In:
PLOS ONE, Public Library of Science (PLoS), Vol. 17, No. 7 ( 2022-7-11), p. e0268483-
Abstract:
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, I 2 82.1%) and 0.99 (95% CI 0.97–0.99, I 2 85.1%), respectively, using culture-based reference standard; and 0.21 (95% CI 0.17–0.26, I 2 81.5%) and 1.00 (95% CI 0.99–1.00, I 2 37.6%), respectively, using composite reference standard. Summary estimates for sensitivity and specificity for Ultra were 0.68 (95% CI 0.55–0.79, I 2 80.0%) and 0.97 (95% CI 0.97–0.99, I 2 92.1%), respectively, using culture-based reference standard; and 0.47 (95% CI 0.40–0.55, I 2 64.1%) and 0.98 (95% CI 0.95–0.99, I 2 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.
Type of Medium:
Online Resource
ISSN:
1932-6203
DOI:
10.1371/journal.pone.0268483
DOI:
10.1371/journal.pone.0268483.g001
DOI:
10.1371/journal.pone.0268483.g002
DOI:
10.1371/journal.pone.0268483.g003
DOI:
10.1371/journal.pone.0268483.g004
DOI:
10.1371/journal.pone.0268483.t001
DOI:
10.1371/journal.pone.0268483.t002
DOI:
10.1371/journal.pone.0268483.s001
DOI:
10.1371/journal.pone.0268483.s002
DOI:
10.1371/journal.pone.0268483.s003
DOI:
10.1371/journal.pone.0268483.s004
DOI:
10.1371/journal.pone.0268483.s005
DOI:
10.1371/journal.pone.0268483.s006
DOI:
10.1371/journal.pone.0268483.s007
DOI:
10.1371/journal.pone.0268483.s008
DOI:
10.1371/journal.pone.0268483.r001
DOI:
10.1371/journal.pone.0268483.r002
DOI:
10.1371/journal.pone.0268483.r003
DOI:
10.1371/journal.pone.0268483.r004
Language:
English
Publisher:
Public Library of Science (PLoS)
Publication Date:
2022
detail.hit.zdb_id:
2267670-3
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