Financial Statement Analysis

  • First Online: 26 February 2020

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literature review on financial ratio analysis

  • Terence M. Yhip 3 &
  • Bijan M. D. Alagheband 4  

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This chapter provides fundamental financial analysis based on ratio analysis, a powerful tool to assess the performance of a firm over a period, or to compare risk and return of firms of different sizes. The discussion centres on the income statement, the balance sheet, the statement of shareholders’ equity, and the cash flow statement and the capitalisation of off-balance obligations. These provide the credit analyst with information to calculate the ratios, which are usually grouped into four categories: profitability, asset utilisation and efficiency, liquidity, and debt and solvency. The ratio examples are based on actual financial reports. Calculated accurately and analysed carefully, financial ratios are revealing and predictive. But financial statements can also mislead with window dressing and fraudulent reporting. The chapter provides examples.

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See Bernstein, Leopold and Wild, John (1998), Financial Statement Analysis, Theory, Application, and Interpretation , 6th edition, Irwin McGraw-Hill. Also, White, Gerald, Sondhi, Ashwinpaul, and Fried, Dov (1997), The Analysis and Use of Financial Statements, 2nd edition, John Wiley and Sons; Kimmel, Weygandt, Kieso, and Trenholm (2009), “ Financial Accounting, Tools for Business and Decision Making ”, 4th Canadian ed., John Wiley and Sons.

Fridson, Martin, and Alvarez, Fernando (2011), Financial Statement Analysis, A Practitioner’s Guide , 4th ed. John Wiley & Sons Inc. In Chap. 1 , the authors discuss “the importance of being skeptical”. This theme carries through the rest of this book, an indispensable resource for credit analysts and for first-time users of financial statements. This book looks at some of the biggest financial scandals in recent times, such as Enron, WorldCom, and Nortel Networks.

Chartered professional accountants provide three types of financial statements. (1) Audited Engagement: It provides the highest assurance that the financial statements are free of material misstatement and are fairly presented based upon the application of generally accepted accounting principles (GAAP). The assurance is supported by testing procedures performed in the compilation of the figures. (2) Review Engagement: It provides only limited or reasonable assurance on a company’s financial statements. (3) Compilation Engagement: They provide no assurance on a company’s financial statements. The accountants merely compile them in a financial statement format that complies with generally accepted accounting principles without any testing performed.

International Financial Reporting Standards (IFRS), the reporting rules for making company accounts understandable and comparable across international boundaries, are issued by the International Accounting Standards Board (IASB) of the International Accounting Standards Committee (IASC). The IASC has no authority to require international compliance, but many countries including Australia, Brazil, Canada, and the European Union have adopted the accounting standards. The financial statements of publicly traded companies in these jurisdictions are prepared in accordance with IAS. The Financial Accounting Standards Board (FASB) of the United States establishes and communicates standards of financial accounting and reporting, known as generally accepted accounting principles (GAAP). The United States has not adopted IFRS, but the FASB also requires the reporting of comprehensive income.

Arthur Andersen LLP was the public accounting firm that audited Enron Corp. The firm cofounded as Andersen, DeLany & Co. in 1913 by Arthur E. Andersen, no longer exists. On June 15, 2002, Arthur Andersen was found guilty of obstructing justice (shredding evidence) in the Enron scandal, and lost its licence to engage in public accounting.

Such data are available from various business services companies. Sources include Risk Management Association (RMA). Banks use RMA Annual Statement Studies as a standard source to evaluate businesses applying for financing. Another source is online web access to Dun & Bradstreet’s Key Business Ratios to benchmarking data. A third source is Wolters Kluwer’s Almanac of Business and Industrial Financial Ratios for 199 industries in all of North America (Canada, the United States, and Mexico).

The widely used variable reduction techniques are Principal Components Analysis and Factor Analysis. The procedures partition a smaller number of metrics from the larger multivariate data set. The result is a subset whose ratios have zero correlation with each other but are strongly correlated with the excluded ratios. The zero or low correlation ensures maximum information or explanatory power is achieved. The strong correlation ensures that the ratios of the subset capture information in the excluded ratios. Bernstein & Wild, op. cit. Lists 48 financial ratios in the front cover; and there are as many as 100 as stated in White, Sondhi, and Fried, op. cit. Page 192.

Sathye, M. V. James, and B. Raymond (2013), Credit Analysis and Lending Management, 3rd Edition, Tilde University Press. Refer to Chapter 2, page 81. The authors list ten ratios that loan officers consider important.

Herbert A. Simon coined the word satisficing by combining “satisfy” and “suffice” to explain the behaviour of decision-makers working with limited information. In such a situation, he argued that an optimal solution is indeterminate. He referred his satisficing theory of the firm as bounded rationality in contrast with unbounded rationality that underpins the classical theory, which assumes that the firm knows with certainty its demand and cost function and can therefore maximise profit. Herbert Simon received the Nobel Memorial Prize in Economics “for his pioneering research into the decision-making process within economic organizations” in 1978.

See online data prepared by Aswath Damodaran, NYU Stern School of Business, Operating and Net Margins by Industry Sector. Data of last update: January 5, 2017. http://people.stern.nyu.edu/adamodar/New_Home_Page/datacurrent.html . See also Grocery Stores Industry Profitability on CSI Market. Web site: http://csimarket.com

See Ganguin, B., J. Bilardello (2005), op. cit., page 99 where the authors examine the pros and cons of using EBITDA; and Martin Fridson & Fernando Alvarez (2011) op. cit., Chapter 8.

Refer to Aswath Damodaran, op. cit. The average for 163 global firms in the industry was 1.92% as of January 2017. Data from CSI Market show that average the Net Income margin for US firms was 2.35% in 2016 and 2.13% in 2015.

Koopmans, Tjalling C., ed. (1951), Activity Analysis of Production and Allocation. New York: Wiley. Koopmans’ notion of technical efficiency is that an input–output vector is technically efficient if, and only if, increasing any output or decreasing any input is possible only by decreasing some other output or increasing some other input.

White, Sondhi, and Fried, op. cit. on methods to adjust leverage ratios to include various off-balance sheet liabilities. In particular, this chapter shows how to capitalise operating leases. Also, Moody’s, “Guideline Rent Expense Multiples for Use with Moody’s Global Standard Adjustment to Capitalize Operating Leases”, Revised March 2006. Refer to Chapter 11.

The general formula for WACC is: \( \mathrm{WACC}=\frac{\sum_{j=1}^N\ {r}_j{V}_j}{\sum_{j=1}^N{V}_j} \) where N is the number of sources of capital, r is the required rate of return for security j , and V is the market value of all outstanding securities j . Applying the formula to two securities, equity and debt, \( \mathrm{WACC}=\frac{E}{E+D}\ {r}_e+\frac{D}{E+D}\ \left(1-t\right){r}_d \) where E is the market value of equity, D is the market value of debt, and t is the marginal tax rate.

Moody’s Investors Services (2015), Announcement: Moody’s updates its global methodology for financial statement adjustments . The methodology is provided in the publication June 2015 article, Financial Statement Adjustments in the Analysis of Non-Financial Corporations . Before the recent revision, the sector multiples ranged from 5× to 8×.

There are numerous readings on financial manipulation. The reader may wish to look up these sources: (1) Martin Fridson and Fernando Alvarez, ibid., Chapter 9, The Reliability of Disclosure and Audits; (2) Roman Weil and Michael Mahler, Handbook of Cost Management, 2nd Edition, John Wiley & Sons, 2005, Chapter 31, Section 41.4, Specific Methods to Manipulate Financial reports; (3) Al Rosen and Mark Rosen, Financial Shenanigans: How to Detect Accounting Gimmicks & Fraud in Financial Reports , Third Edition Hardcover, May 5, 2010.

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Yhip, T.M., Alagheband, B.M.D. (2020). Financial Statement Analysis. In: The Practice of Lending. Palgrave Macmillan, Cham. https://doi.org/10.1007/978-3-030-32197-0_2

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  • DOI: 10.1111/J.1468-5957.1987.TB00106.X
  • Corpus ID: 154406447

The Analysis and Use of Financial Ratios: A Review Article

  • Published 1 December 1987
  • Economics, Business
  • Journal of Business Finance & Accounting

349 Citations

A multicriteria approach for evaluating the performance of industrial firms, the time series properties of financial ratios: lev revisited, composite indicators: a sectorial perspective, financial indicators as predictors of illiquidity, financial reporting : long-term change of financial ratios.

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The impact of constructive operating lease capitalisation on key accounting ratios

Financial ratios for the commercial banking industry: do they measure what you think, the firm's trade credit policy effects on financial distress: a whole response to molina and preve (2012), stability of financial ratios: a study of listed companies in singapore, assessment of financial performance: a case of some financial institutions in ghana, 80 references, financial ratios as predictors of failure, an empirical analysis of useful financial ratios, industry averages as targets for financial ratios, the stability of financial patterns in industrial organizations, ratio analysis and the prediction of firm failure, ratio stability and corporate failure, cluster analysis study of financial ratios and industry characteristics, methodological issues in the use of financial ratios, financial ratios, discriminant analysis and the prediction of corporate bankruptcy, the speed of adjustment of financial ratios - an error-in-variable problem, related papers.

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Financial Statement Analysis: A Review and Current Issues

China Finance Review International, forthcoming

30 Pages Posted: 10 Nov 2021

Andrew B. Jackson

UNSW Australia Business School, School of Accounting

Date Written: October 28, 2021

The literature on financial statement analysis attempts to improve fundamental analysis and to identify market inefficiencies with respect to financial statement information. In this paper, I review the extant research on financial statement analysis. I then provide some preliminary evidence using Chinese data and offer suggestions for future research, with a focus on utilising unique features of the Chinese business environment as motivation.

Keywords: financial statement analysis, fundamental analysis, forecasting, persistence, mean reversion

JEL Classification: M40, M41

Suggested Citation: Suggested Citation

Andrew B. Jackson (Contact Author)

Unsw australia business school, school of accounting ( email ).

Sydney, NSW 2052 Australia

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The Analysis and Use of Financial Ratios: A Review Article

Profile image of Paul Barnes

1987, Journal of Business Finance & Accounting

Related Papers

Journal of Business Finance & Accounting

Ronald Bird

literature review on financial ratio analysis

Usman kabir

The certainty of the reliance on the use of financial ratio analysis in making investment decisions by potential investors still remained a mystery. This has to do with the choice of ratios to select when making investment decisions. Many shareholders in Nigeria are uneducated or illiterate, and due to their ignorance, they cannot use ratio analysis in evaluating firms for investment decisions. Thus, this paper explores the concept of financial ratio analysis in terms of the decision usefulness of financial ratios. The paper suggests that the relevant financial information needed for the purposes of making investment decision can be sourced through the use of financial ratio analysis. Therefore, management must ensure that disclosure of comprehensive financial ratios form part of financial statement prepared for the overall appraisal of firms.

David Woodliff

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Financial ratios are assumed to be very useful predictors of business performance, growth and financial status. This study evaluates the collinearity and correlation of financial ratios to establish a pattern of relationship that could serve s n empirically supported guide for financial ratios reliance in business evaluation decisions. The research data were gathered from the annual account report of vita foam Plc and analyzed using collinearity and correlation to test the research propositions. The paper found the existence of correlation and collinearity in the financial ratios, and concludes that financial ratios are reliable business status indicators. We therefore recommend the application of financial ratios in the evaluation of business performance, growth and financial strength.

navneet joshi

The current business environment has forced business units to devise innovative means and mechanisms so as to stay competitive in the market. This necessitates the need for constantly evaluating their performance measures. Business units have identified several measures which depict the performance yet ambiguities remain with respect to what is appropriate measure for performance measurement. Ratio analysis is one such measure which business units have been using for sufficient period of time. Yet there exists certain points of consideration which form the basis for this paper and their convergence into research question namely (a) What constitutes ratio analysis and (b) Which of the component of ratio analysis, has the greatest contribution? While addressing these questions, HUDCO’s secondary data is used as a base. Ratio analysis is used to depict the measure of performance while descriptive statistics is used for data interpretation. Findings indicate that there is no single comp...

Accounting, Management and Information Technologies

Duarte Trigueiros

Ratios are routinely used for extracting information from accounting reports. However, ratios present only part of the information available and can be easily complemented provided that information-technology facilities are accessible. This study infers the functional form of the information discarded by ratios. Then it develops extensions of ratios incorporating the discarded information, showing examples of their use and discussing the benefits obtained. Extensions of ratios seem promising as a facility attached to computerized databases of accounting reports. The concepts developed here are a step toward a more technology-supported analysis of financial statements.

Paul Barnes

Empirical studies have shown distributions of financial ratios are skewed. An explanation for this is given and it is argued that in such circumstances comparison of a fmancial ratio with some norm (e.g. industry average) is likely to misinform. It is also shown that where financial ratios are used as inputs to statistical models normality is irrelevant but a method of transformation into a normal distribution is provided whereby original interrelationships are preserved. Finally, because of the inadequacies of financial ratios, it is shown how regression analysis may be used in financial statement analysis.

MRS. OKWO IFEOMA MARY

The British Accounting Review

This study identifies general postulates underlying the validity of the financial ratio measurement. Then, new relationships are suggested obeying the same postulates, which may replace the ratio form in the case of non-proportionality. Where proportionality holds, these relationships revert to the traditional ratio. The paper also reviews the reasons for expecting non-proportional components in ratios and presents application examples of the new relationships.

Vichy Pattiasina , Victor Pattiasina

A Company will be interested in investors if its financial report is relevant and reliable. The relevance and reliable financial report can be reflected in the Asset Number and Liability Report on a Financial Position Statement (Balance Sheet). The success of a company can be measured by company ability, which is reflected in management performance. A company's performance parameter that commonly used is profit change. Profit itself is important to the company since this will be decision basis for investors to invest in the company. Profit Change reflected in financial statements using fair value will bring benefits to market participants, as the financial statements itself reflects the real market value. This research aims to examine the influence of Current Ratio, Total Asset Turnover, Price Earnings Ratio, and Return on Asset, towards profit changes that based on fair value. Research problem discussed in this study was how CR, TATO, PER, and ROA influence profit changes of a property company, real estate, and building construction, in period 2013-2016. The study was based on fair value. The population was company property, real estate, and building construction, that have been listed in Indonesia Stock Exchange (ISE). It consisted of 63 companies. Through Purposive Sampling technique, 12 companies were selected to be examined. Data analysis was conducted through a multiple linear regression analysis. Results of multiple linear regression analysis showed that the CR, TATO, and PER had an influence towards Profit Changes, while ROA had no influence toward it.

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Financial statement analysis: Principal component analysis (PCA) approach case study on China telecoms industry

Asian Journal of Accounting Research

ISSN : 2459-9700

Article publication date: 3 September 2019

Issue publication date: 11 December 2019

The Chinese Telecoms Industry has been rapidly growing over the years since 2001. An analysis of financial performance of the three giants in this industry is very important. However, it is difficult to know how many ratios can be used best with little information loss. The paper aims to discuss this issue.

Design/methodology/approach

A total of 18 financial ratios were calculated based on the financial statements for three companies, namely, China Mobile, China Unicom and China Telecom for a period of 17 years. A principal component analysis was run to come up with variables with significance value above 0.5 from each component.

At the end, the authors conclude how financial performance can be analysed using 12 ratios instead of the costly analysis of too many ratios that may be complex to interpret. The results also showed that ratios are all related as they come from the same statements, hence, the authors can use a few to represent the rest with limited loss of information.

Originality/value

This study will help different stakeholders who are interested in the financial performance of each company by giving them a shorter way to analyse performance. It will also assist those who do financial reporting on picking the ratios which matter in reflecting the performance of their companies. The use of PCA gives unbiased ratios that are most significant in assessing performance.

  • Performance analysis
  • Financial ratios
  • Principal component analysis
  • China telecoms industry

Mbona, R.M. and Yusheng, K. (2019), "Financial statement analysis: Principal component analysis (PCA) approach case study on China telecoms industry", Asian Journal of Accounting Research , Vol. 4 No. 2, pp. 233-245. https://doi.org/10.1108/AJAR-05-2019-0037

Emerald Publishing Limited

Copyright © 2019, Reginald Masimba Mbona and Kong Yusheng

Published in Asian Journal of Accounting Research . Published by Emerald Publishing Limited. This article is published under the Creative Commons Attribution (CC BY 4.0) licence. Anyone may reproduce, distribute, translate and create derivative works of this article (for both commercial and non-commercial purposes), subject to full attribution to the original publication and authors. The full terms of this licence may be seen at http://creativecommons.org/licences/by/4.0/legalcode

Introduction

The financial performance of a company is a primary concern for every stakeholder especially for investors, both aspiring and current ones. The measurement of the financial health of a company through the reported financial statements gives a qualitative analysis of the company’s position as well as an account of how the company has utilised its capital in production. According to Bhunia et al. (2011) , financial performance analysis involves using reported results in a company’s financial statements to obtain the quantitative performance characteristics of a company with the aim of determining how efficient the company has been in terms of the use of their resources according to the decisions made by the management.

Financial statement analysis using ratios has been one of the most commonly used primary models of assessing business performance. It is one of the primary models of assessment of a firm’s performance over years and as well as comparing it to the rest of the players in the industry. Due to limited time for those who do the analysis of financial statements and also given the fact that these ratios are mostly correlated, the number of ratios that are being evaluated has to be reduced so that focus is given to a few with minimum loss of data ( Taylor, 1986 ). Using principal component analysis (PCA), the study reduced the number of variables for any further regression analysis from 17 variables to 3 variables. Likewise, the number of ratios that are important have also been reduced with only significant ratios for each principal component now being used to analyse the performance of these companies as well as their industry. This study proves that the performance of a company can be analysed using just a few factors or by focusing on fewer ratios, which is cost effective with lesser time as well as obtaining more precise results that have least duplication of calculations.

Since 2002, China has been the largest telecom market by subscriber base and the industry has been attracting a lot of investment within and outside China ( Uria-Recio and O’Connor, 2004 ). The telecom industry in China has been the backbone of the economy that is highly dependent on the internet and online services ( Grubman, 2010 ). Their research, innovation and building of different technologies including the current 5G that they are jointly working on have given China high growth to make it compete with countries like the USA that are considered as earlier entrants into this market. Their internet and data services have facilitated access to online shopping, IPTV, online messaging and calling platforms, data cloud and many other services that are available at very fast speed and cheap rates. The rapid build-up of the industry’s infrastructure has been the main sign of the aggressive growth and development over the past two decades ( Lu, 2000 ).

The Chinese Telecom industry was heavily controlled by the government through the ownership and formation of policies on investment, areas of operations and tariffs charged. In late 2001, China successfully joined the World Trade Organization and this meant that it had to adjust some of its policies including regulations on players in its telecoms industry. Even though they opened the doors for foreigners, this industry remained monopolised by the three state-owned companies who have been competing for the highest market share, best financial performance and top innovation into new technologies including 5G network. Over the past years, they have cemented their dominance by taking over the other small players in the industry that were state owned as well. This study, thus, seeks to assess the financial performance of this industry since the doors for open competition were opened in this sector.

China Telecom Limited

China Telecom is an incorporated company in the People’s Republic of China as China Telecom Corporation Limited with the aim of providing information services. These are, but not limited to wireline and telecommunication services, broadband and wireless internet access services, information services and other services that relate to information and telecommunications. According to the company’s report, there were at least 250m mobile subscribers, 134m broadband subscribers and 122m active access lines. The company is currently listed on the Hong Kong Stock Exchange and the New York Stock Exchange where they trade American Depositary Shares ( Telecom, 2019 ).

China Mobile Limited

This is a company which is incorporated on Hong Kong and New York Stock Exchanges since 1997 with a constituent stock of Hang Seng Index in Hong Kong. Since its formation, China Mobile has grown to have the highest market share in the telecommunications globally with the highest number of subscribers, of which 887m are mobile subscribers while 113m of them are broadband subscribers. Mobile services in the form of mobile voice and data services are the main businesses of the company and other services include wireline broadband and other services in the telecommunications industry ( Mobile, 2019 ).

China Unicom (Hong Kong) Limited

China Unicom, which was formed in 1994, is one of the oldest Telecoms Company in China and in the 2000s was listed on the Hong Kong and New York Stock Exchange. The company is the second largest mobile services provider in China with a subscriber base of 248m mobile subscribers, and 60m fixed line subscribers. Their service coverage includes all the telecommunications services and it has been doing exceptionally well in the mobile and fixed networks provision ( Unicom, 2019 ).

The rest of this paper is structured as follows: literature review, research objectives, methodology, discussion and analysis of results and finally the conclusion.

Literature review

Financial analysis involves the use of quantitative information from financial statements, that is, income statement, balance sheet and statement of cash flows in order to come up with relationships of the items that are reported by the company according to the accounting standards for reporting. In doing this, the company is able to evaluate its decisions during a financial year or a given period and see its strengths, weaknesses and areas that need attention in the organisation ( Abraham, 2004 ; Bhargava, 2017 ; Schönbohm, 2013 ). Additionally, “they also provide clues on where the management might find more resources to boost its revenue” ( Mahajan and Yaday, 2016 ). In a case study on India’s telecommunications industry, Bhargava (2017) concludes that due to the increased contribution of the telecoms industry to different economies the financial health of the industry is important to the whole economy. Therefore, there is need for measurement of this constantly to monitor the economic performance of the whole industry. The telecoms industry is highly capital intensive and investors will be interested in knowing the “the financial condition and worthiness” of the industry which is achieved through financial analysis. However, even though it is beneficial it has to be noted that the ratios isolate the assessed factors from the rest of the report; hence, precaution has to be taken when interpreting them ( Abraham, 2004 ).

Even though ratios were seen as less significant due to the introduction of more sophisticated statistical analysis tools, authors still believe that they are still a useful tool in measuring performance. For example, a study which was done by Altman (1968) proved how ratios are still useful in prediction of bankruptcy using the case of manufacturing firms. Other studies on proving the importance and usefulness of ratios by Lewellen (2004) and Floros et al. (2009) found that investment ratios are useful in predicting market values of shares.

With this in mind, this study looks at internal determinants of performance as in the study by Allen et al. (2011) and another by Burja (2011) . These are factors within the control of management and can be able to influence them through their decisions. Through this, “the management can anticipate changes in the external environment and try to position the company to take advantage of anticipated developments” ( Burja, 2011 ). The external environment includes factors like demographic changes, GDP, inflation and other external environmental factors. However, besides the quantitative factors, management also have to analyse qualitative factors internally and externally even though these have no standard set to assess them as their measurement can be highly subjective.

A lot of other case studies have been done on financial performance analysis using ratios ( Eversull and Rotan, 1997 ; Collier et al. , 2010 ; Hossan and Habib, 2010 ; Grubman, 2010 ; Bhargava, 2017 ). For example Al-Jafari and Al Samman (2015) investigated the determinants of profitability for industrial firms in Oman. By utilising ordinary least squares (OLS) model on seven ratios, they drew up conclusions on the relationship between profitability ratios and other calculated non-profitability ratios. They found that there is a positive significant relationship between profitability, firm size, growth, fixed assets and working capital. Additionally, they also conclude that management efficiency on these large firms gives them better profit returns.

While Burja (2011) only focussed on the micro or internal environment in his regression analysis of financial performance, Allen et al. (2011) carried out an investigation on both internal and external environment to see how it impacts the profitability of the firm. This was a distinguished study as it included both internal and external factors in the regression analysis.

In a case study on the furniture industry, Traian-Ovidiu and Daniel-Teodor (2013 ) and Tsuji (2014) made a detailed analysis of a company’s statements to aid those who use them for investment decisions. Their studies focussed on bringing together financial ratios from financial statements and market data from stock markets to see how the indices on the market are influenced by the performance of different rations on the reported statements.

A study on the Indian public sector looked at how strategic industries with the government as major player performs financially ( Bhunia et al. , 2011 ). The case study looked at the ratios for India’s pharmaceutical industry financial reports. Using a number of statistical methods including standard deviation, mean and also regression analysis, they established the relationship between profit measure and other performance measures.

According to Buse et al. (2010 ) economic rate of return (ERR) is an important ratio in financial statement analysis because they considered it as an indicator of the economic performance of a company. In their study, they took ERR as a comprehensive ratio that looks at the organisation return and contribution with consideration of both internal and external factors affecting the business.

Kofi-Akrofi (2013 ) carried out a similar study but he, however, used multiple regression to look at the profitability of Telecommunications in Ghana for a period of four years. In his research, the main objective was to establish the relationship between the two main statements, hence, he treated them as independent from each other. A study by Oloko et al. (2014) looked at the telecoms industry but they focussed on how management style, cost of labour and competition impacts performance and profitability of Kenya’s Telkom.

While the literature reviewed covers a number of case studies on financial statements using ratios, some gaps exist. First, we have found that none has so far focussed on the Chinese telecoms especially the period after the Chinese Government opened its doors to the world to invest in their industries. Second, few research studies have used PCA to find out which ratios give best performance analysis with least loss of data from amongst the pool of all ratios. From the review of the past studies, we realized that different ratios were used and some are correlated because they are all from the same statements. A similar study was done by Taylor (1986) which focussed on the Australian firms. The study did not point to a specific industry; hence, with differences in industries the model might not be a one-size-fits-all especially given also the differences in the operational environment between China and Australia. Third, using PCA allows the use of at least 18 ratios reducing subjectivity effects on which ratios should be used for further analysis which include regression analysis on performance. Finally, as shown in our correlation matric we can see that all ratios are related which means that there is no independency to carry out the regression. This relationship comes from the fact that these ratios use data from the same statement. By applying PCA we create new independent variables that allow for effective further analysis with even lesser variables.

To carry out a PCA on 18 financial ratios for the Chinese Telecoms Industry to reduce the number of variables.

To analyse how the components are related to each other.

To recommend a combination or mix of ratios that best assess and analyse performance in the industry.

To examine the ratios with highest variation and assess their impact on the industry.

Methodology

In previous studies on relationship analysis for financial statements and financial ratios, two models have mainly been used. The first one is the panel OLS regression model which has been applied by a number of accounting articles on financial performance and in most literature less than ten variables are used ( Al-Jafari and Al Samman, 2015 ; Jakob, 2017 ; Burja, 2011 ). The second model has been the multiple regression which was adopted by other researchers ( Bhunia et al. , 2011 ; Kofi-Akrofi, 2013 ; Buse et al. , 2010 ).

In this research, we use PCA which is a statistical tool that is used to reduce the variables that are used in data analysis with minimum loss of the original data ( Karamizadeh et al. , 2013 ). It has been used in a number of industries with one of the most common being in biometrics or “bioimaging” where physical features are used to identify a person with application on mobile phones, security systems. PCA has also been used for dimension reduction of large volumes of data and also in image compressing ( Arab et al. , 2018 ; Karamizadeh et al. , 2013 ; Polyak and Mikhail, 2017 ). The application of PCA in reducing variables as already noted in the literature review makes it a useful tool in modern days where large volumes of data are compiled and compared for its usefulness. In accounting field, PCA was used in a study by Taylor (1986) to reduce the number of ratios used in analysis of Australian companies since a lot of ratios are available, this makes the model very useful in helping investors and those who study ratios on knowing the most important ratios as it offers a way to reduce the numbers of ratios by statistically taking those that are most important with limited bias. The fact that PCA creates a new set of artificial variables which are independent makes it less complex to do regressions and come up with conclusions on related variables. In itself the PCA only reduces the variables that can be further used for regression analysis.

The first principal component combines the X -variables that have the maximum variance amongst all the combinations. Much of the variation in the data is taken by this first component. The second one likewise also takes the maximum remaining variation in the data with the condition that the correlation between the first and the second component is 0. This continues until the “ i th” component, which will account to the last variation that has not been accounted for by the other components with the condition still remaining that its correlation with the other components is 0. This condition is what creates the independence of the variable being used.

The principal component estimation uses eigenvectors as the coefficient to come up with the following basic equations: (1) Y 1 = e ˆ 11 Z X 1 + e ˆ 12 Z X 2 + e ˆ 13 Z X 3 + ⋯ + e ˆ 1 i Z X i , (2) Y 2 = e ˆ 21 Z X 1 + e ˆ 22 Z X 2 + e ˆ 23 Z X 3 + ⋯ + e ˆ 2 i Z X i , (3) Y i = e ˆ i 1 Z X 1 + e ˆ i 2 Z X 2 + e ˆ i 3 Z X 3 + ⋯ + e ˆ i i Z X i , where Y is the principal component; e ˆ the eigenvector; ZX the standardized value of the ratios used.

A total of 18 accounting ratios that are used in most literature in accounting and are deemed to be the most important measures of profitability, liquidity, management efficiency, leverage, valuation and growth, cash flow indicator and effective tax rate. This list, however, is not exhaustive; it has the ability to cover more ratios. Some of the ratios differ from the ones by Taylor (1986) because they are more relevant to the telecoms industry as used in previous studies. Second, in his study, Taylor used “debt coverage” due to missing data for interest cover but for this study we used interest cover as all relevant data were available ( Table I ).

The data used are from 2001 to 2017. This is the period that has financial statements available on the websites of the companies. Statistical Package for Social Sciences 20 was then used for the analysis of the financial statement with Microsoft Excel 13 used in the calculation of the final coefficients for each principal component. Standardized data were used instead of the original data as the ratios have different units of measurement. If the raw data are used, then a PCA will tend to give more emphasis to those variables that have higher variances than those variables that have lower variances meaning results will depend on the unit of measurement for each variable and since these data do not have that we used the standardized values.

All the financial data are secondary data taken from the company’s annual financial reports as presented on their websites and also from trusted journals and websites ( Table II ).

The matrix in Table III shows the relations within the ratios, which means we cannot have any ratio that is independent from the other, hence, we cannot use these ratios in regression as independent variables. This means we need to create new variables using PCA that will be independent from each other.

Results and discussion

The financial statements of the three telecoms companies in China were used to assess the firms’ performance. Thus, PCA was adopted to suggest the most suitable ratios that can best explain the firms’ performance while ensuring minimum data loss among the pool of ratios. Using the data from the industry, which is described in Table II , we use standardized values of the ratios in the extraction of the principal component.

In this section, we first examined the components that have been extracted and the new independent variables according to our first objectives. Then second, we looked at the ratio mix that can be used for analysis of the telecoms industry performance.

Based on the extraction in Table IV , we only need four components to use as variables in the telecoms industry instead of the initial 18. These new variables are not only independent but are more easily comparable than the initial variables we had. The first principal component covers the highest variation in the data with an initial eigenvalue of 7.982, which represent 44.344 per cent of the variance. Three other components needed to, at least, get to 85 per cent of the variance, which is significant with least data being lost in the analysis. This contradicts with the initial conclusion that was made on Australian firms, who used similar ratios but got four components at 64.8 per cent Taylor (1986) . This variation is huge and is likely to be because of these data being focussed on one industry, hence, reducing the differences in valuation and reports of numerous firms. The increased percentage means there is lesser data loss from the four components and this allows for better analysis of the financial statements. From the PCA for the telecoms industry, we remain with four variables, Y1–Y4 whose calculation based on Equations (1) –( 3) ( Table V ).

Table VI shows us the mix of ratios that PCA extract to give significant analysis on the performance of the telecoms industry. The 12 ratios represent the mix that has important ratios from the classes that we have in general. The performance of the telecoms industry is measured mainly with four classes of ratios.

First, profitability of the company is very important as also concluded in research studies by Altman (1968) , Collier et al. (2010) and Mahajan and Yaday (2016) . In component 1, we see profitability measures having a very significant value of above 0.8. This is supported through most literatures that use the profitability of a firm as one of the primary indicators of its performance or as the dependent variable in most of the regression analysis, for example, return on assets ROA which was used by Kofi-Akrofi (2013 ) and Al-Jafari and Al Samman (2015) . Profit maximisation should be the main goal of management so as to give the high return expected by their shareholders and measured by ROSE. This is achieved by maintaining a high and constant profit margin throughout operations of the industry with a balance being kept between the profits and the expenditure of the firm especially in the salaries.

Second, liquidity in the industry is very important as proved by component 1. From the analysis, we established the importance of working capital assets as well as the importance of the operating cash to the firms which are also included in literature as significant measures as in the studies published by Bhunia et al. (2011) , Neves (2011) , Baños-Caballero et al. (2012) , Knauer and Wöhrmann (2013) . Operating cash has the highest value in component 1 which may signify its importance in the industry. The combination of the cash and the other current assets shows how performance in this industry is dependent on the liquid assets at the disposal of the firms. These resources are important for use in growth and expansion of operations. In analysing the individual companies it is interesting to see how failure to maintain high liquidity has led to the struggle of China Telecom and China Unicom to perform well and this supports what Singhania et al. (2014) noted the necessity of maintaining a balance between liquidity and profitability. In an analysis done on individual companies as the study built on the industry average, it was observed that China Telecom and China Unicom have been struggling to maintain favourable liquidity balances which has always left them as market followers behind China Mobile in terms of ability to generate profits, launch new services and upgrad to newer technologies including 4G network coverage.

Third, the management efficiency in the industry has also been argued by Al-Jafari and Al Samman (2015) in their study on firms in Omani. The decisions of management in allocation of their short-term resources are of importance and the relationship of this with the liquidity is that short-term decision of management in allocation of their non-fixed assets has impact on their performance. The use of the current ratios to measure their performance gets rid of the historical cost effect from the valuation of fixed assets, which makes it difficult to measure current performance. This factor supports the fact that we can measure the quality of management decisions through analysis of the financial results by relating their outcome to turnover. Even though in 2015 the Chinese Government introduced the tower company to take over network towers of the industry, DBS Vickers Securities (2015) noted that the effect of this on the performance of the company cannot be reflected. This is even though we cannot ignore it as this analysis put more emphasis on liquid resources of the company. Management also has to effectively allocate its expenses to the salaries and wages of its workers as this ratio is important in this service industry. There is need to always keep a favourable rate of return per worker for the industry which means that worker reward should always be related to what is being gained from the output of that worker. Whilst within the service industry there is no specific and accurate measure of the output, we can use the revenue paid to workers to see their relationship with the turnover. The higher this is, the better.

Of particular interest in our findings is the importance of customer growth and revenue per customer. As companies in the industry compete for customers, they still need to find the balance between customer growth and what they gain from it (revenue from the customer). With the government regulating the tariffs Zhiling (2002) and also as companies running different promotions to lure customers to their network, there is a need for management to keep that growth balancing with the revenue growth. In analysing the industrial data, we have noted that the revenue growth is not matching the customer growth and as a result this is very risky for the industry players that may be aiming for customers at the expense of high revenues as it will not be beneficial to its investors. This eventually can lead to a conflict between the government and other shareholders as the company tries to offer services to all at affordable rates with the public shareholder that will mainly be looking forward to high returns from the customer base.

In the financing section, only equity ratio is included in the components. The absence of the interest cover in measuring of performance is likely to prove that the model of financing is not of great importance when measuring the performance in the industry, which has very high capital requirements through investment in fixed assets. However, the allocation of capital is very important as also supported by the return of stockholder equity ratio. This means that management is expected to generate high returns for its shareholders in all their operations. The interests of the shareholders are further cemented by the EPS that needs to remain high and be maintained as the firms grow. The other stakeholders with fixed returns like the fixed tax, fixed interest always have their returns regardless of the performance yet the shareholders’ returns are based on how the firm has performed. Management has to keep a low volatility in their EPS and ROCE to maintain high investment and also attract more investors and partners.

Based on the results from the PCA analysis carried on 18 ratios over 17 years, profitability, liquidity, customer growth and management efficiency are the main performance highlighters for the industry. Maintaining all these will result in favourable returns to the shareholder of this industry. We cannot look at these factors in isolation as they are correlated and they are all combined when assessing the overall performance of the industry or individual firms. A combination of 12 ratios is able to give meaningful conclusion about the industry and can effectively analyse operations of the firms.

Further studies

According to Jakob (2017) , state-owned enterprises are often claimed to be less profitable and less efficient compared to private corporations. A comparison can be carried out within an environment that has both private and public firms. In 2015, the Chinese Government introduced the tower company to take over network towers of the industry DBS Vickers Securities (2015 ). It will be important to see how this change is important and can benefit other governments and industry as well if they implement it.

List of accounting ratios used as variable

Ratio class Ratio name Notation Formula
Profitability ratios Return on assets ROA Net income/average assets
Return on shareholder equity ROSE Net income/average stockholder equity
Profit margin PM Net income/revenue
Liquidity ratios Current ratio CR Current assets/current liabilities
Networking capital ratio WCR Current assets – current liabilities/total assets
Management efficiency ratios Total assets turnover TAT Revenue/total assets
Revenue per worker wage R/W Revenue/salary expense
Revenue per fixed asset R/FA Revenue/fixed assets
Working capital turnover WCT Current assets – current liabilities/revenue
Leverage ratios Debt ratio DR Long term liabilities/total assets
Equity ratio ER Shareholder’s equity/total assets
Debt equity ratio DER Total long term debts/shareholder’s capital
Times interest cover TI Income before interest and tax/interest expense
Valuation and growth Earnings per share EPS Net profit/average number of shares
Customers revenue R/C Revenue/number of subscribers
Customer growth CG Yearly change in customers/customer in base year
Cash flow indicator Cash flow indicator OC/S Operating cash/sales
Tax Effective tax rate ETxR Tax/income before tax

Descriptive statistics for telecoms industry

Minimum Maximum Mean SD Variance
ROA 17 0.034 0.155 0.07047 0.028777 0.001
ROSE 17 0.044 0.227 0.09906 0.044561 0.002
PM 17 0.071 0.197 0.12612 0.038696 0.001
CR 17 0.475 1.461 0.71694 0.300431 0.090
WCR 17 −0.255 0.044 −0.14247 0.090237 0.008
TAT 17 0.366 0.563 0.49141 0.044887 0.002
R/W 17 7.060 14.586 11.23800 2.411187 5.814
R/FA 17 0.438 0.725 0.62741 0.075328 0.006
WCT 17 −19.003 7.642 −0.50535 6.929393 48.016
DR 17 0.369 0.504 0.44800 0.039541 0.002
ER 17 0.457 0.585 0.53306 0.038073 0.001
DER 17 0.738 1.123 0.90176 0.128357 0.016
TI 17 13.193 193.340 68.81465 58.139654 3,380.219
EPS 17 0.655 2.353 1.68376 0.602397 0.363
R/C 17 77.940 120.250 98.09888 14.579564 212.564
CG 17 0.035 1.000 0.18359 0.234845 0.055
OC/S 17 0.299 0.497 0.38606 0.063964 0.004
ETxR 17 0.215 0.595 0.28076 0.085013 0.007
Valid (listwise) 17

Inter-item correlation matrix for China telecoms Industry

ROA ROSE PM CR WCR TAT R/W R/FA WCT DR ER DER TI EPS R/C CG OC/S ETxR
ROA 1.000 0.992 0.840 0.454 0.653 −0.135 0.670 −0.358 0.054 −0.338 0.244 −0.443 −0.658 −0.488 −0.228 0.836 0.835 0.138
ROSE 0.992 1.000 0.824 0.416 0.606 −0.085 0.632 −0.324 0.064 −0.322 0.261 −0.437 −0.650 −0.435 −0.199 0.798 0.812 0.209
PM 0.840 0.824 1.000 0.396 0.655 −0.493 0.770 −0.474 −0.158 −0.395 0.162 −0.432 −0.817 −0.565 −0.644 0.617 0.902 0.272
CR 0.454 0.416 0.396 1.000 0.927 −0.343 0.427 0.105 0.350 −0.738 −0.436 −0.339 −0.395 −0.397 −0.340 0.329 0.573 0.032
WCR 0.653 0.606 0.655 0.927 1.000 −0.462 0.640 −0.142 0.235 −0.726 −0.269 −0.437 −0.604 −0.591 −0.494 0.520 0.797 0.040
TAT −0.135 −0.085 −0.493 −0.343 −0.462 1.000 −0.262 0.632 0.281 0.219 0.305 0.042 0.413 0.589 0.555 −0.229 −0.528 −0.068
R/W 0.670 0.632 0.770 0.427 0.640 −0.262 1.000 −0.324 −0.127 −0.217 −0.156 −0.089 −0.762 −0.654 −0.635 0.536 0.766 −0.013
R/FA −0.358 −0.324 −0.474 0.105 −0.142 0.632 −0.324 1.000 0.509 −0.388 0.080 −0.275 0.373 0.752 0.083 −0.657 −0.470 0.150
WCT 0.054 0.064 −0.158 0.350 0.235 0.281 −0.127 0.509 1.000 −0.481 0.089 −0.420 0.287 0.226 0.121 −0.078 −0.057 0.025
DR −0.338 −0.322 −0.395 −0.738 −0.726 0.219 −0.217 −0.388 −0.481 1.000 −0.115 0.826 0.299 −0.054 0.505 0.013 −0.444 −0.324
ER 0.244 0.261 0.162 −0.436 −0.269 0.305 −0.156 0.080 0.089 −0.115 1.000 −0.640 0.107 0.459 0.069 0.072 −0.033 0.234
DER −0.443 −0.437 −0.432 −0.339 −0.437 0.042 −0.089 −0.275 −0.420 0.826 −0.640 1.000 0.191 −0.229 0.330 −0.103 −0.368 −0.351
TI −0.658 −0.650 −0.817 −0.395 −0.604 0.413 −0.762 0.373 0.287 0.299 0.107 0.191 1.000 0.571 0.676 −0.417 −0.867 −0.151
EPS −0.488 −0.435 −0.565 −0.397 −0.591 0.589 −0.654 0.752 0.226 −0.054 0.459 −0.229 0.571 1.000 0.279 −0.687 −0.691 0.290
R/C −0.228 −0.199 −0.644 −0.340 −0.494 0.555 −0.635 0.083 0.121 0.505 0.069 0.330 0.676 0.279 1.000 0.077 −0.581 −0.293
CG 0.836 0.798 0.617 0.329 0.520 −0.229 0.536 −0.657 −0.078 0.013 0.072 −0.103 −0.417 −0.687 0.077 1.000 0.653 −0.164
OC/S 0.835 0.812 0.902 0.573 0.797 −0.528 0.766 −0.470 −0.057 −0.444 −0.033 −0.368 −0.867 −0.691 −0.581 0.653 1.000 0.120
ETxR 0.138 0.209 0.272 0.032 0.040 −0.068 −0.013 0.150 0.025 −0.324 0.234 −0.351 −0.151 0.290 −0.293 −0.164 0.120 1.000

Total variance explained

Initial eigenvalues Extraction sums of squared loadings
Component Total % of variance Cumulative % Total % of variance Cumulative %
 1 7.982 44.344 44.344 7.982 44.344 44.344
 2 3.430 19.056 63.400 3.430 19.056 63.400
 3 2.217 12.315 75.715 2.217 12.315 75.715
 4 1.779 9.883 85.598 1.779 9.883 85.598
 5 0.967 5.370 90.968
 6 0.719 3.997 94.965
 7 0.432 2.401 97.365
 8 0.234 1.298 98.663
 9 0.108 0.602 99.266
10 0.059 0.327 99.592
11 0.038 0.212 99.805
12 0.016 0.088 99.893
13 0.012 0.067 99.960
14 0.005 0.028 99.988
15 0.001 0.008 99.996
16 0.001 0.004 100.000
17 1.001E-016 5.560E-016 100.000
18 −1.876E-016 −1.042E-015 100.000
Extraction method: principal component analysis

Component
1 2 3 4
-score: ROA 0.091 0.428 0.216
-score: ROSE 0.118 0.464 0.192
-score: PM 0.011 0.199 −0.240
-score: CR 0.320 −0.530 0.374
-score: WCR 0.224 −0.352 0.252
-score: TAT −0.528 0.308 0.408 0.355
-score: R/W −0.154 −0.042 −0.032
-score: R/FA −0.456 0.751 −0.222 0.101
-score: WCT −0.041 −0.129
Z-score: DR −0.488 −0.786 0.310 0.014
-score: ER −0.052 0.434 −0.232
-score: DER −0.391 −0.809 −0.227 0.103
-score: TI −0.836 0.115 0.029 0.279
-score: EPS −0.705 0.188 −0.200
-score: R/C −0.594 −0.159 0.366
-score: CG −0.309 0.409 0.433
-score: OC/S −0.026 0.023 −0.039
-score: ETxR 0.134 0.436 0.131 −0.538
Extraction method: principal component analysis. Ratios extracted from the components are in italic based on significant level above 0.5. Four components extracted

Ratio name Notation Ratio name Notation
Return on assets ROA Working capital turnover WCT
Return on shareholder equity ROSE Equity ratio ER
Profit margin PM Earnings per share EPS
Current ratio CR Customers revenue R/C
Networking capital ratio WCR Customer growth CG
Revenue per worker wage R/W Cash flow indicator OC/S

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literature review on financial ratio analysis

1. Introduction

2. materials and methods, 2.1. search strategy and study selection, 2.2. eligibility criteria, 2.3. inclusion and exclusion criteria, 2.4. data extraction and quality assessment, 2.5. stratification of evidence, 2.6. data synthesis, 4. discussion, 5. conclusions, supplementary materials, author contributions, institutional review board statement, informed consent statement, data availability statement, conflicts of interest.

StudyRisk of BiasApplicability ConcernsConclusions
Patient SelectionIndex TestReference StandardFlow and TimingPatient SelectionIndex TestReference Standard
Yildirim (2013) [ ]?At risk of bias
Platon (2011) [ ]Low risk of bias
Fusetti (2005) [ ]Low risk of bias
Senall (2004) [ ]At risk of bias
Hauger (2002) [ ]Low risk of bias
Herneth (2001) [ ]??At risk of bias
Xie (2020) [ ]???At risk of bias
Kitsis (1989) [ ]??At risk of bias
Thorpe (1996) [ ]??At risk of bias
Fowler (1998) [ ]??At risk of bias
Borel (2017) [ ]?At risk of bias
Edlund (2016) [ ]At risk of bias
De Zwart (2012) [ ]?At risk of bias
Beeres (2008) [ ]At risk of bias
Ilica (2011) [ ]At risk of bias
Mallee (2011) [ ]?At risk of bias
Memasadeghi (2006) [ ]??At risk of bias
Breitenseher (1997) [ ]Low risk of bias
Tiel-van Buul (1996) [ ]???At risk of bias
Nielsen (1983) [ ]???At risk of bias
O’Carroll (1982) [ ]At risk of bias
Stordahl (1984) [ ]?????At risk of bias
Tiel-van Buul (1993) [ ]?At risk of bias
StudyRisk of BiasApplicability ConcernsConclusions
Patient SelectionIndex TestReference StandardFlow and TimingPatient SelectionIndex TestReference Standard
Deutsch (1989) [ ]????At risk of bias
Rizzo (1993) [ ] ????At risk of bias
Quinn and McCarthy (1993) [ ]At risk of bias
Evans (1994) [ ]????At risk of bias
Haramati (1994) [ ]At risk of bias
Bogost (1995) [ ]??At risk of bias
Stiris and Lilleas (1997) [ ]??At risk of bias
Rubin (1998) [ ]???At risk of bias
Pandey (1998) [ ]At risk of bias
Lim (2002) [ ]At risk of bias
Oka and Monu (2004) [ ]At risk of bias
Galloway (2004) [ ]??At risk of bias
Lee (2004) [ ]??At risk of bias
Alam (2005) [ ]?At risk of bias
Frihagen (2005) [ ]At risk of bias
Verbeeten (2005) [ ]?At risk of bias
Lubovsky (2005) [ ]??At risk of bias
Dominguez (2005) [ ]??At risk of bias
Chana (2006) [ ]???At risk of bias
Hossain (2007) [ ]??At risk of bias
Sankey (2009) [ ]At risk of bias
Safran (2009) [ ]Low risk of bias
Szewczyk (2012) [ ]Low risk of bias
Iwata (2012) [ ]??At risk of bias
Dunker (2012) [ ]At risk of bias
Ohishi (2012) [ ]Low risk of bias
Geijer (2012) [ ]?At risk of bias
Gill (2013) [ ] ??At risk of bias
Heikal (2014) [ ]At risk of bias
Haubro (2015) [ ]Low risk of bias
Deleanu (2015) [ ]??At risk of bias
Collin (2016) [ ] Low risk of bias
Rehman (2016) [ ]???At risk of bias
Sadozai (2016) [ ]?At risk of bias
Thomas (2016) [ ]?At risk of bias
Lakshmanan (2017) [ ]??At risk of bias
Lord (2017) [ ]Low risk of bias
Mandell (2018) [ ]At risk of bias
Ross (2019) [ ]Low risk of bias
Heynen (2019) [ ]Low risk of bias
Haims (2020) [ ]???At risk of bias
Lanotte (2019) [ ]?At risk of bias
Kutaiba (2020) [ ]???At risk of bias
Tsukamoto (2023) [ ]?????At risk of bias
Reddy (2015) [ ]??At risk of bias

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Author (Year)ObjectivesAnatomySetting and ContextNumber of Databases Sourced and SearchedDate Range of Database SearchingPublication Date Range of Studies Included in the Review that Inform Each Outcome of InterestNumber of StudiesTypes of StudiesTotal Number of PatientsCountry of Origin of StudiesInstruments Used to Appraise the Primary StudiesAMSTARRelevant Outcomes ReportedMethods of SynthesisPublication BiasHeterogeneityRisk of Bias
Chatha (2011) [ ]To determine the role of CT and MRI in diagnosing occult fractureFemurN/A5 (MEDLINE, EMBASE, CINAHL, Google Scholar, and the Cochrane Library)31 October 20091989 to 20092215 prospective and 7 retrospective996N/ANoneCritically lowMRI was an investigation of choice for occult proximal femoral fractures.QualitativeN/AN/AN/A
Kellock (2019) [ ]The diagnostic performance of CT for the detection of occult proximal femoral fractureFemurN/A3 (Pubmed, Embase, and Web of Science)1 December 20182005 to 2018131 prospective, the rest are retrospective12485 UK, 1 USA, 1 Israel, 3 Sweden, 1 Romania, 1 Denmark, 1 CanadaQUADAS-2High QualityThe estimated summary sensitivity of CT for the detection of nondisplaced hip fracture was 94% (95% credible interval, 83–99%), and the specificity was 100% (95% credible interval, 99–100%) with an AUC of 0.981.Meta-analysisPresentPresentHigh risk of bias in the reference standard, with no single study achieving a good quality
Wilson (2019) [ ]Evaluate the diagnostic accuracy of limited MRI protocols for detecting radiographically occult proximal femoral fracturesFemurAll single-centre, academic hospitals4 (MEDLINE, Embase, Cochrane Library and Scopus)15 November 20191993–2019 (2012 to 2019 for meta-analysis; 1993 to 2016 for systematic review)11 (only five for meta-analysis)5 Prospective, 6 Retrospective (1 prospective and 4 retrospective for meta-analysis; 4 prospective and 2 retrospective for systematic review)938N/AQUADAS-2High QualityThe pooled and weighted summary sensitivity and specificity and the area under the summary ROC curve for limited MRI protocols in detecting radiographically occult hip fractures were 99% (95% CI, 91–100%), 99% (95% CI, 97–100%), and 100% (95% CI, 0.99–1), respectively.Qualitative and Meta-AnalysisN/AN/AAll studies included in the meta-analysis were low-risk
Haj-Mirzaian (2020) [ ]Determine the diagnostic performance of CT and bone scanning in the detection of occult fractures using MRI as the reference standardFemoral head, femoral neck, intertrochanteric, or subtrochanteric fracturesN/A3 (Pubmed, EMBASE, and Cochrane Library)27 September 20181993 to 201835N/A2992N/AROBHigh QualityCT and bone scanning yielded comparable diagnostic performance in the detection of radiographically occult hip fracture (p = 0.67) with a sensitivity of 79% and 87%, respectively.Meta-analysisPresentPresentLow ROB = 27, Moderate ROB = 6, High ROB = 2
Mallee (2015) [ ]identify the most suitable diagnostic imaging strategy for identifying clinically suspected fractures of the scaphoid bone in patients with normal radiographsScaphoidPeople of all ages who presented at the hospital or clinics within one week of trauma with a clinically suspected scaphoid fracture and negative post-trauma radiographs10 (Cochrane Register of Diagnostic Test Accuracy Studies, MEDLINE, EMBASE, the Database of Abstracts of Reviews of EHects, the Cochrane Central Register of Controlled Trials, the NHS Economic Evaluation Database, MEDION, ARIF, Current Controlled Trials, the World Health Organization (WHO) International Clinical Trials Registry Platform)July 20121983–2011119 Prospective, 3 Not Reported10415 Netherlands, 2 Austria, 1 Turkey, 1 Denmark, 1 Ireland, 1 NorwayNot SpecifiedHigh QualitySummary sensitivity and specificity of CT were 0.72 (95% confidence interval (CI) 0.36 to 0.92) and 0.99 (95% CI 0.71 to 1.00); for MRI, these were 0.88 (95% CI 0.64 to 0.97) and 1.00 (95% CI 0.38 to 1.00); for BS, these were 0.99 (95% CI 0.69 to 1.00) and 0.86 (95% CI 0.73 to 0.94). Indirect comparisons suggest that the diagnostic accuracy of BS was significantly higher than CT and MRI, and CT and MRI have comparable diagnostic accuracy.Meta-analysisPresentCould not be investigated formallyFive studies were considered “good quality”, and six studies had “moderate quality”.
Kwee (2018) [ ]To systematically review the literature on the performance of ultrasound in diagnosing radiographically occult scaphoid fracture.ScaphoidN/A2 (MEDLINE and Embase databases)No Limit–8 January 20182001–20137Not Specified3141 Turkey, 2 Switzerland, 1 USA, 1 France, 1 Austria, 1 UKQUADAS-2Critically lowThe sensitivity and specificity of ultrasound in diagnosing radiographically occult scaphoid fracture ranged from 77.8% to 100% and from 71.4% to 100% respectively, with pooled estimates of 85.6% (95% CI: 73.9%, 92.6%) and 83.3% (95% CI: 72.0%, 90.6%), respectively.Meta-analysisNot AssessedCannot be exploredIndex Test: Low ROB: 6, High ROB: 1; Reference Standard: High ROB: 2, Unclear: 2; Low ROB: 3; Patient Selection and Flow and Timing: Low ROB 7.
ParameterScaphoidHip and Femur
UltrasoundCT ScanMRIBone ScanCT ScanMRI
No. of studies65871529
No. of patients27029734558613291905
Sensitivity (%)96 (66–100)81 (64–91)86 (68–94)98 (90–100)94 (80–99)98 (97–99)
Specificity (%)94 (66–99)98 (86–100)98 (28–100)80 (44–95)99 (96–100)99 (98–99)
Positive likelihood ratio16 (2.2–114.4)41.7 (5.5–316.6)48.7 (0.4–6437.6)4.9 (1.3–17.9)82.1 (22.6–298.5)69 (41–116.1)
Posterior probability (%) assuming a 25% prior probability849395629696
Negative likelihood ratio0.04 (0–0.47)0.2 (0.1–0.39)0.15 (0.06–0.35)0.02 (0–0.16)0.06 (0.01–0.22)0.02 (0.01–0.03)
Posterior probability (%) assuming a 25% prior probability160.15121
Positive predictive value0.95 (0.9–1)0.82 (0.8–0.84)0.86 (0.84–0.88)0.97 (0.85–1)82.1 (22.6–298.5)69 (41–116.1)
Negative predictive value0.93 (0.88–0.99)0.97 (0.95–1)0.98 (0.95–1)0.81 (0.7–0.92)0.06 (0.01–0.22)0.02 (0.01–0.03)
Diagnostic odds ratio387 (17–8879)210 (31–1449)334 (2–49,601)213 (12–3743)1425 (171–11851)4185 (2009–8720)
Area under the curve0.99 (0.2–1)0.91 (0.17–1)0.91 (0.89–0.94)0.99 (0.97–0.99)1 (0.99–1)1 (0.99–1)
I (%) and p-value81 (59–100) and 0.00385 (70–100) and 0.00196 (93–99) and <0.00011 (0–100) and 0.18292 (83–100) and <0.0001100 (0–100) and 0.5
Publication bias0.560.030.070.13<0.001<0.001
Likelihood ratio scattergramLUQ; Exclusion and confirmationRUQ; Confirmation onlyRUQ; Confirmation onlyRLQ; No exclusion or confirmationLUQ; Exclusion and confirmationLUQ; Exclusion and confirmation
Stratification of evidenceWeakWeakWeakWeakSuggestiveSuggestive
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Jorisal, P.; Sulay, C.B.H.; Octavius, G.S. An Umbrella Review and Updated Meta-Analysis of Imaging Modalities in Occult Scaphoid and Hip and Femoral Fractures. J. Clin. Med. 2024 , 13 , 3769. https://doi.org/10.3390/jcm13133769

Jorisal P, Sulay CBH, Octavius GS. An Umbrella Review and Updated Meta-Analysis of Imaging Modalities in Occult Scaphoid and Hip and Femoral Fractures. Journal of Clinical Medicine . 2024; 13(13):3769. https://doi.org/10.3390/jcm13133769

Jorisal, Patricia, Callistus Bruce Henfry Sulay, and Gilbert Sterling Octavius. 2024. "An Umbrella Review and Updated Meta-Analysis of Imaging Modalities in Occult Scaphoid and Hip and Femoral Fractures" Journal of Clinical Medicine 13, no. 13: 3769. https://doi.org/10.3390/jcm13133769

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