Erythrocyte Sedimentation Rate and C-Reactive Protein in Acute Inflammation: Meta-Analysis of Diagnostic Accuracy Studies. Issue 1 (10th October 2019)

• Record Type: Journal Article
• Authors: Lapić, Ivana; Padoan, Andrea; Bozzato, Dania; Plebani, Mario
• Is Part Of: American journal of clinical pathology. Volume 153:Issue 1(2020)
• Page Start: 14
• Page End: 29
• Publication Date: 2019-10-10
• Subjects: Erythrocyte sedimentation rate -- C-reactive protein -- Acute phase reaction -- Inflammation -- Diagnostic accuracy -- Meta-analysis; Diagnosis, Laboratory -- Periodicals; Pathology -- Periodicals; 616.07
• DOI: 10.1093/ajcp/aqz142
• Languages: English
• ISSNs: 0002-9173

Abstract

Abstract: Objectives: To assess the diagnostic accuracy of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in acute inflammation. Methods: PubMed and Scopus were searched and eligible articles were screened for methodologic quality using the Quality Assessment of the Diagnostic Accuracy Studies–Revised. Meta-analysis with calculation of pooled sensitivity (Se), specificity (Sp), and summary area under the curve (SAUC) was performed. Results: Twenty-nine studies were eligible. Se and Sp were 0.78 and 0.68 (SAUC = 0.80) for ESR in orthopedic infections and 0.79 and 0.70 (SAUC = 0.81) for CRP. For the diagnosis of other various inflammatory conditions, CRP had a superior diagnostic accuracy, with a Se of 0.86, Sp of 0.67, and SAUC of 0.86 compared with a Se of 0.77, Sp of 0.59, and SAUC of 0.75 for ESR. Heterogeneity among studies was elevated. Combined use of ESR and CRP yielded higher diagnostic accuracy. Conclusions: Despite observed heterogeneity among studies, ESR and CRP have a similar diagnostic accuracy in assessment of inflammation, especially in orthopedic conditions.