Accuracy of prostigmin tests in the diagnosis of myasthenia gravis: a meta-analysis.

Abstract

Myasthenia gravis (MG) is an acquired autoimmune disease diagnosed based on clinical manifestations, muscle fatigue tests, prostigmin tests, serum antibody tests, and neuroelectrophysiological examination. This study conducted a comprehensive search of PubMed, Web of Science, Scopus, Ovid, Embase, Cochrane Library, China National Knowledge Infrastructure, WanFang, Chinese Periodical Database, Chinese Bio-Medicine Database, VIP, and DuXiu Database to identify relevant studies on the accuracy of prostigmin tests for diagnosing MG, covering publications from 1941 to 2021. Ten studies met the inclusion criteria and were included in the meta-analysis. The analysis found no heterogeneity caused by threshold effects but identified heterogeneity due to non-threshold effects. The combined sensitivity was 0.861 (95% CI: 0.831-0.888), and the combined specificity was 0.844 (95% CI: 0.816-0.870). The combined positive likelihood ratio was 5.496 (95% CI: 1.454-20.77), and the combined negative likelihood ratio was 0.237 (95% CI: 0.123-0.455). The area under the curve for diagnostic accuracy was 0.88 (95% CI: 0.84-0.90), with Q* = 0.8520. The combined diagnostic odds ratio was 19.344 (95% CI: 4.327-86.488). In conclusion, the prostigmin test demonstrated good diagnostic value for MG.