scholarly journals Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis

PLoS ONE ◽  
2019 ◽  
Vol 14 (3) ◽  
pp. e0213728 ◽  
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Inderpaul Singh Sehgal ◽  
Sahajal Dhooria
Keyword(s):  
Systematic Review ◽  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Meta Analysis ◽  
Tuberculous Pleural Effusion

scholarly journals Diagnostic accuracy of interleukin 27 for tuberculous pleural effusion: two prospective studies and one meta-analysis

Thorax ◽  
2017 ◽  
Vol 73 (3) ◽  
pp. 240-247 ◽  
Author(s):  
Wen Wang ◽  
Qiong Zhou ◽  
Kan Zhai ◽  
Yao Wang ◽  
Jing-Yuan Liu ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Interferon Gamma ◽  
Predictive Value ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Tuberculous Pleural Effusion ◽  
Interleukin 27 ◽  
Independent Population

BackgroundAccurate differentiating diagnosis is essential for choosing treatment for exudative pleural effusions.ObjectiveTo establish the diagnostic accuracy of interleukin 27 for tuberculous pleural effusion (TPE).MethodsFirst, the concentrations of pleural interleukin 27, interferon-gamma and adenosine deaminase were compared between 51 patients with TPE and 103 with non-TPEs (Beijing cohort), and their diagnostic values were evaluated. These were further verified in another independent population (Wuhan cohort, n=120). In the second part of the study, we performed a meta-analysis.ResultsWith a cut-off value of 591.4 ng/L in the Beijing cohort, the area under the curve, sensitivity, specificity, positive predictive value and negative predictive value of interleukin 27 to diagnose TPE were 0.983 (95% CI 0.947 to 0.997), 96.1% (86.5% to 99.5%), 99.0% (94.7% to 100%), 98.0 (89.4 to 99.9) and 98.1 (93.3 to 99.8), respectively. Excellent diagnostic accuracy of interleukin 27 was also found in the Wuhan cohort and was further confirmed in the meta-analysis. The diagnostic performance of interleukin 27 was comparable to that of interferon-gamma and was more accurate than that of adenosine deaminase. Since the post-test probability of a negative result was always <0.1%, a negative test was considered to exclude TPE in all tuberculosis prevalence settings.ConclusionsInterleukin 27 can be used to diagnose TPE in a high prevalence setting, and a negative result can also be reliably used to rule out TPE in all prevalence settings.

scholarly journals Diagnostic Performance of Xpert MTB/RIF in Tuberculous Pleural Effusion: Systematic Review and Meta-analysis

2016 ◽  
Vol 54 (4) ◽  
pp. 1133-1136 ◽  
Author(s):  
Inderpaul Singh Sehgal ◽  
Sahajal Dhooria ◽  
Ashutosh Nath Aggarwal ◽  
Digambar Behera ◽  
Ritesh Agarwal
Keyword(s):  
Systematic Review ◽  
Pleural Effusion ◽  
Diagnostic Performance ◽  
Meta Analysis ◽  
Reference Standard ◽  
Tuberculous Pleural Effusion ◽  
Low Sensitivity ◽  
Composite Reference Standard

A systematic review investigating the role of Xpert MTB/RIF in the diagnosis of tuberculous pleural effusion (TPE) was conducted. The pooled sensitivities and specificities of Xpert MTB/RIF were 51.4% and 98.6%, respectively, with culture used as a reference standard and 22.7% and 99.8%, respectively, with a composite reference standard (CRS) used as the benchmark. Xpert MTB/RIF has low sensitivity but excellent specificity in the diagnosis of TPE.

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

2003 ◽  
Vol 40 (4) ◽  
pp. 374-381 ◽  
Author(s):  
Masashi Goto ◽  
Yoshinori Noguchi ◽  
Hiroshi Koyama ◽  
Kenji Hira ◽  
Takuro Shimbo ◽  
...  
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Meta Analysis ◽  
Cochrane Library ◽  
Pleural Biopsy ◽  
Tuberculous Pleural Effusion ◽  
Test Characteristics ◽  
Tuberculous Pleurisy ◽  
Gold Standards

Background: Many studies have investigated the usefulness of adenosine deaminase activity (ADA) in pleural fluid for the early diagnosis of tuberculous pleurisy. To summarize the diagnostic characteristics of ADA we undertook a meta-analysis using a summary receiver operating characteristic (SROC) curve method. Methods: Data sources were MEDLINE (1966-1999), the Cochrane Library and bibliographies of review and original articles. Studies were included if the absolute numbers of true positive, false negative, true negative and false positive observations were available or could be derived from the data presented; gold standards were described explicitly; and the criteria for a positive ADA result were reported. We constructed an SROC curve based on these extracted data to estimate the test characteristics. Results: Forty articles were available for analysis. The gold standards used were pleural biopsy histology, microbiological examination of pleural fluid, pleural biopsy and sputum and the patient's clinical course or combinations of these. The sensitivity of ADA reported in the articles ranged from 47·1% to 100% and the specificity from 50·0% to 100%. The summary measure of test characteristics derived from the SROC curve was 92·2% for both sensitivity and specificity. Conclusions: The test performance of ADA in tuberculous pleural effusion is reasonably good. Measurement of pleural ADA is thus likely to be a useful diagnostic tool for tuberculous pleurisy.

Adenosine Deaminase in Tuberculous Pleural Effusion

CHEST Journal ◽  
1994 ◽  
Vol 106 (5) ◽  
pp. 1634
Author(s):  
Luis Valdes ◽  
David Alvarez ◽  
José Manuel Valle ◽  
Esther San Jose ◽  
Antonio Pose
Keyword(s):  
Pleural Effusion ◽  
Adenosine Deaminase ◽  
Tuberculous Pleural Effusion

scholarly journals Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis

PLoS ONE ◽  
2021 ◽  
Vol 16 (6) ◽  
pp. e0253525
Author(s):  
Ashutosh Nath Aggarwal ◽  
Ritesh Agarwal ◽  
Sahajal Dhooria ◽  
Kuruswamy Thurai Prasad ◽  
Inderpaul Singh Sehgal ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Adenosine Deaminase ◽  
Pleural Fluid ◽  
Sensitivity And Specificity ◽  
Interferon Gamma ◽  
Meta Analysis ◽  
Paired Data ◽  
Ifn Γ ◽  
Meta Regression

Objective We compared diagnostic accuracy of pleural fluid adenosine deaminase (ADA) and interferon-gamma (IFN-γ) in diagnosing tuberculous pleural effusion (TPE) through systematic review and comparative meta-analysis. Methods We queried PubMed and Embase databases to identify studies providing paired data for sensitivity and specificity of both pleural fluid ADA and IFN-γ for diagnosing TPE. We used hierarchical summary receiver operating characteristic (HSROC) plots and HSROC meta-regression to model individual and comparative diagnostic performance of the two tests. Results We retrieved 376 citations and included 45 datasets from 44 publications (4974 patients) in our review. Summary estimates for sensitivity and specificity for ADA were 0.88 (95% CI 0.85–0.91) and 0.91 (95% CI 0.89–0.92), while for IFN-γ they were 0.91 (95% CI 0.89–0.94) and 0.96 (95% CI 0.94–0.97), respectively. HSROC plots showed consistently greater diagnostic accuracy for IFN-γ over ADA across the entire range of observations. HSROC meta-regression using test-type as covariate yielded a relative diagnostic odds ratio of 2.22 (95% CI 1.68–2.94) in favour of IFN-γ, along with better summary sensitivity and specificity figures. No prespecified subgroup variable significantly influenced the summary diagnostic accuracy estimates. Conclusion Pleural fluid IFN-γ estimation has better diagnostic accuracy than ADA estimation for diagnosis of TPE.

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