title: Hysterosalpingosonography for diagnosing tubal occlusion in subfertile women: a systematic review protocol.
abstract: BACKGROUND
  Hysterosalpingosonography has been suggested as a less invasive alternative to hysterosalpingography for detecting tubal occlusion among subfertile women. We aim to determine the diagnostic accuracy of hysterosalpingosonography and to compare it to hysterosalpingography.
  
  
  METHODS
  We will conduct a systematic review of diagnostic test accuracy. We will search Medline, Embase, Cochrane Library, Web of Science and Biosis, as well as reference lists of included studies and previous related review articles. Diagnostic studies that compared hysterosalpingosonography ± hysterosalpingography to laparoscopy with chromotubation in women suffering from subfertility will be eligible. Two authors will independently screen for inclusion, data extraction, and quality assessment. Methodological quality will be assessed using the Quality Assessment of Diagnostic Accuracy Study 2 tool (QUADAS-2). We will use SAS 9.3 (SAS Institute Inc., Cary, NC, USA, 2011) to program bivariate random-effects models, estimate pooled sensitivity and specificity with 95% confidence intervals and to generate summary receiver operating characteristics curves. We will perform sensitivity analyses to examine the effect of differences in techniques used for hysterosalpingosonography and in methodological quality of studies.
  
  
  CONCLUSIONS
  This systematic review will help to determine if hysterosalpingosonography is an adequate alternative screening test for diagnosing tubal occlusion. Accuracy of specific sono-HSG techniques may also be identified.
  
  
  BACKGROUND
  This review has been registered at PROSPERO. The registration number is CRD42013003829.
authors.affiliation: Département d'Obstétrique, Gynécologie et Reproduction, Université Laval, 2325, Rue de l'Université, Québec, QC, G1V 0A6, Canada. sarah.maheux-lacroix.1@ulaval.ca
authors.forename: Sarah
authors.initials: S
authors.lastname: Maheux-Lacroix
authors.forename: Amélie
authors.initials: A
authors.lastname: Boutin
authors.forename: Lynne
authors.initials: L
authors.lastname: Moore
authors.forename: Marie-Ève
authors.initials: MÈ
authors.lastname: Bergeron
authors.forename: Emmanuel
authors.initials: E
authors.lastname: Bujold
authors.forename: Philippe Y
authors.initials: PY
authors.lastname: Laberge
authors.forename: Madeleine
authors.initials: M
authors.lastname: Lemyre
authors.forename: Sylvie
authors.initials: S
authors.lastname: Dodin
mesh_terms: D003955:Diagnostic Tests, Routine / Q000379:methods / Q000592:standards*; D005184:Fallopian Tube Diseases / Q000000981:diagnostic imaging*; D005187:Fallopian Tubes / Q000000981:diagnostic imaging*; D005260:Female; D006801:Humans; D007047:Hysterosalpingography; D007247:Infertility, Female / Q000175:diagnosis / Q000000981:diagnostic imaging* / Q000209:etiology; D010535:Laparoscopy; D011247:Pregnancy; D015203:Reproducibility of Results; D012107:Research Design; D013246:Sterilization, Tubal; D000078202:Systematic Reviews as Topic; D014463:Ultrasonography