About: Blood metal ion levels are not a useful test for adverse reactions to metal debris: A systematic review and meta-analysis

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About: Blood metal ion levels are not a useful test for adverse reactions to metal debris: A systematic review and meta-analysis Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : covidontheweb.inria.fr associated with source document(s)

Attributes	Values
type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Blood metal ion levels are not a useful test for adverse reactions to metal debris: A systematic review and meta-analysis
Creator	Beaule, Kim, P Pahuta, M Peck, J Smolders, Canada Smolders, J Van Susante, J
Source	PMC
abstract	OBJECTIVES: Alarm over the reported high failure rates for metal-on-metal (MoM) hip implants as well as their potential for locally aggressive Adverse Reactions to Metal Debris (ARMDs) has prompted government agencies, internationally, to recommend the monitoring of patients with MoM hip implants. Some have advised that a blood ion level >7 µg/L indicates potential for ARMDs. We report a systematic review and meta-analysis of the performance of metal ion testing for ARMDs. METHODS: We searched MEDLINE and EMBASE to identify articles from which it was possible to reconstruct a 2 × 2 table. Two readers independently reviewed all articles and extracted data using explicit criteria. We computed a summary receiver operating curve using a Bayesian random-effects hierarchical model. RESULTS: Our literature search returned 575 unique articles; only six met inclusion criteria defined a priori. The discriminative capacity of ion tests was homogeneous across studies but that there was substantial cut-point heterogeneity. Our best estimate of the “true” area under curve (AUC) for metal ion testing is 0.615, with a 95% credible interval of 0.480 to 0.735, thus we can state that the probability that metal ion testing is actually clinically useful with an AUC ≥ 0.75 is 1.7%. CONCLUSION: Metal ion levels are not useful as a screening test for identifying high risk patients because ion testing will either lead to a large burden of false positive patients, or otherwise marginally modify the pre-test probability. With the availability of more accurate non-invasive tests, we did not find any evidence for using blood ion levels to diagnose symptomatic patients. Cite this article: M. Pahuta, J. M. Smolders, J. L. van Susante, J. Peck, P. R. Kim, P. E. Beaule. Blood metal ion levels are not a useful test for adverse reactions to metal debris: a systematic review and meta-analysis. Bone Joint Res 2016;5:379–386. DOI: 10.1302/2046-3758.59.BJR-2016-0027.R1.
has issue date	2016-09-09(xsd:dateTime)
bibo:doi	10.1302/2046-3758.59.bjr-2016-0027.r1
bibo:pmid	27612918
has license	no-cc
sha1sum (hex)	ff365ebbc0fc55476886b0abd129e227c1f8a527
schema:url	https://doi.org/10.1302/2046-3758.59.bjr-2016-0027.r1
resource representing a document's title	Blood metal ion levels are not a useful test for adverse reactions to metal debris: A systematic review and meta-analysis
has PubMed Central identifier	PMC5027892
has PubMed identifier	27612918
schema:publication	Bone Joint Res
resource representing a document's body	covid:ff365ebbc0fc55476886b0abd129e227c1f8a527#body_text
is schema:about of	named entity 'HIP IMPLANTS' named entity 'METAL ION' named entity 'SYSTEMATIC REVIEW' named entity 'patients' named entity 'metal' named entity 'Hip' covid:arg/ff365ebbc0fc55476886b0abd129e227c1f8a527 named entity 'ARTICLE' named entity 'HIP' named entity 'PERFORMANCE' named entity 'METAL' named entity 'METAANALYSIS' named entity 'BLOOD' named entity 'TESTING' named entity 'ADVERSE REACTIONS' named entity 'PATIENTS' named entity 'REPORT' named entity 'FOCUS' named entity 'DEBRIS' named entity 'confidence intervals' named entity 'metal ion' named entity 'blood' named entity 'systematic review' named entity 'Austria' named entity 'cut-point' named entity 'specificity and sensitivity' named entity 'ion' named entity 'work-up' named entity 'meta-analysis' named entity 'logistic regression' named entity 'Regulatory Agency' named entity 'general population' named entity 'ion' named entity 'ion' named entity 'polyethylene' named entity 'ion' named entity 'metal ion' named entity 'cobalt' named entity 'metal ion' named entity 'Sensitivity and specificity' named entity 'cut-point' named entity 'hip implants' named entity 'ion' named entity 'logistic regression' named entity 'cobalt' named entity 'work-up' named entity 'fellowship-trained' named entity 'plasma' named entity 'ion' named entity 'ion' named entity 'ion concentrations' named entity 'ion' named entity 'meta-analysis' named entity 'ion' named entity 'meta-analysis' named entity 'credible region' named entity 'aseptic' named entity 'adverse reaction' named entity 'ion' named entity 'hip implants' named entity 'RoC curve' named entity 'meta-analysis' named entity 'expectant management' named entity 'United Kingdom' named entity 'meDlINe' named entity '21%' named entity 'soft-tissue' named entity 'hip prosthesis' named entity 'therapeutic Goods Administration' named entity 'meta-analytic' named entity 'covariate' named entity 'odds ratio' named entity 'diagnostic algorithm' named entity 'diagnostic tests' named entity 'receiver operating characteristic'

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