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Abstract：
BACKGROUND: Previous systematic reviews and meta-analyses on the diagnostic accuracy of shoulder clinical tests do not reach conclusions regarding subscapularis tears.
OBJECTIVE: To compare the diagnostic accuracy of commonly used clinical tests for subscapularis tears.
METHODS: Systematic review; Level of evidence, 3.
METHODS: An electronic literature search was conducted using Medline, Embase, and the Cochrane Library/Central. Eligibility criteria were original clinical studies reporting the diagnostic accuracy of clinical tests to diagnose the presence of rotator cuff tears involving the subscapularis.
RESULTS: The electronic literature search returned 2212 records, of which 13 articles were eligible. Among 8 tests included in the systematic review, the lift-off test was most frequently reported (12 studies). Four tests were eligible for meta-analysis: bear-hug test, belly-press test, internal rotation lag sign (IRLS), and lift-off test. The highest pooled sensitivity was 0.55 (95% CI, 0.28-0.79) for the bear-hug test, while the lowest pooled sensitivity was 0.32 (95% CI, 0.13-0.61), for the IRLS. In all tests, pooled specificity was >0.90.
CONCLUSIONS: Among the 4 clinical tests eligible for meta-analysis (bear-hug test, belly-press test, IRLS, and lift-off test), all had pooled specificity >0.90 but pooled sensitivity <0.60. No single clinical test is sufficiently reliable to diagnose subscapularis tears.
BACKGROUND: PROSPERO (CRD42019137019).
OBJECTIVE: To compare the diagnostic accuracy of commonly used clinical tests for subscapularis tears.
METHODS: Systematic review; Level of evidence, 3.
METHODS: An electronic literature search was conducted using Medline, Embase, and the Cochrane Library/Central. Eligibility criteria were original clinical studies reporting the diagnostic accuracy of clinical tests to diagnose the presence of rotator cuff tears involving the subscapularis.
RESULTS: The electronic literature search returned 2212 records, of which 13 articles were eligible. Among 8 tests included in the systematic review, the lift-off test was most frequently reported (12 studies). Four tests were eligible for meta-analysis: bear-hug test, belly-press test, internal rotation lag sign (IRLS), and lift-off test. The highest pooled sensitivity was 0.55 (95% CI, 0.28-0.79) for the bear-hug test, while the lowest pooled sensitivity was 0.32 (95% CI, 0.13-0.61), for the IRLS. In all tests, pooled specificity was >0.90.
CONCLUSIONS: Among the 4 clinical tests eligible for meta-analysis (bear-hug test, belly-press test, IRLS, and lift-off test), all had pooled specificity >0.90 but pooled sensitivity <0.60. No single clinical test is sufficiently reliable to diagnose subscapularis tears.
BACKGROUND: PROSPERO (CRD42019137019).
摘要：
背景：先前关于肩关节临床测试诊断准确性的系统评价和荟萃分析没有得出关于肩胛骨下撕裂的结论。
目的：比较常用临床检查对肩胛骨下撕裂的诊断准确性。
方法：系统评价；证据水平，3.
方法：使用Medline进行电子文献检索，Embase,和科克伦图书馆/中央。合格标准是原始的临床研究，报告了临床测试的诊断准确性，以诊断涉及肩胛骨下的肩袖撕裂的存在。
结果：电子文献检索返回2212条记录，其中13条符合资格。在系统评价中包含的8项测试中，最常报告的是剥离试验(12项研究).四项测试有资格进行荟萃分析：拥抱测试，腹部按压测试，内部旋转滞后信号(IRLS)，和提离试验。熊抱试验的最高合并敏感性为0.55(95%CI，0.28-0.79)，而最低的合并敏感性为0.32(95%CI，0.13-0.61)，对于IRLS。在所有测试中,合并特异性>0.90.
结论：在符合荟萃分析条件的4项临床试验中（熊抱试验，腹部按压测试，IRLS,和提离试验),所有患者的合并特异性>0.90,但合并敏感性<0.60.没有单一的临床测试足够可靠地诊断肩胛骨下撕裂。
背景：PROSPERO（CRD42019137019）。
目的：比较常用临床检查对肩胛骨下撕裂的诊断准确性。
方法：系统评价；证据水平，3.
方法：使用Medline进行电子文献检索，Embase,和科克伦图书馆/中央。合格标准是原始的临床研究，报告了临床测试的诊断准确性，以诊断涉及肩胛骨下的肩袖撕裂的存在。
结果：电子文献检索返回2212条记录，其中13条符合资格。在系统评价中包含的8项测试中，最常报告的是剥离试验(12项研究).四项测试有资格进行荟萃分析：拥抱测试，腹部按压测试，内部旋转滞后信号(IRLS)，和提离试验。熊抱试验的最高合并敏感性为0.55(95%CI，0.28-0.79)，而最低的合并敏感性为0.32(95%CI，0.13-0.61)，对于IRLS。在所有测试中,合并特异性>0.90.
结论：在符合荟萃分析条件的4项临床试验中（熊抱试验，腹部按压测试，IRLS,和提离试验),所有患者的合并特异性>0.90,但合并敏感性<0.60.没有单一的临床测试足够可靠地诊断肩胛骨下撕裂。
背景：PROSPERO（CRD42019137019）。
