Evidence map›Paper›PMID 26954678›Full record

SynthesisPloS one2016

Impact of Molecular Diagnostics for Tuberculosis on Patient-Important Outcomes: A Systematic Review of Study Methodologies.

Samuel G Schumacher, Hojoon Sohn, Zhi Zhen Qin, Genevieve Gore, J Lucian Davis, Claudia M Denkinger, Madhukar Pai

Open access · goldAbstract readSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in PloS one, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 28 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
28citing papers in PubMed, 9 pooled it
5.4field-weighted citation impact, top 4% of its field
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

28 citing papers in PubMed, 9 syntheses or guidelines pooled it, 55 citations in OpenAlex.

  1. Pooled it
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  9. Treatment outcomes, diagnostic and therapeutic impact: Xpert vs. smear. A systematic review and meta-analysis.The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2019
    Pooled it
  10. Trial
  11. Review
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  16. Review
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  18. Advances in Molecular Diagnosis of Tuberculosis.Journal of clinical microbiology · 2020
    Review
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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

7 authors at 3 institutions in 2 countries.

Samuel G SchumacherMcGill University Department of Epidemiology & Biostatistics, Montreal, Canada.
Hojoon SohnMcGill University Department of Epidemiology & Biostatistics, Montreal, Canada.
Zhi Zhen QinMcGill University Department of Epidemiology & Biostatistics, Montreal, Canada.
Genevieve GoreMcGill University, Schulich Library of Science and Engineering, Montreal, Canada.
J Lucian DavisUCSF Pulmonary & Critical Care Medicine, San Francisco, United States of America.
Claudia M DenkingerMcGill University Department of Epidemiology & Biostatistics, Montreal, Canada.
Madhukar PaiMcGill University Department of Epidemiology & Biostatistics, Montreal, Canada.
McGill University · CABeth Israel Deaconess Medical Center · USPulmonary and Critical Care Associates · US

Funding

Canadian Institutes of Health Research MOP-89918Wellcome Trust
6 · The paper itself

Abstract

backgroundSeveral reviews on the accuracy of Tuberculosis (TB) Nucleic Acid Amplification Tests (NAATs) have been performed but the evidence on their impact on patient-important outcomes has not been systematically reviewed. Given the recent increase in research evaluating such outcomes and the growing list of TB NAATs that will reach the market over the coming years, there is a need to bring together the existing evidence on impact, rather than accuracy. We aimed to assess the approaches that have been employed to measure the impact of TB NAATs on patient-important outcomes in adults with possible pulmonary TB and/or drug-resistant TB.

methodsWe first develop a conceptual framework to clarify through which mechanisms the improved technical performance of a novel TB test may lead to improved patient outcomes and outline which designs may be used to measure them. We then systematically review the literature on studies attempting to assess the impact of molecular TB diagnostics on such outcomes and provide a narrative synthesis of designs used, outcomes assessed and risk of bias across different study designs.

resultsWe found 25 eligible studies that assessed a wide range of outcomes and utilized a variety of experimental and observational study designs. Many potentially strong design options have never been used. We found that much of the available evidence on patient-important outcomes comes from a small number of settings with particular epidemiological and operational context and that confounding, time trends and incomplete outcome data receive insufficient attention.

conclusionsA broader range of designs should be considered when designing studies to assess the impact of TB diagnostics on patient outcomes and more attention needs to be paid to the analysis as concerns about confounding and selection bias become relevant in addition to those on measurement that are of greatest concern in accuracy studies.

Indexed as

Molecular Diagnostic TechniquesHumansMycobacterium tuberculosisNucleic Acid Amplification TechniquesOutcome Assessment, Health CarePublication BiasTuberculosisTuberculosis, Multidrug-ResistantTuberculosis, Pulmonary

Identifiers

PMID26954678
PMCPMC4783056
OpenAlexW2293334163

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.