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首页> 外文期刊>British Journal of Radiology >Advanced neuroimaging in the clinic: critical appraisal of the evidence base
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Advanced neuroimaging in the clinic: critical appraisal of the evidence base

机译:临床中的高级神经影像学:对证据基础的严格评估

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The shortage of high-quality systematic reviews in the field of radiology limits evidence-based integration of imaging methods into clinical practice and may perpetuate misconceptions regarding the efficacy and appropriateness of imaging techniques for specific applications. Diffusion tensor imaging for patients with mild traumatic brain injury (DTI-mTBI) and dynamic susceptibility contrast MRI for patients with glioma (DSC-glioma) are applications of quantitative neuroimaging, which similarly detect manifestations of disease where conventional neuroimaging techniques cannot. We performed a critical appraisal of reviews, based on the current evidence-based medicine methodology, addressing the ability of DTImTBI and DSC-glioma to (a) detect brain abnormalities and/ or (b) predict clinical outcomes. 23 reviews of DTI-mTBI and 26 reviews of DSC-glioma met criteria for inclusion. All reviews addressed detection of brain abnormalities, whereas 12 DTI-mTBI reviews and 22 DSC-glioma reviews addressed prediction of a clinical outcome. All reviews were assessed using a critical appraisal worksheet consisting of 19 yes/ no questions. Reviews were graded according to the total number of positive responses and the 2011 Oxford Centre for evidence-based medicine levels of evidence criteria. Reviews addressing DTI-mTBI detection had moderate quality, while those addressing DSC-glioma were of low quality. Reviews addressing prediction of outcomes for both applications were of low quality. Five DTI-mTBI reviews, but only one review of DSC-glioma met criteria for classification as a meta-analysis/ systematic/ quantitative review.
机译:放射学领域缺乏高质量的系统评价,限制了将影像学方法整合到临床实践中的循证医学,并可能使人们对针对特定应用的影像学技术的有效性和适当性产生误解。轻度颅脑损伤患者的弥散张量成像(DTI-mTBI)和神经胶质瘤患者(DSC-神经胶质瘤)的动态磁化造影MRI是定量神经影像学的应用,可类似地检测传统神经影像学技术无法检测的疾病表现。我们基于当前的循证医学方法,对DTImTBI和DSC神经胶质瘤(a)检测大脑异常和/或(b)预测临床结果的能力进行了严格的评估评估。 DTI-mTBI的23条评论和DSC-神经胶质瘤的26条评论符合纳入标准。所有评论均针对检测脑异常,而12篇DTI-mTBI评论和22篇DSC-神经胶质瘤评论均针对临床结果的预测。所有评论均使用包含19个是/否问题的关键评估工作表进行评估。根据阳性反应的总数和2011年牛津中心基于证据的医学证据标准对评论进行分级。处理DTI-mTBI检测的评论质量中等,而处理DSC-神经胶质瘤的评论质量低。涉及两种应用的结果预测的评论质量较低。有5篇DTI-mTBI评论,但只有1篇DSC神经胶质瘤评论符合荟萃分析/系统/定量评论的分类标准。

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