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Fecal immunochemical test for predicting mucosal healing in ulcerative colitis patients: A systematic review and meta‐analysis
Author(s) -
Dai Cong,
Jiang Min,
Sun MingJun,
Cao Qin
Publication year - 2018
Publication title -
journal of gastroenterology and hepatology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.214
H-Index - 130
eISSN - 1440-1746
pISSN - 0815-9319
DOI - 10.1111/jgh.14121
Subject(s) - diagnostic odds ratio , likelihood ratios in diagnostic testing , medicine , receiver operating characteristic , confidence interval , meta analysis , odds ratio , ulcerative colitis , area under the curve , gastroenterology , checklist , pre and post test probability , disease , psychology , cognitive psychology
Background and Aim Fecal immunochemical test (FIT) is a promising marker for assessment of inflammatory bowel disease activity. However, the utility of FIT for predicting mucosal healing (MH) of ulcerative colitis (UC) patients has yet to be clearly demonstrated. The objective of our study was to perform a diagnostic test accuracy test meta‐analysis evaluating the diagnostic accuracy of FIT in predicting MH of UC patients. Methods We systematically searched the databases from inception to November 2017 that evaluated MH in UC. The methodological quality of each study was assessed according to the Quality Assessment of Diagnostic Accuracy Studies checklist. The extracted data were pooled using a summary receiver operating characteristic curve model. Random‐effects model was used to summarize the diagnostic odds ratio, sensitivity, specificity, positive likelihood ratio, and negative likelihood ratio. Results Six studies comprising 625 UC patients were included in the meta‐analysis. The pooled sensitivity and specificity values for predicting MH in UC were 0.77 (95% confidence interval [CI], 0.72–0.81) and 0.81 (95% CI, 0.76–0.85), respectively. The FIT level had a high rule‐in value (positive likelihood ratio, 3.79; 95% CI, 2.85–5.03) and a moderate rule‐out value (negative likelihood ratio, 0.26; 95% CI, 0.16–0.43) for predicting MH in UC. The results of the receiver operating characteristic curve analysis (area under the curve, 0.88; standard error of the mean, 0.02) and diagnostic odds ratio (18.08; 95% CI, 9.57–34.13) also revealed improved discrimination for identifying MH in UC with FIT concentration. Conclusion Our meta‐analysis has found that FIT is a simple, reliable non‐invasive marker for predicting MH in UC patients.