SynthesisJournal of clinical microbiology2010
Does bleach processing increase the accuracy of sputum smear microscopy for diagnosing pulmonary tuberculosis?
Synthesis in Journal of clinical microbiology, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 1 of them a synthesis 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
28 citing papers in PubMed, 1 synthesis or guideline pooled it, 62 citations in OpenAlex.
- Symptom- and chest-radiography screening for active pulmonary tuberculosis in HIV-negative adults and adults with unknown HIV status.The Cochrane database of systematic reviews · 2022Pooled it
- Performance of Bleach Method Sputum Smear Microscopy for the Diagnosis of Tuberculosis in a Highly Endemic District in Lima, Peru.International journal of environmental research and public health · 2022Article
- Added value of bleach for tuberculosis microscopy diagnostic in limited resources setting.Infectious disease reports · 2020Article
- Use of sodium dodecyl sulfate to improve tuberculosis sputum smear microscopy.Global health innovation · 2019Article
- Smear Microscopy for Diagnosis of Pulmonary Tuberculosis in Eastern Sudan.Tuberculosis research and treatment · 2018Article
- Spot sputum samples are at least as good as early morning samples for identifying Mycobacterium tuberculosis.BMC medicine · 2017Article
- Agreement between Direct Fluorescent Microscopy and Ziehl-Neelsen Concentration Techniques in Detection of Pulmonary Tuberculosis in Northwest Ethiopia.Ethiopian journal of health sciences · 2017Article
- Article
- Laboratory Diagnosis of Central Nervous System Infection.Current infectious disease reports · 2016Review
- Performance of the BacT Alert 3D System Versus Solid Media for Recovery and Drug Susceptibility Testing ofTuberculosis and respiratory diseases · 2016Article
- Magnetic Multivalent Trehalose Glycopolymer Nanoparticles for the Detection of Mycobacteria.Advanced healthcare materials · 2016Article
- Current trends and intricacies in the management of HIV-associated pulmonary tuberculosis.AIDS research and therapy · 2016Review
- Article
- Detection of Mycobacterium tuberculosis in extrapulmonary biopsy samples using PCR targeting IS6110, rpoB, and nested-rpoB PCR Cloning.Frontiers in microbiology · 2015Article
- Choosing algorithms for TB screening: a modelling study to compare yield, predictive value and diagnostic burden.BMC infectious diseases · 2014Article
- Demonstration of mycobacterium tuberculosis in sputum and saliva smears of tuberculosis patients using ziehl neelsen and flurochrome staining- a comparative study.Journal of clinical and diagnostic research : JCDR · 2014Article
- Advances and challenges in biosensor-based diagnosis of infectious diseases.Expert review of molecular diagnostics · 2014Review
- An evaluation of systematic tuberculosis screening at private facilities in Karachi, Pakistan.PloS one · 2014Article
- Comparison of direct versus concentrated smear microscopy in detection of pulmonary tuberculosis.BMC research notes · 2013Article
- Artificial neural networks trained to detect viral and phage structural proteins.PLoS computational biology · 2012Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
Abstract
Bleach digestion of sputum prior to smear preparation has been reported to increase the yield of microscopy for diagnosing pulmonary tuberculosis, even in high-HIV-prevalence settings. To determine the diagnostic accuracy of bleach microscopy, we updated a systematic review published in 2006 and applied the Grading of Recommendations Assessment, Development, and Evaluation framework to rate the overall quality of the evidence. We searched multiple databases (as of January 2009) for primary studies in all languages comparing bleach and direct microscopy. We assessed study quality using a validated tool and heterogeneity by standard methods. We used hierarchical summary receiver operating characteristic (HSROC) analysis to calculate summary estimates of diagnostic accuracy and random-effects meta-analysis to pool sensitivity and specificity differences. Of 14 studies (11 papers) included, 9 evaluated bleach centrifugation and 5 evaluated bleach sedimentation. Overall, examination of bleach-processed versus direct smears led to small increases in sensitivity (for bleach centrifugation, 6% [95% confidence interval [CI] = 3 to 10%, P = 0.001]; for bleach sedimentation, 9% [95% CI = 4 to 14%, P = 0.001]) and small decreases in specificity (for bleach centrifugation, -3% [95% CI = -4% to -1%, P = 0.004]; for bleach sedimentation, -2% [95% CI = -5% to 0%, P = 0.05]). Similarly, analysis of HSROC curves suggested little or no improvement in diagnostic accuracy. The quality of evidence was rated very low for both bleach centrifugation and bleach sedimentation. This updated systematic review suggests that the benefits of bleach processing are less than those described previously. Further research should focus on alternative approaches to optimizing smear microscopy, such as light-emitting diode fluorescence microscopy and same-day sputum collection strategies.
Indexed as
Identifiers
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.