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Results In total, 25 articles involving 1920 subjects with 3493 experimental results were included. The majority of the studies had been of fair quality. A top degree of heterogeneity (I2=57.2%, p less then 0.001) was discovered. The Youden index values had been 1.56 and 1.55 when the CPOT limit was set at two and three, correspondingly. The diagnostic performance of this CPOT was suffering from the reference standard. The CPOT had a greater diagnostic od