Auteur en jaartal

Redenen van exclusie

Balsak 2014

Voldoet niet aan selectiecriteria

Bonneau 2012

Voldoet niet aan selectiecriteria

Broeze 2011

Voldoet niet aan selectiecriteria

Coppus 2011

Voldoet niet aan selectiecriteria

Keltx 2011

Voldoet niet aan selectiecriteria

Kouame 2012

Artikel in het Frans

Lim 2011

Voldoet niet aan selectiecriteria

Lovsin 2010

Editorial

Malek – Mellouli 2012

Twijfel aan methodologische kwaliteit, gepubliceerd in nationaal Tunesisch tijdschrift.

Mohammedbeigi 2012

Twijfel aan methodologische kwaliteit, gepubliceerd in nationaal Pools tijdschrift.

Mununvy 2012

Situatie niet toepasbaar voor Nederlnadse klinische praktijk.

Perreria 2010

Artikel in het Portugees

Raoofi 2010

Voldoet niet aan selectiecriteria

Schakanth 2012

Andere studies met methodologisch betere opzet reeds geïncludeerd, die dezelfde vraag beantwoorden

Verhoeve 2011

Voldoet niet aan selectiecriteria

Zimmer 2011

Letter to the editor

Study referen ce

(first author, year of publicat ion)

Was             the spectrum of patients represent ative                       of the patients who             will receive the test in practice?

Is              the

reference standard likely                 to correctly classify the

target condition

?

Is               the

time period between reference standard and index test short enough to be reasonabl y             sure

that               the target

condition did               not change

Did              the whole sample or a random selection of the

sample, receive verificatio n using a reference standard?

Did patients receive the same reference standard irrespectiv e of the index test result?

Was             the reference standard independ ent of the index

test (i.e. the index test did

not          form

part                of the reference

standard)

?

Were the index test results interprete d without

knowledg e of the results of the reference standard and             vice versa?

Were the same clinical data available when test results were interprete d                 as

would be available when the test                  is

used                 in practice?

Were uninterpret able/ intermediat e (unclear) test results reported?

Were withdraw als           from the study explained

?

Level of evide nce

yes/no/un clear

yes/no/un clear

between the              two tests?

yes/no/un clear

yes/no/un clear

yes/no/un clear

yes/no/un clear

yes/no/un clear

yes/no/un clear

yes/no/uncl ear

yes/no/un clear

Broeze 2011

Yes

Yes

Unclear

Yes

Yes

Yes

No

Yes

Yes

Yes

A1

Broeze 2012

Yes

Yes

Unclear

Yes

Yes

Yes

No

Yes

Yes

Yes

A1

Maheux

-Lacroix 2014

Yes

Yes

Unclear

Yes

Yes

Yes

No

Unclear

Unclear

Unclear

A1

Malik 2014

Yes

Yes

Yes

Yes

No

No

No

Unclear

Yes

Yes

B

reported

patient          data

for                     meta- analysis

3)             Minimal requested data:

a)                      patient identifiers

b)      CAT results, HSG results and results of laparoscopy

c)       age, type of subfertility and BMI

Exclusion criteria:

-

N= 4521

outcome data described? No

Sub-analyses: women with risk factors versus women with no risk factors:

No risk factors: sensitivity: 13%

Risk factors: sensitivity: 47%

(p for difference between groups 0.01)

Specificity stable: 97 – 98%        across all subgroups.

From 7 studies

Mean age (5th

–                       95th

percentile): 31

(24 – 39)

Sex: 100 % F

Other important characteristics:

Broeze 2012

Type of study: Individual patient                data meta-analysis

Setting: outpatients

Country:                  the

Inclusion criteria:

1)                      studies containing diagnostic data on both CAT and HSG or             sono-HSG and in which laparoscopy

Describe index test:

1) Chlamydia antibody tests

Cut-off point(s): ELISA: 1.1

IF: 1:32

Describe reference test:

Diagnostic laparoscopy

Cut-off point(s):

Endpoint                     of follow-up:

Not applicable

For how many participants were                    no complete outcome data

Outcome measures and effect size (include 95%CI and p-value if available):

For bilateral tubal pathology:

Patient characteristics model contained:

Duration                         of subfertility, number                         of previous pregnancies, history                         of

Netherlands

Conflicts of interest: not reported

was performed             as a             reference test

2)                     authors willing            to participate and                  able                     to provide individual patient   data

for                     meta- analysis

3)                   Minimal requested data:

a)                      patient identifiers

b)      CAT results, HSG results and results of laparoscopy

c)       age, type of subfertility and BMI

MIF 1:32

2) hysterosalpinoggraphy

Cut-off point(s): impaired or absent flow of contrast medium = tubal pathology

not applicable

available?

Not applicable

Reasons                  for incomplete outcome data described? No

CAT

Sensitivity: 0.66 (95%

CI: 0.59 – 0.72)

Specificity: 70% (95%

CI: 0.68 – 0.73)

HSG

Sensitivity: 0.62 (95%

CI: 0.50 – 0.71)

Soecificity: 0.91 (95%

CI: 0.89 – 0.93)

AUC:

Patient characteristics model: 0.63 (95% CI:

0.60 – 0.66)

With addition of CAT or HSG: 0.72, p<0.001

compared to patient

pelvic inflammatory disease, pelvic surgery                       of Chlamydia infection.

Exclusion criteria:

-

N=4883

From 4 studies

Mean age: not reported

Sex: 100 % F

Other important characteristics:

characteristics only)

With addition of both CAT and HSG: 0.76 (95% CI: 0.74 – 0.79)

Maheux- Lacroix

Type of study: systematic review                  and

Inclusion criteria:

Describe index test:

Describe reference

Endpoint                    of follow-up: not

Outcome measures and effect size (include 95%CI and p-value if

2014

meta-analysis

Setting: outpatients

Country: Canada

Conflicts                   of interest: none

1)               Studies assessing        the accuracy of sono-HSG      for diagnosing tubal occlusion in              subfertile female population

2)                                 no

restriction on language or age of studies

Exclusion criteria:

1)                  other

modalities than laparoscopy used                             as

reference standard

1)

Hysterosalpingosonography

2) Hysterosalpingography Cut-off point(s):

test:

Diagnostic laparoscopy

Cut-off point(s):

reported

For how many participants were                  no complete outcome data available?

Not reported

Reasons                  for incomplete outcome data described?

Not reported

available):

For hysterosalpingography, diagnosing                                     tubal

occlusion,                                 pooled results:

Sensitivity: 0.94 (95%

CI: 0.74 – 0.99)

Specificity: 0.92 (95%

CI: 0.87 – 0.95)

N= 1551

In 9 studies

Mean age: not reported

Sex: 100 % F

Other important characteristics:

Malik 2014

Type of study: prospective, cross- sectional

Setting: outpatients

Country: India

Inclusion criteria:

1) women who attended                       the outpatient department of the Obstetrics and Gynaecology clinic                     with primary                                 or

Describe index test:

1)

Hysterosalpingosonography on day 7 of the menstrual cycle

2) Hysterosalpingography on day 9 of the menstrual

Describe reference test:

Diagnostic laparoscopy

Cut-off

Endpoint                   of follow-up:

Not reported

For how many participants were                  no complete outcome data available?

Outcome measures and effect size (include 95%CI and p-value if available):

Sensitivity                      and specificity of positive HSG for evaluation of tubal patency:

Small        number of patients

Conflicts                    of interest: none

secondary infertility       and uknown uterine                             or tubal factors

Exclusion criteria:

1)                          active bleeding           or pelvic infection

2)                  previous allergic reaction                to iodine-based dyes

N=30

Mean                          age (range): 30 (21

– 38)

cycle

point(s):

none

Reasons                      for incomplete outcome data described?

Not applicable

Sensitivity: 92%

Specificity: 100%

Sex: 100% F

Other important characteristics:

Duration                           of infertility (range): 7.7 (2

– 20) years

Primary infertility: 22(73%)

Study reference

(first author, year                    of publication)

Was           there                    a representative and well-defined sample of patients at a similar point in the course of the disease?

(yes/no/unclear)

Was follow-up sufficiently long and complete?

(yes/no/unclear)

Was the outcome of                  interest defined                               and adequately measured?

(yes/no/unclear)

Was                            the

prognostic factor of                  interest defined                                and adequately measured?

(yes/no/unclear)

Was           loss                    to

follow-up                                           / incomplete outcome                          data

described                           and acceptable?

(yes/no/unclear)

Was                       there statistical adjustment for all important prognostic factors?

(yes/no/unclear)

Level of evidence

Verhoeve 2011

Yes

Yes

Yes

Yes

Yes

Yes

A2

1)           clomiphene citrate use

2)                          semen analysis               of male partner showed severe impairement of semen quality (total motile count <1 x 106)

3)            history     of reversal              of sterilization, tubal surgery in-vitro fertilisation            or previous            tubal patency testing

N= 3301

Mean age (5th – 95th

percentile): 33