Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review

Kenrick Lam; Suzanne A V Van Asten; Tea Nguyen; Javier La Fontaine; Lawrence A. Lavery

doi:10.1093/cid/ciw445

Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review

Kenrick Lam, Suzanne A V Van Asten, Tea Nguyen, Javier La Fontaine, Lawrence A. Lavery

Research output: Contribution to journal › Review article › peer-review

77 Scopus citations

Abstract

The probe-to-bone (PTB) test is a commonly used clinical test for osteomyelitis (OM), but its utility has been questioned in clinical settings where the prevalence of OM is low. This article aims to systematically review the accuracy of the PTB test to diagnose diabetic foot OM. We searched Ovid Medline and Scopus databases for studies using the keywords "probe to bone," "osteomyelitis," and "diabetic foot" from 1946 to May 2015. We summarized characteristics of the included studies and pooled the accuracy numbers using a bivariate random-effects model. Seven studies met our inclusion criteria. Pooled sensitivity and specificity for the PTB test was 0.87 (95% confidence interval [CI],. 75-.93) and 0.83 (95% CI,. 65-.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high-risk patients and rule out OM in low-risk patients.

Original language	English (US)
Pages (from-to)	944-948
Number of pages	5
Journal	Clinical Infectious Diseases
Volume	63
Issue number	7
DOIs	https://doi.org/10.1093/cid/ciw445
State	Published - Oct 1 2016

Keywords

accuracy
diabetic foot
meta-analysis
osteomyelitis
probe to bone

ASJC Scopus subject areas

Microbiology (medical)
Infectious Diseases

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title = "Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review",

abstract = "The probe-to-bone (PTB) test is a commonly used clinical test for osteomyelitis (OM), but its utility has been questioned in clinical settings where the prevalence of OM is low. This article aims to systematically review the accuracy of the PTB test to diagnose diabetic foot OM. We searched Ovid Medline and Scopus databases for studies using the keywords {"}probe to bone,{"} {"}osteomyelitis,{"} and {"}diabetic foot{"} from 1946 to May 2015. We summarized characteristics of the included studies and pooled the accuracy numbers using a bivariate random-effects model. Seven studies met our inclusion criteria. Pooled sensitivity and specificity for the PTB test was 0.87 (95% confidence interval [CI],. 75-.93) and 0.83 (95% CI,. 65-.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high-risk patients and rule out OM in low-risk patients.",

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note = "Publisher Copyright: {\textcopyright} 2016 The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.",

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doi = "10.1093/cid/ciw445",

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AU - La Fontaine, Javier

AU - Lavery, Lawrence A.

N1 - Publisher Copyright: © 2016 The Author 2016. Published by Oxford University Press for the Infectious Diseases Society of America. All rights reserved. Copyright: Copyright 2018 Elsevier B.V., All rights reserved.

PY - 2016/10/1

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N2 - The probe-to-bone (PTB) test is a commonly used clinical test for osteomyelitis (OM), but its utility has been questioned in clinical settings where the prevalence of OM is low. This article aims to systematically review the accuracy of the PTB test to diagnose diabetic foot OM. We searched Ovid Medline and Scopus databases for studies using the keywords "probe to bone," "osteomyelitis," and "diabetic foot" from 1946 to May 2015. We summarized characteristics of the included studies and pooled the accuracy numbers using a bivariate random-effects model. Seven studies met our inclusion criteria. Pooled sensitivity and specificity for the PTB test was 0.87 (95% confidence interval [CI],. 75-.93) and 0.83 (95% CI,. 65-.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high-risk patients and rule out OM in low-risk patients.

AB - The probe-to-bone (PTB) test is a commonly used clinical test for osteomyelitis (OM), but its utility has been questioned in clinical settings where the prevalence of OM is low. This article aims to systematically review the accuracy of the PTB test to diagnose diabetic foot OM. We searched Ovid Medline and Scopus databases for studies using the keywords "probe to bone," "osteomyelitis," and "diabetic foot" from 1946 to May 2015. We summarized characteristics of the included studies and pooled the accuracy numbers using a bivariate random-effects model. Seven studies met our inclusion criteria. Pooled sensitivity and specificity for the PTB test was 0.87 (95% confidence interval [CI],. 75-.93) and 0.83 (95% CI,. 65-.93), respectively. We conclude that the PTB test can accurately rule in diabetic foot OM in the high-risk patients and rule out OM in low-risk patients.

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Diagnostic Accuracy of Probe to Bone to Detect Osteomyelitis in the Diabetic Foot: A Systematic Review

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