CT pulmonary angiograghy in the diagnosis of pulmonary embolism:a Meta analysis

Objective To assess the overall diagnostic value of computed tomography pulmonary angiography (CTPA) in patients with suspected pulmonary embolism with the pulmonary angiography as the gold standard.Methods A search in Cochrane Library,PubMed,OVID,and China National Knowledge Infrastructure (CNKI) was performed to identify relevant English and Chinese-language articles from 01/01/1992 to 01/01/2003 (English) and from 01/01/1994 to 01/01/2003 (Chinese),respectively.Criteria for inclusion were established based on validity criteria for diagnostic research published by the Cochrane Methods Group on Screening and Diagnostic Tests.Subsequently,the characteristics of the included articles were appraised and extracted.Statistical analysis was performed employing Meta-Test version 0.9.Heterogeneity of the included articles was tested,which was used to select proper effect model to calculate pooled weighted sensitivity and specificity.Summary Receiver Operating Characteristic (SROC) curve was performed and the area under the curve (AUC) was calculated.Finally,sensitivity analysis was performed.Results Ten of 407 retrieved articles were included,with a total of 855 patients.The reported sensitivity of CTPA ranged from 0.57 to 1.00,and specificity ranged from 0.78 to 1.00.The pooled weighted sensitivity and specificity for CTPA with 95% confidence interval (95% CI) after correction for standard error were 0.84 (0.73,0.91) and 0.91 (0.87,0.94),respectively.The AUC of SROC was 94.95%. Sensitivity analysis demonstrated no disproportionate influences of individual study.Conclusion CTPA has a highly accurate sensitivity and specificity with a strong ROC curve making it an alternative non-invasive method of pulmonary angiography in the diagnosis of PE.