACS for articles evaluating the diagnostic accuracy of ECG criteria for LVH in patients with LBBB published between 1984 and 2023. Echocardiogram, magnetic resonance imaging, or autopsy were used as the reference standard for diagnosis of LVH. Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) tool. The co-primary outcomes were sensitivity, specificity, the diagnostic odds ratio, and likelihood ratios, estimated using a bivariate generalized linear mixed model for each ECG criterion. The prespecified protocol was registered in the International Prospective Register of Systematic Reviews (PROSPERO). Results: We included 12 studies with a total of 1023 patients. We analyzed 10 criteria for LVH on ECG, including the Sokolow-Lyon criterion, the Cornell criterion, the RaVL (R wave in aVL) criterion, the Gubner-Ungerleider criterion, and the Dálfo criterion, among others. The Dalfó criterion was used for 487 patients and had the highest pooled sensitivity of 86% (95% confidence interval [CI] 57%-97%). All the other criteria had poor sensitivities. The Gubner-Ungerleider criterion and the RV5 or RV6 > 25 mm criterion had the highest specificities, with the former being used for 805 patients, obtaining a specificity of 99% (95% CI 80%-100%) and the latter being used for 355 patients, obtaining a specificity of 99% (95% CI 94%-100%). Conclusions: In patients with LBBB, the use of ECG criteria had poor performance for ruling out LVH, mostly due to low sensitivities. None of the criteria analyzed demonstrated a balanced tradeoff between sensitivity and specificity, suggesting that ECG should not be used routinely to screen for LVH.

Identifiers

PMID38204852
PMCPMC10774079
OpenAlexW4386296053

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.