Endoscopic ultrasound: It’s accuracy in evaluating mediastinal lymphadenopathy? A meta-analysis and systematic review

Table 1 Characteristics of studies included in this meta-analysis for EUS without FNA

Author	Year of publication	No. of patients	Type of recruitment	Confirmatory procedure
Tio et al[71]	1986	26	Prospective	Surgery
Murata et al[57]	1988	173	Consecutive	Surgery
Tio et al[69]	1989	75	Prospective	Surgery
Vilgrain et al[75]	1990	51	Consecutive	Surgery
Tio et al[68]	1990	102	Consecutive	Surgery
Rice et al[63]	1991	22	Consecutive	Surgery
Heintz et al[52]	1991	40	Consecutive	Surgery
Botet et al[40]	1991	50	Consecutive	Surgery
Tio et al[70]	1989	74	Prospective	Surgery
Ziegler et al[80]	1991	52	Consecutive	Surgery
Rosch et al[64]	1992	44	Consecutive	Surgery
Fok et al[46]	1992	54	Consecutive	Surgery
Yoshikane et al[79]	1993	28	Consecutive	Surgery
Grimm et al[49]	1993	63	Prospective	Surgery
Dittler et al[45]	1993	167	Consecutive	Surgery
Peters et al[61]	1994	42	Consecutive	Surgery
Catalano et al[43]	1994	100	Consecutive	Surgery
McLoughlin et al[18]	1995	15	Consecutive	Surgery
Binmoeller et al[39]	1995	87	Prospective	Surgery
HunerBein et al[53]	1996	19	Consecutive	Surgery
Hasegawa et al[50]	1996	22	Consecutive	Surgery
Francois et al[47]	1996	29	Consecutive	Surgery
Natsugoe et al[58]	1996	37	Consecutive	Surgery
Milena et al[54]	1997	40	Prospective	Surgery
Vikers et al[73]	1997	50	Consecutive	Surgery
Shimizu et al[67]	1997	431	Consecutive	Surgery
Pham et al[62]	1998	28	Consecutive	Surgery
Vikers et al[74]	1998	50	Prospective	Surgery
Salminen et al[65]	1999	32	Consecutive	Surgery
Krasna et al[56]	1999	88	Consecutive	Surgery
Browrey et al[41]	1999	98	Prospective	Surgery
Catalano et al[42]	1999	149	Prospective	Surgery
Giovannini et al[48]	1999	198	Prospective	Surgery
Nishimaki et al[60]	1999	224	Consecutive	Surgery
Heidemann et al[51]	2000	68	Consecutive	Surgery
Nesje et al[59]	2000	68	Prospective	Surgery
Vazquez-Sequeiros et al[105]	2001	37	Consecutive	Surgery
Wiersema et al[77]	2001	82	Prospective	Surgery
Wakelin et al[76]	2002	36	Consecutive	Surgery
Kienle et al[55]	2002	117	Prospective	Surgery
Schwartz et al[66]	2002	188	Consecutive	Surgery
Wu et al[78]	2003	31	Prospective	Surgery
Arima et al[17]	2003	58	Consecutive	Surgery
DeWitt et al[44]	2005	102	Prospective	Surgery

Table 2 Characteristics of studies included in this meta-analysis for EUS with FNA

Author	Year of publication	No. of patients	Type of recruitment	Confirmatory procedure
Kondo et al[6]	1990	503	Consecutive	Surgery
Schuder et al[25]	1991	32	Consecutive	Surgery
Silvestri et al[83]	1995	27	Prospective	Surgery
Giovannini et al[82]	1995	141	Prospective	Surgery or appropriate follow-up
Pedersen et al[21]	1996	9	Consecutive	FNA and appropriate follow-up
HunerBein et al[90]	1996	19	Consecutive	Surgery
Gress et al[19]	1997	52	Prospective	Surgery
Wiersema et al[104]	1997	60	Consecutive	FNA and appropriate follow-up
HunerBein et al[91]	1998	15	Consecutive	Surgery
HunerBein et al[98]	1998	16	Consecutive	Surgery
Fritscher-Ravens et al[101]	1999	16	Consecutive	FNA and appropriate follow-up
Mishra et al[102]	1999	111	Consecutive	FNA and appropriate follow-up
Giovannini et al[81]	1999	198	Prospective	Surgery or appropriate follow-up
Williams et al[89]	1999	333	Prospective	Surgery or appropriate follow-up
Fritscher-Ravens et al[84]	2000	35	Prospective	Surgery
Fritscher-Ravens et al[98]	2000	35	Consecutive	FNA and appropriate follow-up
Savides et al[100]	2000	54	Consecutive	FNA and appropriate follow-up
Fritscher-Ravens et al[103]	2000	153	Consecutive	FNA and appropriate follow-up
Vazquez-Sequeiros et al[105]	2001	37	Consecutive	Surgery
Wallace et al[91]	2001	43	Consecutive	FNA and appropriate follow-up
Wiersema et al[85]	2001	82	Prospective	Surgery
Chhieng et al[96]	2001	103	Consecutive	Surgery
Devereaux et al[22]	2002	49	Consecutive	Surgery
Catalano et al[92]	2002	62	Consecutive	Surgery
Schwartz et al[66]	2002	188	Consecutive	Surgery
Arima et al[95]	2003	58	Consecutive	Surgery
Pellise et al[23]	2004	11	Consecutive	Surgery
Kramer et al[86]	2004	81	Prospective	Surgery
Walsh et al[97]	2005	27	Consecutive	Surgery or appropriate follow-up
Tournoy et al[88]	2005	67	Prospective	Surgery
Khoo et al[93]	2006	20	Prospective	Surgery
Beek et al[87]	2006	43	Prospective	Surgery

Table 3 Pooled diagnostic accuracy estimates of EUS alone and EUS-FNA

	EUS	EUS-FNA
Studies	44	32
Pooled sensitivity	84.7% (82.9-86.4)	88.0% (85.8-90.0)
Pooled specificity	84.6% (83.2-85.9)	96.4% (95.3-97.4)
Positive likelihood ratio	3.3 (2.6-4.3)	11.2 (5.9-21.2)
Negative likelihood ratio	0.24 (0.1-0.3)	0.13 (0.1-0.2)
Diagnostic odds ratio	19.1 (12.7-28.5)	106.9 (54.4-210.3)
Area under the curve	0.91	0.97

Table 4 Pooled diagnostic accuracy estimates of EUS alone and EUS-FNA for different time periods with 95% CI

Time period	No. of studies	Pooled sensitivity	Pooled specificity	Pooled LR+1	Pooled LR-2	Pooled DOR3
EUS without FNA
1988 to 1994	17	88.0% (85.4-90.2)	85.2% (83.4-86.9)	3.6 (2.4-5.4)	0.2 (0.1-0.3)	27.5 (14.5-52.4)
1995 to 1999	17	82.6% (78.8-85.9)	84.4% (81.6-86.9)	3.0 (2.0-4.5)	0.3 (0.2-0.4)	14.8 (7.5-29.3)
2000 to 2005	10	81.6% (77.8-85.1)	82.4% (78.2-86.1)	3.4 (2.2-5.3)	0.3 (0.2-0.4)	14.9 (6.7-33.1)
EUS-FNA
1988 to 1994	4	71.8% (63.9-78.9)	96.8% (94.9-98.1)	15.5 (2.4-101.2)	0.3 (0.1-0.6)	61.8 (10.5-63.8)
1995 to 1999	10	88.9% (83.5-93.0)	94.7% (90.7-97.3)	8.1 (2.8-23.3)	0.1 (0.1-0.2)	57.0 (20.7-57.1)
2000 to 2005	18	91.7% (89.3-93.7)	96.8% (94.9-98.2)	12.5 (5.2-29.8)	0.1 (0.1-0.2)	17.7 (5.0-62.8)

¹LR+: Positive likelihood ratio; ²LR-: Negative likelihood ratio; ³DOR: Diagnostic odds ratio.