Evaluation on the accuracy of the biomarkers of intrahepatic cholestasis of pregnancy based on evidence-based medicine

Abstract:

Objective：To use 5 methods of summary receiver operating characteristic（SROC） to evaluate the diagnostic value of the total bile acid（TBA） in intrahepatic cholestasis of pregnancy（ＩＣＰ） based on the Ｍeta-analysis. Methods：Articles were identified from searches of PubMed，HighWire，Ovid，the Cochrane Library，Google scholar research，the Chinese National Knowledge Infras－tructure，WanFang Dissertation Database and Chinese Biological Medical. The retrieval time was conducted at May 2015． Bivariate random effect models：η on ξ，ξ on η，D on S，R&G（Rutter’s and Gatsonis），major axis，were used based on the information of sensitivity，specificity，etc. SAS MIXED and NLMIXED procedure was applied to build 5 kinds of model to evaluate the diagnostic value of total bile acid of intrahepatic cholestasis of pregnancy. Results：The results area under curve（AUC） of diagnostic evaluation showed that η on ξ：0.711，ξ on η：0.448，D on S：0.730，Rutter and Gatsonis（R&G）：0.801，major axis：0.703，which indicated the di－agnostic accuracy of TBA was moderate，and 5 technical methods results of AUC and SROC curve showed that the effect of R&G was superior to other methods in evaluating the accuracy of TBA than. Conclusion：TBA is accurate when diagnosing intrahepatic choles-tasis of pregnancy，but the efficacy of R&G needs further consideration.