Evidence map›Paper›PMID 12843069›Full record

SynthesisJournal of clinical microbiology2003

Assessment by meta-analysis of PCR for diagnosis of smear-negative pulmonary tuberculosis.

Olga L Sarmiento, Kristen A Weigle, Janet Alexander, David J Weber, William C Miller

Abstract readMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in Journal of clinical microbiology, 2003. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 63 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
63citing papers in PubMed, 6 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

63 citing papers in PubMed, 6 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Trial
  8. Article
  9. Article
  10. Article
  11. Primary Nasopharyngeal Tuberculosis: A Diagnostic Challenge.Iranian journal of otorhinolaryngology · 2023
    Article
  12. Article
  13. Ocular tuberculosis: Where are we today?Indian journal of ophthalmology · 2020
    Review
  14. Article
  15. Review
  16. Article
  17. A case report on esophageal tuberculosis - A rare entity.International journal of surgery case reports · 2017
    Article
  18. Article
  19. Article
  20. Article

3 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

5 authors.

Olga L SarmientoDepartment of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, Chapel Hill, North Carolina 27599, USA.
Kristen A Weigle
Janet Alexander
David J Weber
William C Miller

Funding

Zonisamide in Patients with Neuropathic Pain Associated with Diabetic NeuropathyM01RR000046 · NCRR · UNIV OF NORTH CAROLINA CHAPEL HILL · PI MUENZER, JOSEPH J. · 1985 to 2008
$38.5M
PAUCIBACILLARY TUBERCULOIS, DIAGNOSIS AND MORBIDITYR01AI041917 · NIAID · UNIVERSITY OF NORTH CAROLINA CHAPEL HILL · PI WEIGLE, KRISTEN A · 1997 to 1999
–
NCRR NIH HHS M01 RR000046NCRR NIH HHS RR00046NIAID NIH HHS 1-R01-AI41917
6 · The paper itself

Abstract

We conducted a meta-analysis to assess the performance of PCR for the diagnosis of smear-negative pulmonary tuberculosis (SPT) and to identify factors that account for differences in the diagnostic accuracy of different studies. Studies published before February 2002 were included if sensitivity and specificity of PCR in smear-negative respiratory or gastric-aspirate specimens could be calculated. Analysis was conducted by using summary receiver operating characteristics models. Sensitivity and specificity ranged from 9 to 100% and from 25 to 100%, respectively. Fewer than 40% of the 50 studies reported results by number of patients, reported clinical characteristics of patients, or used as a reference standard combined culture and clinical criteria. Studies that included bronchial specimens showed higher accuracy than studies that evaluated only sputum specimens or included gastric aspirates. Studies that did not report that tests were applied blindly showed higher accuracy than those reporting blind testing. Increased sensitivity due to the use of DNA purification methods was associated with decreased specificity. Studies published after 1995, using Amplicor or dUTP-UNG, were associated with an increase in specificity at the expense of lower sensitivity. We concluded that PCR is not consistently accurate enough to be routinely recommended for the diagnosis of SPT. However, PCR of bronchial specimens could be useful in highly suspicious SPT cases. Studies not reporting blind testing are likely to overestimate accuracy of PCR. Future evaluation of PCR accuracy should be conducted by patient and type of respiratory specimen, blindly, by using a reference standard that combines culture and clinical criteria and addresses the issue of how patient characteristics affect PCR accuracy.

Indexed as

HumansMycobacterium tuberculosisPolymerase Chain ReactionSensitivity and SpecificitySpecimen HandlingSputumTuberculosis, Pulmonary

Identifiers

PMID12843069
PMCPMC165327

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.