BACKGROUND: Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients' values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity. TYPES OF STUDIES REVIEWED: The authors searched for preexisting systematic reviews and assessed their quality using the Assessing the Methodological Quality of Systematic Reviews tool. The authors updated the selected reviews and searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and DTA and PVPs studies. Pairs of reviewers independently conducted study selection, data extraction, and assessment of the certainty in the evidence by using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: The authors identified 4 existing reviews. DTA reviews included 37 studies. The authors retrieved 7,534 records, of which 9 DTA and 10 PVPs studies were eligible. Pooled sensitivity and specificity of adjuncts ranged from 0.39 to 0.96 for the evaluation of innocuous lesions and from 0.31 to 0.95 for the evaluation of suspicious lesions. Cytologic testing used in suspicious lesions appears to have the highest accuracy among adjuncts (sensitivity, 0.92; 95% confidence interval, 0.86 to 0.98; specificity, 0.94; 95% confidence interval, 0.88 to 0.99; low-quality evidence). CONCLUSIONS AND PRACTICAL IMPLICATIONS: Cytologic testing appears to be the most accurate adjunct among those included in this review. The main concerns are the high rate of false-positive results and serious issues of risk of bias and indirectness of the evidence. Clinicians should remain skeptical about the potential benefit of any adjunct in clinical practice.
BACKGROUND:Oral squamous cell carcinoma is the most common manifestation of malignancy in the oral cavity. Adjuncts are available for clinicians to evaluate lesions that seem potentially malignant. In this systematic review, the authors summarized the available evidence on patient-important outcomes, diagnostic test accuracy (DTA), and patients' values and preferences (PVPs) when using adjuncts for the evaluation of clinically evident lesions in the oral cavity. TYPES OF STUDIES REVIEWED: The authors searched for preexisting systematic reviews and assessed their quality using the Assessing the Methodological Quality of Systematic Reviews tool. The authors updated the selected reviews and searched MEDLINE, Embase, and the Cochrane Central Register of Controlled Trials to identify randomized controlled trials and DTA and PVPs studies. Pairs of reviewers independently conducted study selection, data extraction, and assessment of the certainty in the evidence by using the Grading of Recommendations Assessment, Development and Evaluation approach. RESULTS: The authors identified 4 existing reviews. DTA reviews included 37 studies. The authors retrieved 7,534 records, of which 9 DTA and 10 PVPs studies were eligible. Pooled sensitivity and specificity of adjuncts ranged from 0.39 to 0.96 for the evaluation of innocuous lesions and from 0.31 to 0.95 for the evaluation of suspicious lesions. Cytologic testing used in suspicious lesions appears to have the highest accuracy among adjuncts (sensitivity, 0.92; 95% confidence interval, 0.86 to 0.98; specificity, 0.94; 95% confidence interval, 0.88 to 0.99; low-quality evidence). CONCLUSIONS AND PRACTICAL IMPLICATIONS: Cytologic testing appears to be the most accurate adjunct among those included in this review. The main concerns are the high rate of false-positive results and serious issues of risk of bias and indirectness of the evidence. Clinicians should remain skeptical about the potential benefit of any adjunct in clinical practice.
Authors: Walter J Psoter; Douglas E Morse; Alexander Ross Kerr; Scott L Tomar; Maria L Aguilar; D Robert Harris; Laurence H Stone; Sonia K Makhija; Linda M Kaste; Brett Strumwasser; Daniel J Pihlstrom; Erin E Masterson; Cyril Meyerowitz Journal: Prev Med Date: 2019-07 Impact factor: 4.018
Authors: Caryn E Peterson; Sara C Gordon; Charles W Le Hew; J A Dykens; Gina D Jefferson; Malavika P Tampi; Olivia Urquhart; Mark Lingen; Karriem S Watson; Joanna Buscemi; Marian L Fitzgibbon Journal: Transl Behav Med Date: 2019-07-16 Impact factor: 3.046
Authors: Anil K Chaturvedi; Natalia Udaltsova; Eric A Engels; Jed A Katzel; Elizabeth L Yanik; Hormuzd A Katki; Mark W Lingen; Michael J Silverberg Journal: J Natl Cancer Inst Date: 2020-10-01 Impact factor: 13.506
Authors: Ryan C Hall; Nadia R Ayat; Peter L Qiao; Amita M Vaidya; Dan Ma; Anita Aminoshariae; Ivan Stojanov; Zheng-Rong Lu Journal: Mol Imaging Biol Date: 2020-08-12 Impact factor: 3.488
Authors: Paula Demétrio de Souza França; Susanne Kossatz; Christian Brand; Daniella Karassawa Zanoni; Sheryl Roberts; Navjot Guru; Dauren Adilbay; Audrey Mauguen; Cristina Valero Mayor; Wolfgang A Weber; Heiko Schöder; Ronald A Ghossein; Ian Ganly; Snehal G Patel; Thomas Reiner Journal: Eur J Nucl Med Mol Imaging Date: 2021-05-05 Impact factor: 10.057
Authors: Tanya Walsh; Richard Macey; Alexander R Kerr; Mark W Lingen; Graham R Ogden; Saman Warnakulasuriya Journal: Cochrane Database Syst Rev Date: 2021-07-20