Sophie L St Clair, Caitlyn M Ulyatt, Maria T Corkin, Libby G Lord, Caroline A Crowther, Jane E Harding, Luling Lin
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引用次数: 0
摘要
研究目的评估各种护理点设备方法测量有新生儿低血糖风险的婴儿血糖浓度的准确性:本系统综述和荟萃分析纳入了截至 2024 年 5 月 20 日来自 Ovid MEDLINE、Ovid Embase 和 Web of Science 的研究。纳入的研究将新生儿血糖的护理点检测方法与标准实验室方法进行了比较,但不包括连续血糖监测或 1990 年前进行的研究。由两名研究人员独立评估纳入情况,并使用 QUADAS-2 评估偏倚风险。敏感性和特异性采用或然率表进行计算,诊断准确性采用分层随机效应模型进行分析。对数据不足的研究按估计方向进行了总结:结果:共纳入 71 项研究。定量分析(n = 31)评估了葡萄糖氧化酶(GO)+光度法(n = 8)、葡萄糖-1-脱氢酶(GDH)+光度法(n = 6)、GO+电化学法(n = 13)、GDH+电化学法(n = 12)和己糖激酶(HK)+电化学法(n = 2)。所有方法的特异性都很高(≥93%),其中 GO + 电化学法、GDH + 电化学法和 HK + 电化学法的灵敏度更高。SROC 曲线证实 HK + 电化学法最为准确:结论:某些护理点设备方法在测量新生儿血糖浓度方面具有更高的准确性。在所评估的方法中,HK + 电化学法被证明是最可靠的。然而,使用这种方法的研究数量有限,这表明有必要在不同环境和人群中开展进一步研究,以证实这些发现。
Glucose Testing Methods: A Systematic Review and Meta-Analysis of Diagnostic Accuracy of Point-of-Care Devices for Neonatal Hypoglycemia.
Objective: To evaluate the accuracy of various point-of-care device methodologies for measuring blood glucose concentrations in babies at risk of neonatal hypoglycemia.
Study design: This systematic review and meta-analysis included studies from Ovid MEDLINE, Ovid Embase, and Web of Science up to May 20, 2024. Studies comparing point-of-care testing methods for neonatal blood glucose to a standard laboratory method were included, excluding those on continuous glucose monitoring or conducted before 1990. Two researchers independently assessed inclusion and evaluated risk of bias using QUADAS-2. Sensitivity and specificity were calculated using contingency tables, and diagnostic accuracy was analyzed using hierarchical random-effects modelling. Studies with insufficient data were summarized by estimation direction.
Results: Seventy-one studies were included. The quantitative analysis (n = 31) evaluated glucose oxidase (GO) + photometry (n = 8), glucose-1-dehydrogenase (GDH) + photometry (n = 6), GO + electrochemistry (n = 13), GDH + electrochemistry (n = 12), and hexokinase (HK) + electrochemistry (n = 2). All methods showed high specificity (≥93%), with GO + electrochemistry, GDH + electrochemistry, and HK + electrochemistry showing superior sensitivity. The SROC curve confirmed HK + electrochemistry as the most accurate.
Conclusion: Certain point-of-care device methodologies demonstrate greater accuracy in measuring neonatal blood glucose concentrations. Of the methods evaluated, HK + electrochemistry proved to be the most reliable. However, the limited number of studies using this method suggests the need for further research to confirm these findings across diverse settings and populations.
期刊介绍:
The Journal of Pediatrics is an international peer-reviewed journal that advances pediatric research and serves as a practical guide for pediatricians who manage health and diagnose and treat disorders in infants, children, and adolescents. The Journal publishes original work based on standards of excellence and expert review. The Journal seeks to publish high quality original articles that are immediately applicable to practice (basic science, translational research, evidence-based medicine), brief clinical and laboratory case reports, medical progress, expert commentary, grand rounds, insightful editorials, “classic” physical examinations, and novel insights into clinical and academic pediatric medicine related to every aspect of child health. Published monthly since 1932, The Journal of Pediatrics continues to promote the latest developments in pediatric medicine, child health, policy, and advocacy.
Topics covered in The Journal of Pediatrics include, but are not limited to:
General Pediatrics
Pediatric Subspecialties
Adolescent Medicine
Allergy and Immunology
Cardiology
Critical Care Medicine
Developmental-Behavioral Medicine
Endocrinology
Gastroenterology
Hematology-Oncology
Infectious Diseases
Neonatal-Perinatal Medicine
Nephrology
Neurology
Emergency Medicine
Pulmonology
Rheumatology
Genetics
Ethics
Health Service Research
Pediatric Hospitalist Medicine.