title: Controlled attenuation parameter for assessment of hepatic steatosis grades: a diagnostic meta-analysis.
abstract: OBJECTIVE
  to evaluate the performance and accuracy of Controlled attenuation parameter CAP for hepatic steatosis detection.
  
  
  METHODS
  PubMed, EBSCO, Elsevier Science, Ovid, and Wiley were selected to search studies until August 31, 2014. Quality Assessment of Diagnostic Accuracy Studies checklist was used to assess the quality of included studies. Heterogeneity was evaluated using Q test. Sensitivity, specificity, diagnostic odds ratio (DOR), and the area under curve (AUC) with its 95% confidence intervals (CIs) were calculated to evaluate the accuracy of CAP for assessment of hepatic steatosis stage (≥ S1, ≥ S2 and ≥ S3).
  
  
  RESULTS
  Totally 11 studies (13 cohorts) with high methodological qualities were identified. The summary point estimations with 95% CIs of sensitivity, specificity, AUC and DORs were 0.78 (0.71, 0.84), 0.79 (0.70, 0.86), 0.86 (0.82, 0.88), and 14 (7, 27) for ≥ S1; 0.82 (0.74, 0.88), 0.79 (0.73, 0.85), 0.88 (0.85, 0.90) and 18 (10, 30) for ≥ S2; 0.86 (0.82, 0.89), 0.89 (0.86, 0.92), 0.94 (0.91, 0.96) and 51 (35, 76) for ≥ S3. Significant heterogeneity was found among the studies in ≥ S1 and ≥ S3. Threshold effect was existed in ≥ S3, but not in ≥ S1 and ≥ S2. Publication bias was not existed in ≥ S1 and ≥ S2 except ≥ S3.
  
  
  CONCLUSIONS
  CAP provides good sensitivity and specificity for detection of ≥ S1, ≥ S2, and ≥ S3 steatosis. However, future studies with large samples are still necessary to confirm the clinical application.
authors.affiliation: Department of Infectious Diseases, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Yuee
authors.initials: Y
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Qingqi
authors.initials: Q
authors.lastname: Fan
authors.affiliation: Department of Infectious Diseases, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Ting
authors.initials: T
authors.lastname: Wang
authors.affiliation: Department of Infectious Diseases, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Jia
authors.initials: J
authors.lastname: Wen
authors.affiliation: Department of Gastroenterology, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Hong
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of TCM, Jing'an District Central Hospital Shanghai 200040, China.
authors.forename: Tiansong
authors.initials: T
authors.lastname: Zhang
keywords: Controlled attenuation parameter; diagnostic meta-analysis; hepatic steatosis