Diagnostic Of Accuracy Of External Anal Sphincter EMG For Differentiating Multiple System Atrophy From Parkinson Disease

Objective: To evaluate the diagnostic accuracy of EAS-EMG for differentiating multiple system atrophy from Parkinson disease.Methods: We searched Pub Med, SCI, OVID, Chinese Wanfang Database, Chinese National Knowledge Infrastructure. We also searched with manual searching and others, searching about EAS-EMG for the differential diagnosis of MSA and PD literature. According to the QUADAS(quality assessment of diagnostic accuracy studies) quality evaluation into the study of literature, data extraction, using stata12.0 packages to joint into data using bivariate mixed effect model and hierarchical summary receiver-operating characteristic curve(HSROC) model for meta analysis.Results: There are nine articles, six English articles, three Chinese articles, involving in 1143 patients. Bivariate mixed effects model analysis results show that the summary sensitivity, summary specificity, summary positive likelihood ratio and summary negative likelihood ratio and summary diagnostic odds ratio are 0.83, 0.81, 4.4, 0.21, 21, SROC curve under the area is 0.89(95% CI = 0 5-0,91); hierarchical summary receiver operating characteristic curve(HSROC)curve model analysis results show that the summary sensitivity, summary specific, summary positive likelihood ratio summary negative likelihood ratio and summary diagnostic odds ratio were 0.83, 0.81, 4.4, 0.21, 21, Beta = 0.32(95% CI = 0.45 0.45), Z = 0.81, P = 0.417 > 0.1, Lambda = 3.10(95% CI = 1.75 4.45). Fagan pre-test probability =54%,positive likelihood ratio = 4.4, positive post-test probability = 84%, negative likelihood ratio = 0.21, negative post-test probability = 20%.Conclusions: EAS-EMG differential diagnosis of MSA and PD has good clinical application value.