Erythrocyte Sedimentation Rate and C-Reactive Protein in Acute Inflammation: Meta-Analysis of Diagnostic Accuracy Studies

• Published in: American journal of clinical pathology 2020-01, Vol.153 (1), p.14-29
• Main Authors: Lapic, Ivana, Padoan, Andrea, Bozzato, Dania, Plebani, Mario
• Format: Article
• Language: English
• Subjects: Accuracy; C-reactive protein; Diagnosis; Erythrocyte sedimentation rate; Inflammation; Medical diagnosis; Medical research; Medicine, Experimental; Meta-analysis; Orthopedics; Quality control; Testing
• ISSN: 0002-9173; 1943-7722
• DOI: 10.1093/AJCP/AQZ142

Objectives: To assess the diagnostic accuracy of erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) in acute inflammation. Methods: PubMed and Scopus were searched and eligible articles were screened for methodologic quality using the Quality Assessment of the Diagnostic Accuracy Studies-Revised, Meta-analysis with calculation of pooled sensitivity (Se), specificity (Sp), and summary area under the curve (SAUC) was performed, Results: Twenty-nine studies were eligible, Se and Sp were 0,78 and 0,68 (SAUC = 0,80) for ESR in orthopedic infections and0,79 and 0,70 (SAUC = 0,81) for CRP. For the diagnosis of other various inflammatory conditions, CRP had a superior diagnostic accuracy, with a Se of 0,86, Sp of 0,67, and SAUC of 0,86 compared with a Se of 0,77, Sp of 0,59, and SA UC of 0,75 for ESR, Heterogeneity among studies was elevated, Combined use of ESR and CRP yielded higher diagnostic accuracy, Conclusions: Despite observed heterogeneity among studies, ESR and CRP have a similar diagnostic accuracy in assessment of inflammation, especially in orthopedic conditions, Key Words: Erythrocyte sedimentation rate; C-reactive protein; Acute phase reaction; Inflammation; Diagnostic accuracy; Meta-analysis