Abstract | OBJECTIVE: DESIGN: Systematic review. DATA SOURCES: Medline and Embase, the Cochrane Library, reference lists, and experts. Review methods Literature search (1980-2007) for articles of the spot protein: creatinine ratio or albumin: creatinine ratio in hypertensive pregnancy, with 24 hour proteinuria as the comparator. RESULTS: 13 studies concerned the spot protein: creatinine ratio (1214 women with primarily gestational hypertension). Nine studies reported sensitivity and specificity for eight cut-off points, median 24 mg/mmol (range 17-57 mg/mmol; 0.15-0.50 mg/mg). Laboratory assays were not well described. Diagnostic test characteristics were recalculated for a cut-off point of 30 mg/mmol. No significant heterogeneity in cut-off points was found between studies over a range of proteinuria. Pooled values gave a sensitivity of 83.6% (95% confidence interval 77.5% to 89.7%), specificity of 76.3% (72.6% to 80.0%), positive likelihood ratio of 3.53 (2.83 to 4.49), and negative likelihood ratio of 0.21 (0.13 to 0.31) (nine studies, 1003 women). Two studies of the spot albumin: creatinine ratio (225 women) found optimal cut-off points of 2 mg/mmol for proteinuria of 0.3 g/day or more and 27 mg/mmol for albuminuria. CONCLUSION:
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Authors | Anne-Marie Côté, Mark A Brown, Elaine Lam, Peter von Dadelszen, Tabassum Firoz, Robert M Liston, Laura A Magee |
Journal | BMJ (Clinical research ed.)
(BMJ)
Vol. 336
Issue 7651
Pg. 1003-6
(May 03 2008)
ISSN: 1756-1833 [Electronic] England |
PMID | 18403498
(Publication Type: Evaluation Study, Journal Article, Research Support, Non-U.S. Gov't, Review, Systematic Review, Validation Study)
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Chemical References |
- Reagent Strips
- Creatinine
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Topics |
- Albuminuria
(etiology)
- Creatinine
(urine)
- Diagnostic Tests, Routine
(methods, standards)
- Female
- Humans
- Hypertension, Pregnancy-Induced
(urine)
- Pregnancy
- Proteinuria
(etiology)
- Reagent Strips
(standards)
- Sensitivity and Specificity
- Urinalysis
(methods)
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