TY - JOUR
T1 - Transcranial doppler in the non-invasive estimation of intracranial pressure in traumatic brain injury compared to other non-invasive methods in lower-middle income countries: Systematic review and meta-analysis: Systematic review and meta-analysis
AU - Dokponou, Yao Christian Hugues
AU - Badirou, Omar Boladji Adébayo
AU - Agada, Kpègnon Nicaise
AU - Dossou, Mèhomè Wilfried
AU - Lawson, Laté Dzidoula
AU - Ossaga, Madjoue Arsène Désiré
AU - Nyalundja, Arsene Daniel
AU - Adjiou, Dognon Kossi François de Paule
AU - Lassissi, Katib Ulrich
AU - Houndodjade, Sena Midas Credo
AU - Gbénou, Ferol Baudelaire Babatundé
AU - Lantonkpode, Romaric Paterne
AU - Togbenon, Nukunté David Lionel
AU - Bankole, Nourou Dine Adeniran
PY - 2023/7/1
Y1 - 2023/7/1
N2 - Background: The prediction of raised Intracranial Pressure (ICP) with accuracy in Traumatic Brain Injury (TBI) patients is a clinically important decision and therapeutic tool. This study aimed to evaluate the existing methods used for non-invasive ICP monitoring in TBI patients in LMICs. Methods: Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from database inception to November 2021. Studies reporting the prediction of raised ICP in TBI patients by non-invasive means in LMICs were included. Pooled estimates of sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios with 95 %CI were calculated for each index test consisting of the fifteen studies, using the MEDDECIDE module 0.0.2 for meta-analysis of diagnostic test accuracy, reliability, and decision studies in JAMOVI 2.2.5. Results: A total of 1032 studies were identified, of which, 15 included 3316 patients with male predominance (n = 2458, 74.13%). Patients' ages range from 15 to 96 years with 40–80 (n = 1205, 36.34%), the most represented population. The ICP measured by Transcranial Doppler (TCD) had a sensitivity of 92.3%, and a specificity of 70%. The positive predictive value was 66.67%, with a negative predictive value of 93.33%. Furthermore, the positive Likelihood Ratio (+LR) was 3.69; 2<+LR < 5 and the negative Likelihood Ratio (-LR) 0.103; 0.1 < -LR < 0.2. We carried out a “Medical Decision”, “Plots”, “Fagan Normogram” and the ROC curve to find the perfect discrimination point of all the five tests used for the non-invasive measurement of ICP in the TBI patients in LMICs. Conclusion: The TCD had shown high performance in its sensitivity and specificity, placing it on top of the other four different tests used in LMICs for the management of patients with TBI.
AB - Background: The prediction of raised Intracranial Pressure (ICP) with accuracy in Traumatic Brain Injury (TBI) patients is a clinically important decision and therapeutic tool. This study aimed to evaluate the existing methods used for non-invasive ICP monitoring in TBI patients in LMICs. Methods: Systematic searches of PubMed, Google Scholar, and ScienceDirect were performed from database inception to November 2021. Studies reporting the prediction of raised ICP in TBI patients by non-invasive means in LMICs were included. Pooled estimates of sensitivity, specificity, positive likelihood ratios, and negative likelihood ratios with 95 %CI were calculated for each index test consisting of the fifteen studies, using the MEDDECIDE module 0.0.2 for meta-analysis of diagnostic test accuracy, reliability, and decision studies in JAMOVI 2.2.5. Results: A total of 1032 studies were identified, of which, 15 included 3316 patients with male predominance (n = 2458, 74.13%). Patients' ages range from 15 to 96 years with 40–80 (n = 1205, 36.34%), the most represented population. The ICP measured by Transcranial Doppler (TCD) had a sensitivity of 92.3%, and a specificity of 70%. The positive predictive value was 66.67%, with a negative predictive value of 93.33%. Furthermore, the positive Likelihood Ratio (+LR) was 3.69; 2<+LR < 5 and the negative Likelihood Ratio (-LR) 0.103; 0.1 < -LR < 0.2. We carried out a “Medical Decision”, “Plots”, “Fagan Normogram” and the ROC curve to find the perfect discrimination point of all the five tests used for the non-invasive measurement of ICP in the TBI patients in LMICs. Conclusion: The TCD had shown high performance in its sensitivity and specificity, placing it on top of the other four different tests used in LMICs for the management of patients with TBI.
KW - Intracranial pressure
KW - LMICs
KW - Non-invasive
KW - Optic nerve sheath diameter
KW - Transcranial doppler
KW - Traumatic brain injury
U2 - 10.1016/j.jocn.2023.05.010
DO - 10.1016/j.jocn.2023.05.010
M3 - Review article
SN - 0967-5868
VL - 113
SP - 70
EP - 76
JO - Journal of Clinical Neuroscience
JF - Journal of Clinical Neuroscience
ER -