Usefulness of bone scintigraphy for the diagnosis of Complex Regional Pain Syndrome 1: A systematic review and Bayesian meta-analysis

Maria M Wertli, Florian Brunner, Johann Steurer and Ulrike Held

PLOS ONE, 2017, vol. 12, issue 3, 1-18

Abstract: Background: Since 2007, the Budapest criteria are recommended for the diagnosis of Complex Regional Pain Syndrome (CRPS) 1. The usefulness of bone scintigraphy (BS, index test) for the diagnosis of CRPS 1 remains controversial. Imperfect reference tests (RT) result in underestimation of the diagnostic accuracy of BS. Further, biased results can occur when a dependency between the RT and BS exists. Methods: Systematic literature review and Bayesian meta-analysis to assess the test accuracy of BS with and without accounting for the imperfect nature of the RT. We examined correlations (Spearman correlation coefficients / Wilcoxon tests) between baseline characteristics and the proportion of positive BS in patients with CRPS 1. Results: The pooled sensitivity was 0.804 (95% credible interval (CI) 0.225–1.0, 21 studies) and specificity 0.853 (95%CI 0.278–1.00). Sensitivity and specificity of BS increased when accounting for the imperfect nature of the RT. However, in studies using Budapest criteria as reference, the sensitivity decreased (0.551; 95% CI 0.046–1) and the specificity increased (0.935; 95% CI 0.306–1). Shorter disease duration and a higher proportion of males were associated with a higher proportion of positive BS (27 studies, disease duration

Date: 2017
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Persistent link: https://EconPapers.repec.org/RePEc:plo:pone00:0173688

DOI: 10.1371/journal.pone.0173688

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