Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis

Goto, Masashi; Noguchi, Yoshinori; Koyama, Hiroshi; Hira, Kenji; Shimbo, Takuro; Fukui, Tsuguya

doi:10.1258/000456303766477011

Cited by 131 publications

(86 citation statements)

References 35 publications

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“…Paired data from two studies did suggest that in a direct comparison the NAAT tests were more accurate than ADA, but this was predominantly influenced by a single, small study using an inadequate reference standard, which produced very low sensitivity and specificity estimates for ADA. 212 Two previous meta-analyses assessing ADA for detection of pleural infection also found ADA to perform well (Q-points of 93% from 31 studies 86 and 92.2% from 40 studies 189 ). Both reviews included case-control studies and per specimen data.…”

Section: Discussion: Test Accuracy In Pleural Tb Infectionmentioning

confidence: 88%

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Dinnes¹,

Deeks²,

Kunst³

et al. 2007

Health Technol Assess

538

361

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Non-UK purchasers will have to pay a small fee for post and packing. For European countries the cost is £2 per monograph and for the rest of the world £3 per monograph.You can order HTA monographs from our Despatch Agents:-fax (with credit card or official purchase order) -post (with credit card or official purchase order or cheque) -phone during office hours (credit card only).Additionally the HTA website allows you either to pay securely by credit card or to print out your order and then post or fax it. NHS libraries can subscribe free of charge. Public libraries can subscribe at a very reduced cost of £100 for each volume (normally comprising 30-40 titles). The commercial subscription rate is £300 per volume. Please see our website for details. Subscriptions can only be purchased for the current or forthcoming volume. Contact details are as follows: Payment methods Paying by chequeIf you pay by cheque, the cheque must be in pounds sterling, made payable to Direct Mail Works Ltd and drawn on a bank with a UK address. Paying by credit cardThe following cards are accepted by phone, fax, post or via the website ordering pages: Delta, Eurocard, Mastercard, Solo, Switch and Visa. We advise against sending credit card details in a plain email. Paying by official purchase orderYou can post or fax these, but they must be from public bodies (i.e. NHS or universities) within the UK. We cannot at present accept purchase orders from commercial companies or from outside the UK. How do I get a copy of HTA on CD?Please use the form on the HTA website (www.hta.ac.uk/htacd.htm). Or contact Direct Mail Works (see contact details above) by email, post, fax or phone. HTA on CD is currently free of charge worldwide.The website also provides information about the HTA Programme and lists the membership of the various committees. HTA NIHR Health Technology Assessment ProgrammeT he Health Technology Assessment (HTA) programme, now part of the National Institute for Health Research (NIHR), was set up in 1993. It produces high-quality research information on the costs, effectiveness and broader impact of health technologies for those who use, manage and provide care in the NHS. 'Health technologies' are broadly defined to include all interventions used to promote health, prevent and treat disease, and improve rehabilitation and long-term care, rather than settings of care. The research findings from the HTA Programme directly influence decision-making bodies such as the National Institute for Health and Clinical Excellence (NICE) and the National Screening Committee (NSC). HTA findings also help to improve the quality of clinical practice in the NHS indirectly in that they form a key component of the 'National Knowledge Service'. The HTA Programme is needs-led in that it fills gaps in the evidence needed by the NHS. There are three routes to the start of projects. First is the commissioned route. Suggestions for research are actively sought from people working in the NHS, the public and consumer groups and professional bodies such as ...

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Section: Discussion: Test Accuracy In Pleural Tb Infectionmentioning

confidence: 88%

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Dinnes¹,

Deeks²,

Kunst³

et al. 2007

Health Technol Assess

538

361

View full text Add to dashboard Cite

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“…This cutoff value shows high efficiency in the classification of lymphocytic effusions (sensitivity: 87 to 100% and specificity: 81 to 97%). [19][20][21][22][23][24][25] Despite the high diagnostic sensitivity of ADA, its specificity is influenced by other clinical conditions and by the regional prevalence of tuberculosis. 26,27 In the present study, 13 (9%) patients with cancer presented an ADA activity higher than 40 U/L.…”

Section: Discussionmentioning

confidence: 99%

Clinical and Laboratory Parameters in the Differential Diagnosis of Pleural Effusion Secondary to Tuberculosis or Cancer

Antonângelo

Vargas

Seiscento

et al. 2007

Clinics

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62(5):585-90. PURPOSE:To evaluate the clinical and laboratory characteristics of pleural effusions secondary to tuberculosis (TB) or cancer (CA). METHODS: A total of 326 patients with pleural effusion due to TB (n=182) or CA (n=144) were studied. The following parameters were analyzed: patient gender, age and pleural effusion characteristics (size, location, macroscopic fluid aspect, protein concentration, lactate dehydrogenase (DHL) and adenosine deaminase activity (ADA) and nucleated cell counts). RESULTS: Young male patients predominated in the tuberculosis group. The effusions were generally moderate in size and unilateral in both groups. Yellow-citrine fluid with higher protein (p < 0.001) levels predominated in effusions from the tuberculosis group (5.3 + 0.8 g/dL) when compared to the CA group (4.2 ± 1.0 g/dL), whereas DHL levels were more elevated in CA (1,177 ± 675 x 1,030 ± 788 IU; p = 0.003) than in TB. As expected, ADA activity was higher in the TB group (107.6 ± 44.2 x 30.6 ± 57.5 U/L; p < 0.001). Both types of effusions presented with high nucleated cell counts, which were more pronounced in the malignant group (p < 0.001). TB effusion was characterized by a larger percentage of leukocytes and lymphocytes (p < 0.001) and a smaller number of mesothelial cells (p = 0.005). Lymphocytes and macrophages were the predominant nucleated cell in neoplastic effusions. CONCLUSION: Our results demonstrate that in lymphocytic pleural exudate obtained from patients with clinical and radiological evidence of tuberculosis, protein and ADA were the parameters that better characterize these effusions. In the same way, when the clinical suspicion is malignancy, serous-hemorrhagic lymphocytic fluid should be submitted to oncotic cytology once this easy and inexpensive exam reaches a high diagnostic performance (≅ 80%). In this context, we suggest thoracocentesis with fluid biochemical and cytological examination as the first diagnostic approach for these patients.

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“…A total of ten eligible studies (in English) were identified [12][13][14][15][16][17][18][19][20][21]. To this list, we added two meta-analyses published as abstracts [22,23].…”

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confidence: 99%

“…To this list, we added two meta-analyses published as abstracts [22,23]. TABLE 2 lists the results of all 12 meta-analyses [12][13][14][15][16][17][18][19][20][21][22][23]. All were published within the past 5 years, and included a total of 513 diagnostic trials (with some overlap across meta-analyses).…”

Section: For Reprint Orders Please Contact Reprints@future-drugscommentioning

confidence: 99%

“…For example, meta-analyses on TB pleural effusion included studies that used a variety of reference tests, including clinical diagnoses, histopathology and response to anti-TB therapy [13,15,16]. In some situations, especially when using NATs, investigators often performed discrepant analyses because they believed that NAT was potentially more sensitive than the reference standard [14,16,17].…”

Section: Sources Of Bias In Diagnostic Researchmentioning

confidence: 99%

See 1 more Smart Citation

Tuberculosis diagnostics trials: do they lack methodological rigor?

Pai¹,

O’Brien²

2006

Expert Review of Molecular Diagnostics

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Diagnostic value of adenosine deaminase in tuberculous pleural effusion: a meta-analysis

Cited by 131 publications

References 35 publications

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

A systematic review of rapid diagnostic tests for the detection of tuberculosis infection

Clinical and Laboratory Parameters in the Differential Diagnosis of Pleural Effusion Secondary to Tuberculosis or Cancer

Tuberculosis diagnostics trials: do they lack methodological rigor?

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