Accuracy of continuous glucose monitoring in preterm infants : A systematic review and meta-analysis
Nava, Chiara LU ; Modiano Hedenmalm, Astrid ; Borys, Franciszek ; Hooft, Lotty ; Bruschettini, Matteo LU
and Jenniskens, Kevin
(2020)
In BMJ Open
10(12).
- Abstract
Background and objectives Continuous glucose monitoring (CGM) could be a valuable instrument for measurement of glucose concentration in preterm neonate. We undertook a systematic review and meta-analysis to compare the diagnostic accuracy of CGM devices to intermittent blood glucose evaluation methods for the detection of hypoglycaemic or hypoglycaemic events in preterm infants. Data sources A structured electronic database search was performed for studies that assessed the accuracy of CGM against any intermittent blood glucose testing methods in detecting episodes of altered glycaemia in preterm infants. No restrictions were used. Three review authors screened records and included studies. Data extraction Risk of bias was assessed... (More)
Background and objectives Continuous glucose monitoring (CGM) could be a valuable instrument for measurement of glucose concentration in preterm neonate. We undertook a systematic review and meta-analysis to compare the diagnostic accuracy of CGM devices to intermittent blood glucose evaluation methods for the detection of hypoglycaemic or hypoglycaemic events in preterm infants. Data sources A structured electronic database search was performed for studies that assessed the accuracy of CGM against any intermittent blood glucose testing methods in detecting episodes of altered glycaemia in preterm infants. No restrictions were used. Three review authors screened records and included studies. Data extraction Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. From individual patient data (IPD), sensitivity and specificity were determined using predefined thresholds. The mean absolute relative difference (MARD) of the studied CGM devices was assessed and if those satisfied the accuracy requirements (EN ISO 15197). IPD datasets were meta-analysed using a logistic mixed-effects model. A bivariate model was used to estimate the summary receiver operating characteristic curve (ROC) curve and extract the area under the curve (AUC). The overall level of certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Results Among 4481 records, 11 were included. IPD datasets were obtained for five studies. Only two of the studies showed an MARD lower than 10%, with none of the five CGM devices studied satisfying the European Union (EU) ISO 15197 requirements. Pooled sensitivity and specificity of CGM devices for hypoglycaemia were 0.39 and 0.99, whereas for hyperglycaemia were 0.87 and 0.99, respectively. The AUC was 0.70 and 0.86, respectively. The certainty of the evidence was considered as low to moderate. Limitations primarily related to the lack of representative population, reference standard and CGM device. Conclusions CGM devices demonstrated low sensitivity for detecting hypoglycaemia in preterm infants, however, provided high accuracy for detection of hyperglycaemia. PROSPERO registration number CRD42020152248.
(Less)
- author
- Nava, Chiara
LU
; Modiano Hedenmalm, Astrid
; Borys, Franciszek
; Hooft, Lotty
; Bruschettini, Matteo
LU
and Jenniskens, Kevin
- organization
- publishing date
- 2020
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- biotechnology & bioinformatics, neonatal intensive & critical care, neonatology, paediatric endocrinology, paediatrics
- in
- BMJ Open
- volume
- 10
- issue
- 12
- article number
- e045335
- publisher
- BMJ Publishing Group
- external identifiers
-
- pmid:33361084
- scopus:85098332517
- ISSN
- 2044-6055
- DOI
- 10.1136/bmjopen-2020-045335
- language
- English
- LU publication?
- yes
- id
- 22239cc2-d47e-44bf-9119-d7f934d0aef5
- date added to LUP
- 2021-01-05 09:32:31
- date last changed
- 2024-04-03 20:42:46
@article{22239cc2-d47e-44bf-9119-d7f934d0aef5,
abstract = {{<p>Background and objectives Continuous glucose monitoring (CGM) could be a valuable instrument for measurement of glucose concentration in preterm neonate. We undertook a systematic review and meta-analysis to compare the diagnostic accuracy of CGM devices to intermittent blood glucose evaluation methods for the detection of hypoglycaemic or hypoglycaemic events in preterm infants. Data sources A structured electronic database search was performed for studies that assessed the accuracy of CGM against any intermittent blood glucose testing methods in detecting episodes of altered glycaemia in preterm infants. No restrictions were used. Three review authors screened records and included studies. Data extraction Risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies-2 tool. From individual patient data (IPD), sensitivity and specificity were determined using predefined thresholds. The mean absolute relative difference (MARD) of the studied CGM devices was assessed and if those satisfied the accuracy requirements (EN ISO 15197). IPD datasets were meta-analysed using a logistic mixed-effects model. A bivariate model was used to estimate the summary receiver operating characteristic curve (ROC) curve and extract the area under the curve (AUC). The overall level of certainty of the evidence was assessed using Grading of Recommendations Assessment, Development and Evaluation. Results Among 4481 records, 11 were included. IPD datasets were obtained for five studies. Only two of the studies showed an MARD lower than 10%, with none of the five CGM devices studied satisfying the European Union (EU) ISO 15197 requirements. Pooled sensitivity and specificity of CGM devices for hypoglycaemia were 0.39 and 0.99, whereas for hyperglycaemia were 0.87 and 0.99, respectively. The AUC was 0.70 and 0.86, respectively. The certainty of the evidence was considered as low to moderate. Limitations primarily related to the lack of representative population, reference standard and CGM device. Conclusions CGM devices demonstrated low sensitivity for detecting hypoglycaemia in preterm infants, however, provided high accuracy for detection of hyperglycaemia. PROSPERO registration number CRD42020152248. </p>}},
author = {{Nava, Chiara and Modiano Hedenmalm, Astrid and Borys, Franciszek and Hooft, Lotty and Bruschettini, Matteo and Jenniskens, Kevin}},
issn = {{2044-6055}},
keywords = {{biotechnology & bioinformatics; neonatal intensive & critical care; neonatology; paediatric endocrinology; paediatrics}},
language = {{eng}},
number = {{12}},
publisher = {{BMJ Publishing Group}},
series = {{BMJ Open}},
title = {{Accuracy of continuous glucose monitoring in preterm infants : A systematic review and meta-analysis}},
url = {{http://dx.doi.org/10.1136/bmjopen-2020-045335}},
doi = {{10.1136/bmjopen-2020-045335}},
volume = {{10}},
year = {{2020}},
}