***TASK***
the task is to simplify the input abstract of a biomedical literature

***INPUT***
the input is the abstract of a biomedical literature

***OUTPUT***
the output is the simplified abstract for the input abstract of a biomedical literature

***DOCUMENTATION***

***EXAMPLES***

Input: Ten studies were found including 366 patients in total. We included eight studies in the as-published data analysis, comprising 337 patients . The methodological quality of the studies was overall satisfactory, however there was potential for introduction of significant bias in several specific areas relating to performance of the index test and to the timing of index versus reference tests. Results demonstrated a sensitivity estimate of 0.84 (95% confidence interval (CI) 0.69 to 0.93). The 95% approximate prediction interval was very wide (0.34 to 0.98). Data in three studies were available as a four-vessel interpretation model and the data could be re-analysed to a four-vessel interpretation model in a further five studies, comprising 314 patient events. Results demonstrated a similar sensitivity estimate of 0.85 (95% CI 0.77 to 0.91) but with an improved 95% approximate prediction interval (0.56 to 0.96). The available evidence cannot support the use of CT angiography as a mandatory test, or as a complete replacement for neurological testing, in the management pathway of patients who are suspected to be clinically brain dead. CT angiography may be useful as a confirmatory or add-on test following a clinical diagnosis of death, assuming that clinicians are aware of the relatively low overall sensitivity. Consensus on a standard radiological interpretation protocol for future published studies would facilitate further meta-analysis.
Output:

Ten studies were found, including 366 patients in total. Most of the studies were performed in intensive care departments but involved only small numbers of patients. In most studies it would be possible for the doctors performing the CTA test to already know the results of the clinical test. This might affect the study results, however this situation would also be the case in normal medical practice. Methods used to report the CTA study also varied from study to study and so the published results were re-analysed to take this into account. When compared to clinical testing for brain death, the CTA test had a sensitivity of 0.85. This means that in 100 cases of patients satisfying the clinical tests for death, the CTA test will correctly identify 85 of the cases. The data also showed that this might be as few as 77 cases per 100 and as many as 91 cases per 100. Our review was unable to tell us how many patients the CTA might falsely give a diagnosis of death for, when the patient was not dead. Based on these results, it appears that CTA is not good enough to be a compulsory test.