Comparative diagnostic accuracy of panic provocation tests: A meta-analysis.
Umit Tural, Sara Rose Shannon, Dan V Iosifescu
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In 30 seconds
This meta-analysis evaluated the diagnostic accuracy of various panic provocation tests in a population of 5693 participants across 123 studies. Sodium lactate infusion demonstrated the highest pooled diagnostic odds ratio (DOR) of 24.77, indicating superior diagnostic discrimination for panic disorder compared to healthy controls. The study utilized random-effects meta-analyses with Hartung-Knapp adjustment.
Key findings
- Sodium lactate infusion had the highest pooled DOR of 24.77 (95% CI 19.03-32.25).
- Isoproterenol showed a DOR of 18.85 (95% CI 12.39-28.66).
- Cholecystokinin tetrapeptide (CCK-4) had a DOR of 15.03 (95% CI 7.83-28.84).
- Breath holding, fenfluramine, and flumazenil did not show significant discriminative ability.
Why it matters
Understanding the diagnostic accuracy of panic provocation tests is crucial for clinicians in accurately diagnosing panic disorder. This meta-analysis highlights the effectiveness of specific tests, particularly sodium lactate infusion, which may enhance diagnostic precision in clinical practice.