Diagnostic performance of nucleic acid tests in tuberculous pleurisy

Han, Moonsik; Xiao, Heping; Yan, Liping

doi:10.1186/s12879-020-04974-z

Cited by 12 publications

(5 citation statements)

References 27 publications

(21 reference statements)

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“…A total of 27 out of the 30 included studies showed pooled sensitivity greater than 70%. Only three studies reported sensitivity values of 26% and 45% each ( 19 - 21 ). In terms of FP rate (1-specificity), 27 included studies showed a pooled FP rate higher than 80% ( Fig.…”

Section: Resultsmentioning

confidence: 99%

Efficacy of LAMP assay for Mycobacterial spp. detection to prevent treatment delays and onset of drug resistance: a systematic review and meta-analysis

Bumbrah

Jain

Hameed

2023

dti

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Background: Tuberculosis (TB) remains a deadly disease affecting one-third population globally. Long turnaround time and poor sensitivity of the conventional diagnostics are the major impediments for faster diagnosis of Mycobacterial spp to prevent drug resistance. To overcome these issues, molecular diagnostics have been developed. They offer enhanced sensitivity but require sophisticated infrastructure, skilled manpower and remain expensive. Methods: In that context, loop-mediated isothermal amplification (LAMP) assay, recommended by the WHO in 2016 for TB diagnosis, sounds as a promising alternative that facilitates visual read outs. Therefore, the aim of the present study is to conduct a meta-analysis to assess the diagnostic efficiency of LAMP for the detection of a panel of Mycobacterium spp. following PRISMA guidelines using scientific databases. From 1600 studies reported on the diagnosis of Mycobacterium spp., a selection of 30 articles were identified as eligible to meet the criteria of LAMP based diagnosis. Results: It was found that most of the studies were conducted in high disease burden nations such as India, Thailand, and Japan with sputum as the most common specimen to be used for LAMP assay. Furthermore, IS6110 gene and fluorescence-based detections ranked as the most used target and method respectively. The accuracy and precision rates mostly varied between 79.2% to 99.3% and 73.9% to 100%, respectively. Lastly, a quality assessment based on QUADAS-2 of bias and applicability was conducted. Conclusion: LAMP technology could be considered as a feasible alternative to current diagnostics considering high burden for rapid testing in low resource regions.

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Section: Resultsmentioning

confidence: 99%

Efficacy of LAMP assay for Mycobacterial spp. detection to prevent treatment delays and onset of drug resistance: a systematic review and meta-analysis

Bumbrah

Jain

Hameed

2023

dti

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“…One (1.4%) study was conducted exclusively in HIV seropositive patients [ 43 ], while seven (9.5%) others included a variable number of such subjects [ 37 , 38 , 42 , 44 , 53 , 70 , 89 ]. There were no HIV seropositive patients in thirteen (17.6%) publications [ 30 , 47 , 63 , 73 , 74 , 76 , 78 , 79 , 83 , 84 , 88 , 92 , 96 ], while the remaining did not provide any information. Ten investigators thawed cryopreserved fluid samples for their tests [ 23 , 31 , 35 , 42 , 60 , 66 , 73 , 78 , 80 , 84 ].…”

Section: Resultsmentioning

confidence: 99%

Xpert MTB/RIF Ultra versus Xpert MTB/RIF for diagnosis of tuberculous pleural effusion: A systematic review and comparative meta-analysis

et al. 2022

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Objective We compared diagnostic accuracy of pleural fluid Xpert MTB/RIF (Xpert) and Xpert MTB/RIF Ultra (Ultra) assays for diagnosing tuberculous pleural effusion (TPE), through systematic review and comparative meta-analysis. Methods We searched PubMed and Embase databases for publications reporting diagnostic accuracy of Xpert or Ultra for TPE. We used bivariate random-effects modeling to summarize diagnostic accuracy information from individual studies using either mycobacterial culture or composite criteria as reference standard. We performed meta-regression through hierarchical summary receiver operating characteristic (HSROC) modeling to evaluate comparative performance of the two tests from studies reporting diagnostic accuracy of both in the same study population. Results We retrieved 1097 publications, and included 74 for review. Summary estimates for sensitivity and specificity for Xpert were 0.52 (95% CI 0.43–0.60, I2 82.1%) and 0.99 (95% CI 0.97–0.99, I2 85.1%), respectively, using culture-based reference standard; and 0.21 (95% CI 0.17–0.26, I2 81.5%) and 1.00 (95% CI 0.99–1.00, I2 37.6%), respectively, using composite reference standard. Summary estimates for sensitivity and specificity for Ultra were 0.68 (95% CI 0.55–0.79, I2 80.0%) and 0.97 (95% CI 0.97–0.99, I2 92.1%), respectively, using culture-based reference standard; and 0.47 (95% CI 0.40–0.55, I2 64.1%) and 0.98 (95% CI 0.95–0.99, I2 54.8%), respectively, using composite reference standard. HSROC meta-regression yielded relative diagnostic odds ratio of 1.28 (95% CI 0.65–2.50) and 1.80 (95% CI 0.41–7.84) respectively in favor of Ultra, using culture and composite criteria as reference standard. Conclusion Ultra provides superior diagnostic accuracy over Xpert for diagnosing TPE, mainly because of its higher sensitivity.

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“…Finally, 18 articles were included for meta‐analysis. 5 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 …”

Section: Resultsmentioning

confidence: 99%

Accuracy of Xpert MTB/RIF assay for the diagnosis of tuberculous pleural effusion

Qiu

Chen

et al. 2021

Clinical Laboratory Analysis

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Background Tuberculosis poses a severe threat to human health. At present, compared with the traditional diagnostic methods for tuberculosis pleural effusion, such as Löwenstein–Jensen culture, pleural biopsy, and Ziehl–Neelsen smear microscopy, Xpert MTB/RIF was regarded as an emerging technology for its efficiency. The Xpert MTB/RIF accuracy for tuberculous pleural effusion diagnosis was evaluated in this systematic study. Materials and methods We searched the relevant literature published before January 2021 in PubMed, Cochrane, EMBASE, and Web of Science databases. Utilizing Review Manager 5.3 software, the quality of the included literature was evaluated based on the Quality Assessment of Diagnostic Accuracy Studies criteria. Sensitivity, specificity, and the summary receiver operating characteristic curves were plotted and analyzed with Metadisc 1.40 software. We used Stata 12.0 software to evaluate the publication bias of this study. Results Eighteen articles were identified in total. The sensitivity of Xpert MTB/RIF in the pleural effusion was 0.24, and specificity was 1.00, respectively. The area under the summary receiver operating characteristic curve was 0.9737, which indicated that the overall accuracy of the Xpert MTB/RIF was high. In addition, based on the Deeks funnel plot, no publication bias of the study was found. Conclusion Xpert MTB/RIF is a rapid method with high specificity but relatively low sensitivity for detecting Mycobacterium tuberculosis in pleural effusion. Its less sensitivity made it difficult to be used clinically, but the high specificity suggests that it can be used as a specific diagnostic method for tuberculous pleural effusion.

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Diagnostic performance of nucleic acid tests in tuberculous pleurisy

Cited by 12 publications

References 27 publications

Efficacy of LAMP assay for Mycobacterial spp. detection to prevent treatment delays and onset of drug resistance: a systematic review and meta-analysis

Efficacy of LAMP assay for Mycobacterial spp. detection to prevent treatment delays and onset of drug resistance: a systematic review and meta-analysis

Xpert MTB/RIF Ultra versus Xpert MTB/RIF for diagnosis of tuberculous pleural effusion: A systematic review and comparative meta-analysis

Accuracy of Xpert MTB/RIF assay for the diagnosis of tuberculous pleural effusion

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