High-risk symptoms and quantitative faecal immunochemical test accuracy: Systematic review and meta-analysis

Table 6 Advanced neoplasia and significant colonic lesion detection: Diagnostic accuracy parameters based on quantitative faecal immunochemical test threshold concentration and brand (DerSimonian´s method)

Variable	Studies(n)	Sensitivity1	I22	Specificity1	I22	Positive LR3	I22	Negative LR3	I22	Diagnostic OR3	I22	Pa
Advanced neoplasia
OC-Sensor, > LoD µg Hb/g faeces
All studies	3	91.0 (88.7-93.0)	87.9	36.9 (35.0-38.8)	95.2	1.40 (1.35-1.45)	0.0	0.26 (0.16-0.44)	76.6	5.44 (3.48-8.48)	58	< 0.001
OC-Sensor, ≥ 10 µg Hb/g faeces
All studies	5	67.9 (65.1-70.5)	97.4	81.0 (80.0-82.0)	99.5	3.42 (1.97-5.94)	98.8	0.41 (0.30-0.57)	93.4	9.43 (8.10-10.98)	0.0	< 0.001
100% Symptomatic	3	79.7 (76.5-82.6)	94.6	67.3 (65.5-69.1)	99.4	2.43 (1.41-4.17)	98.5	0.32 (0.21-0.49)	86.5	8.67 (6.96-10.80)	5.8	< 0.001
Prevalence CRC ≥ 2.5%	4	71.7 (68.8-74.5)	97.1	76.7 (75.4-77.9)	99.5	2.96 (1.65-5.30)	98.9	0.36 (0.25-0.53)	91.8	9.29 (7.79-11.09)	9.3	< 0.001
OC-Sensor, ≥ 15 µg Hb/g faeces
All studies	5	65.0 (62.2-67.8)	97.6	83.5 (82.5-84.4)	99.6	3.90 (2.04-7.47)	99.0	0.43 (0.31-0.60)	94.2	10.06 (8.14-12.44)	42.4	< 0.001
100% Symptomatic	3	76.8 (73.5-79.9)	95.6	70.3 (68.5-72.1)	99.4	2.63 (1.39-4.97)	98.8	0.34 (0.22-0.52)	88.4	8.88 (7.23-10.91)	0.0	< 0.001
Prevalence CRC ≥ 2.5%	4	69.3 (66.3-72.1)	97.1	79.4 (78.2-80.6)	99.6	3.33 (1.67-6.66)	99.1	0.38 (0.27-0.54)	91.1	9.72 (7.46-12.66)	55.4	< 0.001
OC-Sensor, ≥ 20 µg Hb/g faeces
All studies	5	62.9 (60.1-65.7)	97.8	85.1 (84.2-86.0)	99.6	4.34 (2.16-8.73)	99.0	0.45 (0.32-0.62)	95.3	10.62 (8.24-13.67)	57.4	< 0.001
100% Symptomatic	3	75.1 (71.7-78.3)	96.1	72.4 (70.7-74.1)	99.5	2.85 (1.43-5.65)	98.8	0.35 (0.23-0.55)	90.4	9.19 (7.47-11.32)	1.8	< 0.001
Prevalence CRC ≥ 2.5%	4	67.5 (64.5-70.4)	97.3	81.2 (80.0-82.3)	99.6	3.66 (1.74-7.71)	99.1	0.40 (0.29-0.55)	91.7	10.19 (7.49-13.86)	66.5	< 0.001
Significant colonic lesion
OC-Sensor, LoD µg Hb/g faeces
All studies	3	91.7 (89.5-93.6)	0.0	36.9 (35.0-39.0)	94.2	1.45 (1.32-1.59)	80.4	0.24 (0.19-0.30)	0.0	6.01 (4.57-7.92)	0.0	< 0.001
OC-Sensor, ≥ 10 µg Hb/g faeces
All studies	4	78.6 (75.6-81.4)	91.5	69.8 (67.9-71.6)	99.2	3.75 (2.08-6.76)	98.3	0.34 (0.27-0.42)	59.6	11.72 (6.41-21.45)	82.8	< 0.001
100% Symptomatic4	3	80.4 (77.4-83.2)	89.6	67.0 (65.0-68.9)	99.2	2.54 (1.45-4.46)	98.5	0.31 (0.26-0.37)	23.7	8.56 (6.18-11.86)	49.8	< 0.001

¹Values are expressed as percentages and its 95% confidence interval;

²Values are expressed as percentages;

³Values are expressed as absolute numbers and its 95% confidence interval;

⁴The studies that comprise the 100% symptomatic subgroup also have CRC prevalence ≥ 2.5%; P^a: Significance of the threshold effect using the Spearman rank correlation (P < 0.01 is considered statistically significant). I²: Inconsistency index; LoD: Limit of detection; LR: Likelihood ratio; OR: Odds ratio; CRC: Colorectal cancer.