SynthesisFrontiers in microbiology2026
Noninvasive microbiota-based diagnostic models for pancreatic ductal adenocarcinoma: a systematic review and diagnostic test accuracy meta-analysis.
Synthesis in Frontiers in microbiology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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.
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.
Who cites it
0 citing papers in PubMed.
No citing paper in PubMed yet.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
Background: Due to delays in diagnosis, many patients with pancreatic ductal adenocarcinoma (PDAC) miss the window for curative interventions. The oral and gut microbiomes are attractive as noninvasive triage instruments; however, while the literature provides AUROC values, it has not established clinically useful thresholds. Objective: To systematically assess the diagnostic performance and clinical maturity of noninvasive microbiota-derived tools for identifying PDAC. Methods: Following PRISMA 2020 and PRISMA-DTA, we searched eight databases up to April 19, 2026, and conducted a targeted supplementary search on September 3, 2026. Risk of bias was assessed using PROBAST and QUADAS-2. The nine-row meta-analysis, which included approximations and correlated estimates, was exploratory. Results: The initial search and targeted supplementary search yielded 16 studies covering 21 sample-domain items; 20 model-based records constituted the units of analysis for the risk-of-bias assessment. Fifty-one AUROC estimates formed a separate list of discrimination estimates. Six-row fixed-threshold data from five studies constituted the primary descriptive core. Sensitivity ranged from 0.682 to 0.964, and specificity ranged from 0.667 to 0.963. The exploratory nine-row bivariate model yielded pooled sensitivity of 0.86 (95% CI 0.80-0.90) and specificity of 0.80 (95% CI 0.73-0.86). These nine rows represented seven studies; Li 2025 and Chen 2025b each provided a correlated row, so the pooled estimates were hypothesis-generating. The certainty of evidence was rated very low using an adapted, GRADE-informed appraisal. All model-based rows (20/20) were at high risk of bias in the PROBAST analysis domain and high overall risk on QUADAS-2. Although stool-based testing provided the clearest signal of external validation, benign pancreatic mimics remained underrepresented. Conclusion: Detecting PDAC via noninvasive microbiota classifiers carries a biologically plausible yet very low-certainty diagnostic signal. Current findings do not support stand-alone clinical deployment and support only exploratory adjunctive triage. Validating prospectively against benign pancreatic mimics is mandatory before routine clinical adoption. Systematic review registration: https://www.crd.york.ac.uk/PROSPERO/view/CRD420261370926, Identifier, CRD420261370926.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.