Table D-1Summary of analyses of comparative accuracy

ComparisonClinical Decision# StudiesMeasureTest 1 Estimate and 95% CIaTest 2 Estimate and 95% CIaLogit Difference and 95% CIbStatistically Significantly Different?Precise Enough to Indicate Approximately Equivalent Accuracy?
MDCT angiography without 3D reconstruction vs. with 3D reconstructionResectability in those not staged1Sensitivity89% (95% CI: 68% to 97%)100% (95% CI: 83% to 100%)−1.5 (−4.3 to 1.2)NoNA
MDCT angiography without 3D reconstruction vs. with 3D reconstructionResectability in those not staged1Specificity79% (95% CI: 64% to 89%)100% (95% CI: 91% to 100%)−3 (−5.5 to −0.5)YesSee above cell
MDCT vs. EUS-FNADiagnosis3Sensitivity87% (95% CI: 82% to 91%)89% (95% CI: 85% to 93%)−0.2 (−0.8 to 0.4)NoNo
MDCT vs. EUS-FNADiagnosis3Specificity67% (95% CI: 53% to 78%)81% (95% CI: 68% to 90%)−0.7 (−1.7 to 0.2)NoSee above cell
MDCT vs. MRIDiagnosis7Sensitivity89% (95% CI: 82% to 94%)89% (95% CI: 81% to 94%)−0.01 (−1.4 to 1.5)NoYes
MDCT vs. MRIDiagnosis7Specificity90% (95% CI: 80% to 95%)89% (95% CI: 74% to 95%)0.1 (−2.5 to 2.8)NoSee above cell
MDCT vs. PET/CTDiagnosis6Sensitivity85% (95% CI: 80% to 90%)91% (95% CI: 85% to 94%)−0.6 (−1.2 to 0.1)NoNA
MDCT vs. PET/CTDiagnosis6Specificity55% (95% CI: 44% to 66%)72% (95% CI: 61% to 81%)−0.7 (−1.4 to −0.1)YesSee above cell
EUS-FNA vs. PET/CTDiagnosis1Sensitivity81% (95% CI: 62% to 91%)89% (95% CI: 72% to 96%)−0.6 (−2.1 to 0.8)NoNo
EUS-FNA vs. PET/CTDiagnosis1Specificity84% (95% CI: 62% to 94%)74% (95% CI: 51% to 88%)0.6 (−0.9 to 2.2)NoSee above cell
MRI vs. PET/CTDiagnosis1Sensitivity85% (95% CI: 64% to 95%)85% (95% CI: 64% to 95%)0 (−1.6 to 1.6)NoNo
MRI vs. PET/CTDiagnosis1Specificity72% (95% CI: 49% to 87%)94% (95% CI: 74% to 99%)−1.9 (−3.8 to 0.1)NoSee above cell
MDCT vs. EUS-FNAResectability in those not staged1Sensitivity64% (95% CI: 46% to 79%)68% (95% CI: 49% to 82%)−0.2 (−1.2 to 0.9)NoYes
MDCT vs. EUS-FNAResectability in those not staged1Specificity92% (95% CI: 75% to 98%)88% (95% CI: 70% to 96%)0.4 (−1.3 to 2.2)NoSee above cell
MDCT vs. MRIResectability in those not staged2Sensitivity68% (95% CI: 47% to 85%)52% (95% CI: 31% to 72%)0.7 (−0.6 to 1.9)NoNo
MDCT vs. MRIResectability in those not staged2Specificity89% (95% CI: 77% to 96%)91% (95% CI: 80% to 97%)−0.2 (−1.7 to 1.2)NoSee above cell
MDCT vs. EUS-FNAT staging1T stagingAccurate T stage in 41% (95% CI: 20/49); overstaged T in 14% (95% CI: 7/49), understaged T in 44% (95% CI: 22/49)Accurate T stage in 67% (95% CI: 33/49); overstaged T in 18% (95% CI: 9/49), understaged T in 14% (95% CI: 7/49)RR 0.61 (0.41 to 0.90)YesNA
MDCT vs. EUS-FNAVessel involvement1Sensitivity56% (95% CI: 34% to 75%)61% (95% CI: 39% to 80%)−0.2 (−1.5 to 1)NoNo
MDCT vs. EUS-FNAVessel involvement1Specificity94% (95% CI: 80% to 98%)91% (95% CI: 76% to 97%)0.4 (−1.3 to 2.1)NoSee above cell
MDCT vs. MRIT staging1T stagingAccurate T stage in 73% (95% CI: CI 62% to 84%), overstaging in 2% (95% CI: CI 0%–6%), and understaging in 25% (95% CI: CI 14%–36%).Accurate T stage in 62% (95% CI: CI 49% to 75%), overstaging in 6% (95% CI: CI 0%–12%), and understaging in 32% (95% CI: CI 19%–45%).RR 1.17 (0.90 to 1.52)NoNo
MDCT vs. MRIN staging1Sensitivity38% (95% CI: 21% to 57%)15% (95% CI: 5% to 36%)1.2 (−0.2 to 2.6)NoNo
MDCT vs. MRIN staging1Specificity79% (95% CI: 63% to 90%)93% (95% CI: 78% to 98%)−1.3 (−2.8 to 0.2)NoSee above cell
MDCT vs. MRIMetastases5Sensitivity48% (95% CI: 31% to 66%)50% (95% CI: 19% to 82%)−0.09 (−1.2 to 1.0)NoNo
MDCT vs. MRIMetastases5Specificity90% (95% CI: 81% to 95%)95% (95% CI: 91% to 98%)−0.9 (−2.2 to 0.9)NoSee above cell
MDCT vs. MRIPrecise stage1Precise stageAccurate TNM stage in 46% (95% CI: CI 33% to 59%), overstaging in 8% (95% CI: CI 1%–15%), and understaging in 46% (95% CI: CI 33%–59%).Accurate TNM stage in 36% (95% CI: CI 23% to 49%), overstaging in 7% (95% CI: CI 0%–14%), and understaging in 57% (95% CI: CI 44%–70%).RR 1.28 (0.81 to 2.01)NoNo
MDCT vs. MRIVessel involvement2Sensitivity68% (95% CI: 55% to 79%)62% (95% CI: 48% to 74%)0.3 (−0.5 to 1.1)NoYes
MDCT vs. MRIVessel involvement2Specificity97% (95% CI: 94% to 98%)96% (95% CI: 93% to 98%)0.3 (−0.6 to 1.2)NoSee above cell
MDCT vs. MRIResectability in those staged1Sensitivity67% (95% CI: 48% to 81%)57% (95% CI: 37% to 74%)0.4 (−0.7 to 1.5)NoNo
MDCT vs. MRIResectability in those staged1Specificity97% (95% CI: 84% to 99%)90% (95% CI: 74% to 96%)1.2 (−0.8 to 3.2)NoSee above cell
MDCT vs. PET/CTN staging1Sensitivity26% (95% CI: 14% to 43%)32% (95% CI: 19% to 50%)−0.3 (−1.4 to 0.8)NoYes
MDCT vs. PET/CTN staging1Specificity75% (95% CI: 50% to 90%)75% (95% CI: 50% to 90%)0 (−1.5 to 1.5)NoSee above cell
MDCT vs. PET/CTMetastases2Sensitivity57% (95% CI: 37% to 75%)67% (95% CI: 47% to 83%)−0.4 (−1.6 to 0.8)NoNA
MDCT vs. PET/CTMetastases2Specificity91% (95% CI: 81% to 97%)100% (95% CI: 95% to 100%)−2.3 (−4.5 to −0.1)YesSee above cell
EUS-FNA vs. MRIPrecise stage1Precise stageAccurate stage for 34/48 patients who had undergone surgical exploration. Of the 34, 34 were stage 2 and below, and 0 was stage 3 or above. The test understaged 13/48, and overstaged 1/48.Accurate stage for 36/48 patients who had undergone surgical exploration. Of the 36, 35 were stage 2 and below, and 1 was stage 3 or above. The test understaged 12/48, and overstaged 0/48.RR 0.94 (0.74 to 1.21)NoYes
MRI vs. PET/CTMetastases1Sensitivity57% (95% CI: 25% to 84%)86% (95% CI: 48% to 97%)−1.5 (−3.7 to 0.7)NoNo
MRI vs. PET/CTMetastases1Specificity86% (95% CI: 48% to 97%)94% (95% CI: 64% to 100%)−0.9 (−4 to 2.2)NoSee above cell
a

If multiple studies, this is the random-effects summary estimate, but if only one study, this is the single-study estimate

b

For most rows, this column indicates the results of statistical comparison of the two tests using equation 39 of Trikalinos.17 A positive logit difference favors test 1, and a negative logit difference favors test 2. For rows with RR (relative risk), it is the results of the statistical comparison of the two rates using relative risk; RR>1 favors test 1 and RR<1 favors test 2.

NA=Not applicable since the question of equivalence does not apply when a statistically significant difference exists for either sensitivity or specificity; RR=relative risk

From: Appendix D, Analyses and Risk of Bias Assessments

Cover of Imaging Tests for the Diagnosis and Staging of Pancreatic Adenocarcinoma
Imaging Tests for the Diagnosis and Staging of Pancreatic Adenocarcinoma [Internet].
Comparative Effectiveness Review, No. 141.
Treadwell J, Mitchell M, Eatmon K, et al.
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