Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis
Introduction Tuberculous meningitis (TBM) is still a great challenge to global public health. As conventional diagnostic methods for TBM are unsatisfactory, interferon-γ release assays (IGRAs) have been introduced for TBM diagnosis tentatively. However, the role of IGRAs for diagnosing TBM remains u...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
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Termedia Publishing House
2020-03-01
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| Series: | Archives of Medical Science |
| Subjects: | |
| Online Access: | https://www.archivesofmedicalscience.com/Interferon-release-assays-for-tuberculous-meningitis-diagnosis-a-meta-analysis,94520,0,2.html |
| _version_ | 1811181174790291456 |
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| author | You Lan Wei Chen Qun Yan Wenen Liu |
| author_facet | You Lan Wei Chen Qun Yan Wenen Liu |
| author_sort | You Lan |
| collection | DOAJ |
| description | Introduction
Tuberculous meningitis (TBM) is still a great challenge to global public health. As conventional diagnostic methods for TBM are unsatisfactory, interferon-γ release assays (IGRAs) have been introduced for TBM diagnosis tentatively. However, the role of IGRAs for diagnosing TBM remains unclear. Thus, we systematically evaluated the diagnostic performance of cerebrospinal fluid (CSF) and peripheral blood (PB) IGRAs in TBM to fill this blank.
Material and methods
Relevant studies were systematically searched in both foreign and Chinese databases up to March 2018. Studies in which TBM diagnosis was based on microbiological or clinical criteria were included. The quality of the included studies was assessed through the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Main outcome measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR), were pooled statistically using random effects models. The potential heterogeneity was explored by threshold effect analysis, subgroup analyses and meta-regression. Funnel plots and Egger’s test were used to test the potential publication bias. Statistical analyses were performed using Stata and Meta-DiSc software.
Results
Twenty-six out of 656 publications were eligible for meta-analysis, including 1892 participants in total. The pooled estimates of PB IGRAs for TBM diagnosis are as follows: sensitivity: 0.81 (95% CI: 0.78–0.84); specificity: 0.76 (95% CI: 0.73–0.78); PLR: 4.23 (95% CI: 2.95–6.07); NLR: 0.24 (95% CI: 0.19–0.32) and DOR: 21.06 (11.91-37.24). The corresponding estimates for CSF IGRAs were obtained: sensitivity: 0.81 (95% CI: 0.76–0.85); specificity: 0.89 (95% CI: 0.86–0.92); PLR: 7.87 (95% CI: 4.98–12.46); NLR: 0.19 (95% CI: 0.13–0.29); and DOR: 47.74 (25.02–91.12).
Conclusions
The diagnostic performance of IGRAs is suboptimal. In terms of cost, turn-around time and accessibility, these assays are unsuitable for use as biomarkers for TBM diagnosis. |
| first_indexed | 2024-04-11T09:14:58Z |
| format | Article |
| id | doaj.art-676a2a6f5353474b9770658b21cf9725 |
| institution | Directory Open Access Journal |
| issn | 1734-1922 1896-9151 |
| language | English |
| last_indexed | 2024-04-11T09:14:58Z |
| publishDate | 2020-03-01 |
| publisher | Termedia Publishing House |
| record_format | Article |
| series | Archives of Medical Science |
| spelling | doaj.art-676a2a6f5353474b9770658b21cf97252022-12-22T04:32:23ZengTermedia Publishing HouseArchives of Medical Science1734-19221896-91512020-03-011751241125010.5114/aoms.2019.8699494520Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysisYou Lan0Wei Chen1Qun Yan2Wenen Liu3Department of Clinical Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, ChinaDepartment of Clinical Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, ChinaDepartment of Clinical Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, ChinaDepartment of Clinical Laboratory, Xiangya Hospital Central South University, Changsha, Hunan, ChinaIntroduction Tuberculous meningitis (TBM) is still a great challenge to global public health. As conventional diagnostic methods for TBM are unsatisfactory, interferon-γ release assays (IGRAs) have been introduced for TBM diagnosis tentatively. However, the role of IGRAs for diagnosing TBM remains unclear. Thus, we systematically evaluated the diagnostic performance of cerebrospinal fluid (CSF) and peripheral blood (PB) IGRAs in TBM to fill this blank. Material and methods Relevant studies were systematically searched in both foreign and Chinese databases up to March 2018. Studies in which TBM diagnosis was based on microbiological or clinical criteria were included. The quality of the included studies was assessed through the Quality Assessment of Diagnostic Accuracy Studies-2 (QUADAS-2) tool. Main outcome measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR) and diagnostic odds ratio (DOR), were pooled statistically using random effects models. The potential heterogeneity was explored by threshold effect analysis, subgroup analyses and meta-regression. Funnel plots and Egger’s test were used to test the potential publication bias. Statistical analyses were performed using Stata and Meta-DiSc software. Results Twenty-six out of 656 publications were eligible for meta-analysis, including 1892 participants in total. The pooled estimates of PB IGRAs for TBM diagnosis are as follows: sensitivity: 0.81 (95% CI: 0.78–0.84); specificity: 0.76 (95% CI: 0.73–0.78); PLR: 4.23 (95% CI: 2.95–6.07); NLR: 0.24 (95% CI: 0.19–0.32) and DOR: 21.06 (11.91-37.24). The corresponding estimates for CSF IGRAs were obtained: sensitivity: 0.81 (95% CI: 0.76–0.85); specificity: 0.89 (95% CI: 0.86–0.92); PLR: 7.87 (95% CI: 4.98–12.46); NLR: 0.19 (95% CI: 0.13–0.29); and DOR: 47.74 (25.02–91.12). Conclusions The diagnostic performance of IGRAs is suboptimal. In terms of cost, turn-around time and accessibility, these assays are unsuitable for use as biomarkers for TBM diagnosis.https://www.archivesofmedicalscience.com/Interferon-release-assays-for-tuberculous-meningitis-diagnosis-a-meta-analysis,94520,0,2.htmlinterferon-y release assaystuberculous meningitisdiagnosis |
| spellingShingle | You Lan Wei Chen Qun Yan Wenen Liu Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis Archives of Medical Science interferon-y release assays tuberculous meningitis diagnosis |
| title | Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis |
| title_full | Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis |
| title_fullStr | Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis |
| title_full_unstemmed | Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis |
| title_short | Interferon-γ release assays for tuberculous meningitis diagnosis: a meta-analysis |
| title_sort | interferon γ release assays for tuberculous meningitis diagnosis a meta analysis |
| topic | interferon-y release assays tuberculous meningitis diagnosis |
| url | https://www.archivesofmedicalscience.com/Interferon-release-assays-for-tuberculous-meningitis-diagnosis-a-meta-analysis,94520,0,2.html |
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