PMID- 29084286
OWN - NLM
STAT- MEDLINE
DCOM- 20171124
LR  - 20240216
IS  - 1932-6203 (Electronic)
IS  - 1932-6203 (Linking)
VI  - 12
IP  - 10
DP  - 2017
TI  - EZSCAN for undiagnosed type 2 diabetes mellitus: A systematic review and 
      meta-analysis.
PG  - e0187297
LID - 10.1371/journal.pone.0187297 [doi]
LID - e0187297
AB  - OBJECTIVES: The EZSCAN is a non-invasive device that, by evaluating sweat gland 
      function, may detect subjects with type 2 diabetes mellitus (T2DM). The aim of 
      the study was to conduct a systematic review and meta-analysis including studies 
      assessing the performance of the EZSCAN for detecting cases of undiagnosed T2DM. 
      METHODOLOGY/PRINCIPAL FINDINGS: We searched for observational studies including 
      diagnostic accuracy and performance results assessing EZSCAN for detecting cases 
      of undiagnosed T2DM. OVID (Medline, Embase, Global Health), CINAHL and SCOPUS 
      databases, plus secondary resources, were searched until March 29, 2017. The 
      following keywords were utilized for the systematic searching: type 2 diabetes 
      mellitus, hyperglycemia, EZSCAN, SUDOSCAN, and sudomotor function. Two 
      investigators extracted the information for meta-analysis and assessed the 
      quality of the data using the Revised Version of the Quality Assessment of 
      Diagnostic Accuracy Studies (QUADAS-2) checklist. Pooled estimates were obtained 
      by fitting the logistic-normal random-effects model without covariates but random 
      intercepts and using the Freeman-Tukey Arcsine Transformation to stabilize 
      variances. Heterogeneity was also assessed using the I2 measure. Four studies (n 
      = 7,720) were included, three of them used oral glucose tolerance test as the 
      gold standard. Using Hierarchical Summary Receiver Operating Characteristic 
      model, summary sensitivity was 72.0% (95%CI: 60.0%- 83.0%), whereas specificity 
      was 56.0% (95%CI: 38.0%- 74.0%). Studies were very heterogeneous (I2 for 
      sensitivity: 79.2% and for specificity: 99.1%) regarding the inclusion criteria 
      and bias was present mainly due to participants selection. CONCLUSIONS: The 
      sensitivity of EZSCAN for detecting cases of undiagnosed T2DM seems to be 
      acceptable, but evidence of high heterogeneity and participant selection bias was 
      detected in most of the studies included. More studies are needed to evaluate the 
      performance of the EZSCAN for undiagnosed T2DM screening, especially at the 
      population level.
FAU - Bernabe-Ortiz, Antonio
AU  - Bernabe-Ortiz A
AUID- ORCID: 0000-0002-6834-1376
AD  - CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano 
      Heredia, Lima, Peru.
AD  - Faculty of Epidemiology and Population Health, London School of Hygiene and 
      Tropical Medicine, London, United Kingdom.
AD  - Escuela de Medicina, Universidad Peruana de Ciencias Aplicadas-UPC, Lima, Peru.
FAU - Ruiz-Alejos, Andrea
AU  - Ruiz-Alejos A
AD  - CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano 
      Heredia, Lima, Peru.
FAU - Miranda, J Jaime
AU  - Miranda JJ
AD  - CRONICAS Center of Excellence in Chronic Diseases, Universidad Peruana Cayetano 
      Heredia, Lima, Peru.
AD  - Department of Medicine, School of Medicine, Universidad Peruana Cayetano Heredia, 
      Lima, Peru.
FAU - Mathur, Rohini
AU  - Mathur R
AD  - Faculty of Epidemiology and Population Health, London School of Hygiene and 
      Tropical Medicine, London, United Kingdom.
FAU - Perel, Pablo
AU  - Perel P
AD  - Faculty of Epidemiology and Population Health, London School of Hygiene and 
      Tropical Medicine, London, United Kingdom.
FAU - Smeeth, Liam
AU  - Smeeth L
AD  - Faculty of Epidemiology and Population Health, London School of Hygiene and 
      Tropical Medicine, London, United Kingdom.
LA  - eng
GR  - WT_/Wellcome Trust/United Kingdom
GR  - D43 TW009343/TW/FIC NIH HHS/United States
PT  - Journal Article
PT  - Review
PT  - Systematic Review
DEP - 20171030
PL  - United States
TA  - PLoS One
JT  - PloS one
JID - 101285081
SB  - IM
MH  - Diabetes Mellitus, Type 2/*diagnosis/physiopathology
MH  - Humans
MH  - Sweat Glands/physiopathology
PMC - PMC5662214
COIS- Competing Interests: The authors have declared that no competing interests exist.
EDAT- 2017/10/31 06:00
MHDA- 2017/11/29 06:00
PMCR- 2017/10/30
CRDT- 2017/10/31 06:00
PHST- 2017/06/29 00:00 [received]
PHST- 2017/10/17 00:00 [accepted]
PHST- 2017/10/31 06:00 [entrez]
PHST- 2017/10/31 06:00 [pubmed]
PHST- 2017/11/29 06:00 [medline]
PHST- 2017/10/30 00:00 [pmc-release]
AID - PONE-D-17-23793 [pii]
AID - 10.1371/journal.pone.0187297 [doi]
PST - epublish
SO  - PLoS One. 2017 Oct 30;12(10):e0187297. doi: 10.1371/journal.pone.0187297. 
      eCollection 2017.