Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis.

This systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (refer...

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Publicado en:European Journal of Pediatrics Vol. 179; no. 1; pp. 29 - 39
Autores principales: van der Hoek-Snieders, Hanneke E. M., van den Heuvel, Antonius J. M. L., van Os-Medendorp, Harmieke, Kamalski, Digna M. A.
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Jan2020
Acceso en línea:Ver este registro en EBSCOhost
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      pub: Springer Nature
      place: New York, New York
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        atl: Diagnostic accuracy of fetal MRI to detect cleft palate: a meta-analysis.
      aug:
        au:
          van der Hoek-Snieders, Hanneke E. M.
          van den Heuvel, Antonius J. M. L.
          van Os-Medendorp, Harmieke
          Kamalski, Digna M. A.
        affil: Clinical Health Sciences, Faculty of Medicine, Utrecht University, Utrecht, The Netherlands
      sug:
        subj:
          Prenatal Diagnosis Methods
          Magnetic Resonance Imaging
          Cleft Palate
          Human
          Pregnancy
          Female
          Sensitivity and Specificity
          Meta Analysis
          Systematic Review
          Female
      ab: This systematic review aims to determine the diagnostic accuracy of fetal MRI for detecting cleft palate in fetuses at risk for orofacial clefts. Pubmed, Embase, and CINAHL were searched systematically. A diagnostic study was included if it performed MRI (index test) and postnatal examination (reference test) in fetuses at risk for orofacial clefts. Methodological quality was assessed using the QUADAS-2. A meta-analysis was performed with a random-effects model, calculating the pooled sensitivity, specificity, and area under the curve. The search resulted in eight studies (334 fetuses) to be included: four prospective and four retrospective studies. The applicability concern was low. There was, however, a risk of selection and information bias. All studies showed that MRI well predicted the chance of cleft palate. The sensitivity results were homogeneous, but heterogeneity was assumed regarding the specificity estimate (Cochrane's Q test: p = 0.00). The pooled sensitivity was 0.97 (95% CI 0.93-0.99); the pooled specificity was 0.94 (0.89-0.97). The area under the curve was 0.98 (95% CI 0.98-0.99).Conclusion: This meta-analysis shows that MRI has an excellent sensitivity and good to excellent specificity for diagnosing cleft palate in fetuses at risk for orofacial clefts. Future research should assess applicability for clinical care.What is Known:• Using ultrasound for prenatal detection of cleft palate leads to misdiagnosis frequently.• MRI could potentially improve the prenatal detection rate of cleft palate.What is New:• Eight studies describe the diagnostic accuracy of MRI for detecting cleft palate.• Combined results show excellent sensitivity and good to excellent specificity.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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