Evidence map›Paper›PMID 16202138›Full record

SynthesisBMC microbiology2005

In-house nucleic acid amplification tests for the detection of Mycobacterium tuberculosis in sputum specimens: meta-analysis and meta-regression.

Laura L Flores, Madhukar Pai, John M Colford, Lee W Riley

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

Synthesis in BMC microbiology, 2005. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 67 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
67citing papers in PubMed, 11 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

67 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  5. Guideline
  6. Diagnostic accuracy of nucleic acid amplification tests in urine for pulmonary tuberculosis: a meta-analysis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2015
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7 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

4 authors.

Laura L FloresDivisions of Infectious Diseases and Epidemiology, School of Public Health, University of California, Berkeley, CA 94720, USA. LFlores@medsfgh.ucsf.edu
Madhukar Pai
John M Colford
Lee W Riley

Funding

University of California, Berkeley (UCB)/University of *D43TW000003 · FIC · UNIVERSITY OF CALIFORNIA BERKELEY · PI REINGOLD, ARTHUR L · 1988 to 2013
$16.7M
POPULATION-BASED MOLECULAR EPIDEMIOLOGY OF TUBERCULOSISR01AI034238 · NIAID · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI HOPEWELL, PHILIP C · 1993 to 2010
$9.3M
TUBERCULOSIS TRAINING AND RESEARCHD43TW000905 · FIC · UNIVERSITY OF CALIFORNIA BERKELEY · PI RILEY, LEE W · 1997 to 2002
$1.3M
FIC NIH HHS 1-D43-TW00003-16FIC NIH HHS D43 TW000003FIC NIH HHS D43 TW000905NIAID NIH HHS R01 AI034238NIAID NIH HHS R01 AI 34238
6 · The paper itself

Abstract

backgroundMore than 200 studies related to nucleic acid amplification (NAA) tests to detect Mycobacterium tuberculosis directly from clinical specimens have appeared in the world literature since this technology was first introduced. NAA tests come as either commercial kits or as tests designed by the reporting investigators themselves (in-house tests). In-house tests vary widely in their accuracy, and factors that contribute to heterogeneity in test accuracy are not well characterized. Here, we used meta-analytical methods, including meta-regression, to identify factors related to study design and assay protocols that affect test accuracy in order to identify those factors associated with high estimates of accuracy.

resultsBy searching multiple databases and sources, we identified 2520 potentially relevant citations, and analyzed 84 separate studies from 65 publications that dealt with in-house NAA tests to detect M. tuberculosis in sputum samples. Sources of heterogeneity in test accuracy estimates were determined by subgroup and meta-regression analyses. Among 84 studies analyzed, the sensitivity and specificity estimates varied widely; sensitivity varied from 9.4% to 100%, and specificity estimates ranged from 5.6% to 100%. In the meta-regression analysis, the use of IS6110 as a target, and the use of nested PCR methods appeared to be significantly associated with higher diagnostic accuracy.

conclusionEstimates of accuracy of in-house NAA tests for tuberculosis are highly heterogeneous. The use of IS6110 as an amplification target, and the use of nested PCR methods appeared to be associated with higher diagnostic accuracy. However, the substantial heterogeneity in both sensitivity and specificity of the in-house NAA tests rendered clinically useful estimates of test accuracy difficult. Future development of NAA-based tests to detect M. tuberculosis from sputum specimens should take into consideration these findings in improving accuracy of in-house NAA tests.

Indexed as

Gene AmplificationHumansMycobacterium tuberculosisRegression AnalysisReproducibility of ResultsSputumTuberculosis

Identifiers

PMID16202138
PMCPMC1260021

What OpenQuestion holds

Textmetadata
LicenceCC BY
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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.