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Diagnostic accuracy of T-cell interferon-γ release assays in tuberculous pleurisy: A meta-analysis
- Source :
- Respirology. 16:473-480
- Publication Year :
- 2011
- Publisher :
- Wiley, 2011.
-
Abstract
- Background and objective: The diagnosis of tuberculous pleurisy by analysis of pleural fluid using standard diagnostic tools is difficult. Recently, T-cell interferon-γ release assays (IGRA) have been introduced for the diagnosis of tuberculous pleurisy. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of IGRA on both pleural fluid and peripheral blood, for diagnosing tuberculous pleurisy. Methods: A systematic review was performed of English language publications. Sensitivity, specificity and other measures of the accuracy of IGRA for the diagnosis tuberculous pleurisy using both pleural fluid and blood were pooled using a random-effects model or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance. Results: Seven out of eight studies met the inclusion criteria. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and diagnostic odds ratio were, for pleural fluid: 0.75, 0.82, 3.49, 0.24, 0.85, 0.70 and 19.04, respectively; and for blood: 0.80, 0.72, 2.86, 0.28, 0.78, 0.74 and 11.06, respectively. Conclusions: As almost 20% of non-tuberculosis patients would be erroneously treated for tuberculosis and 25% of patients with tuberculous pleurisy would be missed, pleural fluid IGRA are not useful for the clinical diagnosis of tuberculous pleurisy.
- Subjects :
- Pulmonary and Respiratory Medicine
Pathology
medicine.medical_specialty
Tuberculosis
Receiver operating characteristic
business.industry
T cell
Diagnostic accuracy
medicine.disease
Likelihood ratios in diagnostic testing
Gastroenterology
medicine.anatomical_structure
Pleurisy
Internal medicine
Meta-analysis
medicine
Diagnostic odds ratio
business
Subjects
Details
- ISSN :
- 13237799
- Volume :
- 16
- Database :
- OpenAIRE
- Journal :
- Respirology
- Accession number :
- edsair.doi...........da1fb556773738423548f49413fa80d3