TY  - JOUR
PY  - 2014//
TI  - Sensitivity and specificity of EtG in hair as a marker of chronic excessive drinking. Pooled analysis of raw data and meta-analysis of diagnostic accuracy studies
JO  - Therapeutic drug monitoring
A1  - Boscolo-Berto, Rafael
A1  - Favretto, Donata
A1  - Cecchetto, Giovanni
A1  - Vincenti, Marco
A1  - Kronstrand, Robert
A1  - Ferrara, Santo Davide
A1  - Viel, Guido
SP  - 560
EP  - 575
VL  - 36
IS  - 5
N2  - BACKGROUND: To assess the debated diagnostic performance of ethyl glucuronide in the 3-cm proximal scalp hair fraction (HEtG) as a marker of chronic excessive drinking. METHODS: In July 2012/May 2013, after a systematic search through the Medline, Ovid/Embase, Web of Science and Scopus databases, 8 studies were included in the pooled analysis, that report raw single data on HEtG concentration and Self-reported Daily Alcohol Intake (SDAI). A Receiver Operating Characteristic curve analysis and a Spearman rank order correlation test were used. A meta-analysis was performed following the PRISMA and Cochrane recommendations, comprising quality and bias assessments. RESULTS: The pooled analysis showed that 30 pg/mg could be a useful cut-off value for HEtG to detect a SDAI > 60 g/day, and demonstrated a parabolic direct correlation between HEtG and SDAI data (rho 0.79; 95% CI 0.69-0.87; p<0.001). The meta-analysis found an overall HEtG sensitivity of 0.96 (95% CI 0.72-1.00) and specificity of 0.99 (95% 0.92-1.00); a nomogram to predict the post-test probability of exhibiting the targeted condition in the general population was built. Significant variability among the included studies was detected, which is mainly explained by true heterogeneity in the presence of publication bias. CONCLUSIONS: With the available data we conclude that HEtG is a promising marker for identifying chronic excessive drinking. Nonetheless, larger and well-designed population studies are required to draw any definitive conclusions on the significance and appropriateness of its application in the forensic setting.<p />  <p>Language: en</p>
LA  - en
SN  - 0163-4356
UR  - http://dx.doi.org/10.1097/FTD.0000000000000063
ID  - ref1
ER  -