Journal of Rehabilitation Medicine 51-7 | Page 15

V. Bélanger et al. 484 Fig. 3. Hierarchical summary receiver operating characteristic (ROC) curve examining the diagnostic value of high-resolution ultrasound (HRUS) for characterization of long head of the biceps tendon (LHBT) (A) dislocation and (B) complete rupture. The 95% prediction region is defined by the blue dotted-curve, while the red dot-dashed-curve marks the boundary of the 95% credible interval of the pooled estimates. Prediction region is defined by pairing the confidence interval with the credible interval. Sn and Sp ranged or were for each test, respectively: from 0.60 to 0.91 and from 0.13 to 0.85 for the active compression test (35, 37, 39), from 0.10 to 0.48 and from 0.81 to 0.82 for anterior slide test (37, 39), 0.55 and 0.53 for biceps load II test (35), from 0.13 to 0.39 and from 0.67 to 0.83 for crank test (36, 39), from 0.58 to 0.89 and from 0.31 to 0.98 for dynamic labral shear test (35, 37, 41), 0.27 and 0.75 for labral tension test (35), 0.48 and 0.52 for palpation test (36), 0.82 and 0.86 for passive compression test (45), from 0.09 to 0.47 and from 0.56 to 0.74 for Speed test (35–37, 39), and 0.23 and 0.57 for uppercut test (37). Data were pooled from studies assessing the Speed test (Table V, Fig. 4). The results indicate a widely variable performance. Its point estimates for Sn and Sp are 0.36 (95% CI 0.00–0.82) and 0.71 (95% CI 0.23–1.00), respectively. SLAP II–IV lesions. Accuracy for diagnosing SLAP II–IV lesions was assessed for 8 OSTs (Fig. S3 1 ). The Sn and Sp for each test were, respectively, from 0.47 to 0.65 and from 0.38 to 0.92 for the active compression test, (22, 25, 27, 31, 38–40), from 0.04 to 0.70 and from 0.69 to 0.98 for anterior slide test (22, 27, 31, 38–40), from 0.29 to 0.90 and from 0.78 to 0.97 for biceps load II test (31, 46), from 0.09 to 0.83 and from 0.42 to 1.00 for crank test (22, 26, 27, 39), from 0.25 to 0.26 and from 0.65 to 0.80 for palpation test (27, 31), 0.89 and 0.82 for passive compression test (45), 0.52 and 0.94 for passive distraction test (40), and from 0.04 to 0.48 and from 0.65 to 1.00 for Speed test (27, 31, 39). Data were pooled from studies assessing the active compression test, the anterior slide test and the crank test (Table V, Fig. 4). The results indicate a widely variable performance for the 3 tests. The pooled Sn and Sp for the active compression test are 0.59 (95% CI 0.19–0.96) and 0.57 (95% CI 0.18–0.96), respectively, for the anterior slide test 0.21 (95% CI 0.00–0.79) and 0.88 (95% CI 0.35–1.00), respectively, and for the crank test 0.49 (95% CI 0.02–1.00) and 0.70 (95% CI 0.06–1.00), respectively. Tendinopathy. Accuracy for diagnosing LHBT tendi- nopathy was assessed for 3 OSTs, and HRUS was the reference standard. The Sn and Sp estimates from each study are shown in forest plots (Fig. S4 1 ). The Sn and Sp were for each test, respectively: from 0.57 to 0.85 and from 0.49 to 0.72 for the palpation test, (30, 47), from 0.47 to 0.83 and from 0.36 to 0.75 for Speed test (47-49), and from 0.32 to 0.86 and from 0.74 to 0.82 for Yergason’s manoeuvre (47–49). Table V. Overall orthopaedic special tests’ accuracy in characterization of long head of the biceps tendon (LHBT) pathology Studies, n SLAP I–IV lesions Speed test SLAP II–IV lesions Active compression test Anterior slide test Crank test Any LHBT pathology except SLAP lesion Speed test Yergason’s manoeuvre Shoulders, n Sensitivity (95% CI) Specificity (95% CI) LR+ LR– 4 380 0.36 (0.00–0.82) 0.71 (0.23–1.00) 1.24 0.90 7 6 4 1,151 1,060 248 0.59 (0.19–0.96) 0.21 (0.00–0.79) 0.49 (0.02–1.00) 0.57 (0.18–0.96) 0.88 (0.35–1.00) 0.70 (0.06–1.00) 1.37 1.75 1.63 0.72 0.90 0.73 7 5 1,542 559 0.65 (0.17–1.00) 0.41 (0.14–0.72) 0.61 (0.15–1.00) 0.84 (0.65–1.00) 1.67 2.56 0.57 0.70 SLAP: superior labrum anterior and posterior; 95% CI: 95% confidence interval; LR+: positive likelihood ratio; LR–: negative likelihood ratio. www.medicaljournals.se/jrm