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EZSCAN for undiagnosed type 2 diabetes mellitus: A systematic review and meta-analysis

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dc.contributor.author Bernabe-Ortiz, Antonio
dc.contributor.author Ruiz-Alejos, Andrea
dc.contributor.author Miranda, J. Jaime
dc.contributor.author Mathur, Rohini
dc.contributor.author Perel, Pablo
dc.contributor.author Smeeth, Liam
dc.date.accessioned 2019-01-25T15:18:34Z
dc.date.available 2019-01-25T15:18:34Z
dc.date.issued 2017
dc.identifier.uri https://hdl.handle.net/20.500.12866/4650
dc.description.abstract OBJECTIVES: The EZSCAN is a non-invasive device that, by evaluating sweat gland function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of the study was to conduct a systematic review and meta-analysis including studies assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM. METHODOLOGY/PRINCIPAL FINDINGS: We searched for observational studies including diagnostic accuracy and performance results assessing EZSCAN for detecting cases of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS databases, plus secondary resources, were searched until March 29, 2017. The following keywords were utilized for the systematic searching: type 2 diabetes mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two investigators extracted the information for meta-analysis and assessed the quality of the data using the Revised Version of the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Pooled estimates were obtained by fitting the logistic-normal random-effects model without covariates but random intercepts and using the Freeman-Tukey Arcsine Transformation to stabilize variances. Heterogeneity was also assessed using the I2 measure. Four studies (n = 7,720) were included, three of them used oral glucose tolerance test as the gold standard. Using Hierarchical Summary Receiver Operating Characteristic model, summary sensitivity was 72.0% (95%CI: 60.0%- 83.0%), whereas specificity was 56.0% (95%CI: 38.0%- 74.0%). Studies were very heterogeneous (I2 for sensitivity: 79.2% and for specificity: 99.1%) regarding the inclusion criteria and bias was present mainly due to participants selection. CONCLUSIONS: The sensitivity of EZSCAN for detecting cases of undiagnosed T2DM seems to be acceptable, but evidence of high heterogeneity and participant selection bias was detected in most of the studies included. More studies are needed to evaluate the performance of the EZSCAN for undiagnosed T2DM screening, especially at the population level. en_US
dc.language.iso eng
dc.publisher Public Library of Science
dc.relation.ispartof urn:issn:1932-6203
dc.rights info:eu-repo/semantics/restrictedAccess
dc.rights.uri https://creativecommons.org/licenses/by-nc-nd/4.0/deed.es
dc.subject Diabetes Mellitus, Type 2/diagnosis/physiopathology en_US
dc.subject Humans en_US
dc.subject Sweat Glands/physiopathology en_US
dc.title EZSCAN for undiagnosed type 2 diabetes mellitus: A systematic review and meta-analysis en_US
dc.type info:eu-repo/semantics/article
dc.identifier.doi https://doi.org/10.1371/journal.pone.0187297
dc.subject.ocde https://purl.org/pe-repo/ocde/ford#3.02.00 es_PE


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