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The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis

(1) Background: Magnetic resonance imaging (MRI) is the gold standard investigation for all patients who present with asymmetrical hearing loss (AHL) and a high index of suspicion for vestibular schwannoma (VS). However, pure-tone audiometry (PTA) is an investigation that can be used for the screeni...

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Autores principales: Gheorghe, Liliana, Negru, Dragos, Cobzeanu, Mihail Dan, Palade, Octavian Dragos, Botnariu, Eosefina Gina, Cobzeanu, Bogdan Mihail, Cobzeanu, Maria-Luiza
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689241/
https://www.ncbi.nlm.nih.gov/pubmed/36428836
http://dx.doi.org/10.3390/diagnostics12112776
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author Gheorghe, Liliana
Negru, Dragos
Cobzeanu, Mihail Dan
Palade, Octavian Dragos
Botnariu, Eosefina Gina
Cobzeanu, Bogdan Mihail
Cobzeanu, Maria-Luiza
author_facet Gheorghe, Liliana
Negru, Dragos
Cobzeanu, Mihail Dan
Palade, Octavian Dragos
Botnariu, Eosefina Gina
Cobzeanu, Bogdan Mihail
Cobzeanu, Maria-Luiza
author_sort Gheorghe, Liliana
collection PubMed
description (1) Background: Magnetic resonance imaging (MRI) is the gold standard investigation for all patients who present with asymmetrical hearing loss (AHL) and a high index of suspicion for vestibular schwannoma (VS). However, pure-tone audiometry (PTA) is an investigation that can be used for the screening of these patients in order to reduce the costs. The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of different PTA protocols for VS in patients with ASHL, when compared with MRI; (2) Methods: Medline, Embase, and Cochrane databases were used to find relevant studies. All prospective and retrospective observational studies that evaluated the accuracy of PTA protocols for the screening of VS were assessed, according to the international guidelines; (3) Results: We analyzed seven studies (4369 patients) of poor-to-moderate quality. Their pooled sensitivity was good (0.73–0.93), but their specificity was low (0.31–0.60). All protocols were located in the right lower quadrant on the likelihood scattergram, and the post-test probabilities for positive and negative diagnosis of these protocols were extremely low; (4) Conclusions: PTA protocols cannot be used for a proper screening or diagnosis of vestibular schwannoma despite their good sensibility, and MRI remains the gold standard for this purpose.
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spelling pubmed-96892412022-11-25 The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis Gheorghe, Liliana Negru, Dragos Cobzeanu, Mihail Dan Palade, Octavian Dragos Botnariu, Eosefina Gina Cobzeanu, Bogdan Mihail Cobzeanu, Maria-Luiza Diagnostics (Basel) Systematic Review (1) Background: Magnetic resonance imaging (MRI) is the gold standard investigation for all patients who present with asymmetrical hearing loss (AHL) and a high index of suspicion for vestibular schwannoma (VS). However, pure-tone audiometry (PTA) is an investigation that can be used for the screening of these patients in order to reduce the costs. The aim of this systematic review and meta-analysis was to evaluate the diagnostic accuracy of different PTA protocols for VS in patients with ASHL, when compared with MRI; (2) Methods: Medline, Embase, and Cochrane databases were used to find relevant studies. All prospective and retrospective observational studies that evaluated the accuracy of PTA protocols for the screening of VS were assessed, according to the international guidelines; (3) Results: We analyzed seven studies (4369 patients) of poor-to-moderate quality. Their pooled sensitivity was good (0.73–0.93), but their specificity was low (0.31–0.60). All protocols were located in the right lower quadrant on the likelihood scattergram, and the post-test probabilities for positive and negative diagnosis of these protocols were extremely low; (4) Conclusions: PTA protocols cannot be used for a proper screening or diagnosis of vestibular schwannoma despite their good sensibility, and MRI remains the gold standard for this purpose. MDPI 2022-11-14 /pmc/articles/PMC9689241/ /pubmed/36428836 http://dx.doi.org/10.3390/diagnostics12112776 Text en © 2022 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Systematic Review
Gheorghe, Liliana
Negru, Dragos
Cobzeanu, Mihail Dan
Palade, Octavian Dragos
Botnariu, Eosefina Gina
Cobzeanu, Bogdan Mihail
Cobzeanu, Maria-Luiza
The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title_full The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title_fullStr The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title_full_unstemmed The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title_short The Diagnostic Accuracy of Pure-Tone Audiometry Screening Protocols for Vestibular Schwannoma in Patients with Asymmetrical Hearing Loss—A Systematic Review and Meta-Analysis
title_sort diagnostic accuracy of pure-tone audiometry screening protocols for vestibular schwannoma in patients with asymmetrical hearing loss—a systematic review and meta-analysis
topic Systematic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9689241/
https://www.ncbi.nlm.nih.gov/pubmed/36428836
http://dx.doi.org/10.3390/diagnostics12112776
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