SynthesisChest2009
Systematic review and metaanalysis: urinary antigen tests for Legionellosis.
Synthesis in Chest, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 72 papers, 2 of them syntheses that pooled 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.
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.
Who cites it
72 citing papers in PubMed, 2 syntheses or guidelines pooled it, 231 citations in OpenAlex.
- Global Perspective ofInternational journal of environmental research and public health · 2022Pooled it
- Diagnostic Accuracy of PCR Alone and Compared to Urinary Antigen Testing for Detection of Legionella spp.: a Systematic Review.Journal of clinical microbiology · 2016Pooled it
- Article
- Characteristic computed tomography features of mild-to-moderate Legionella pneumonia: evaluation of a known pattern and identification of a novel indicator.BMC pulmonary medicine · 2026Article
- Inter-platform agreement and diagnostic performance of the automated LIAISONFrontiers in microbiology · 2026Article
- Article
- Detecting Respiratory Pathogens for Diagnosing Lower Respiratory Tract Infections at the Point of Care: Challenges and Opportunities.Biosensors · 2025Review
- Legionnaires' disease following lake swimming in Iowa.CMAJ : Canadian Medical Association journal = journal de l'Association medicale canadienne · 2025Article
- Case report: The value of early application of mNGS technology in the diagnosis and treatment of severe Legionnaires' disease: reports of two cases with different outcomes.Frontiers in medicine · 2025Article
- Diagnostic Utility of SARS-CoV-2 Nucleocapsid Antigenemia: A Meta-analysis.Open forum infectious diseases · 2024Article
- CRP under 130 mg/L rules out the diagnosis of Legionella pneumophila serogroup 1 (URINELLA Study).European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Observational
- Practicing Medicine Wisely: Routine Use of Urine Legionella in Suspicious Pneumonia - Are we Overdoing?JNMA; journal of the Nepal Medical Association · 2024Article
- Identification rate ofJournal of clinical microbiology · 2024Article
- Severe Legionnaires' disease.Annals of intensive care · 2024Review
- Venovenous extracorporeal membrane oxygenation after cardiac arrest for acute respiratory distress syndrome caused by Legionella: a case report.Journal of cardiothoracic surgery · 2024Article
- Association between the Timing of Urinary Antigen Testing and Outcomes in Legionella Pneumonia Patients: A Nationwide Database Study.Internal medicine (Tokyo, Japan) · 2024Article
- Severe Legionella Pneumonia in Which Serial Testing by RibotestInternal medicine (Tokyo, Japan) · 2023Article
- Increased Incidence of Legionellosis after Improved Diagnostic Methods, New Zealand, 2000-2020.Emerging infectious diseases · 2023Article
- Identification and comparison of Chlamydia psittaci, Legionella and Mycoplasma pneumonia infection.The clinical respiratory journal · 2023Article
- Acute management of pneumonia in adult patients.Singapore medical journal · 2023Article
12 more citing papers are in PubMed but not listed here.
Corrections and comments
- Commented on by
Authors and funding
9 authors at 4 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundUrinary antigen assays offer simplicity and rapidity in diagnosing Legionnaires' disease, though studies report a range of sensitivities. We conducted a systematic review to assess the test characteristics of Legionella urinary antigen.
methodsWe searched Medline, Excerpta Medica Database, and bibliographies of retrieved articles. English-language studies were used and included if the absolute number of true-positive, false-negative, true-negative, and false-positive observations were available, and the "gold standards" were described clearly. Two investigators independently reviewed articles and extracted data. Quality was assessed with the Quality Assessment for Diagnostic Accuracy Studies (QUADAS). Sensitivities and specificities were pooled using a random-effects model weighted with the inverse of the SE calculated through the Wald method.
resultsFifty articles were retrieved for detailed evaluation, and 30 met the inclusion criteria. All but two studies focused on serotype 1 Legionella. Forty assays were reported using six different methodologies, whereas 26 assays used commercial tests, and 14 assays used in-house tests. Study quality was generally low, with average QUADAS scores of 4.4 of a total of 14 points (range, 1 to 9 points). The pooled sensitivity was 0.74 (95% CI, 0.68 to 0.81), and the specificity was 0.991 (95% CI, 0.984 to 0.997). Higher quality studies had lower sensitivity, and there was evidence of publication bias.
conclusionsLegionella urinary antigen for serotype 1 appears to have excellent specificity, though modest sensitivity. However, the poor quality of the included studies and the presence of publication bias suggest an overestimation of test performance. High-quality studies are needed.
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What OpenQuestion holds
Registered trials
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.