SynthesisBMC infectious diseases2016
The diagnostic accuracy of serological tests for Lyme borreliosis in Europe: a systematic review and meta-analysis.
Synthesis in BMC infectious diseases, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 98 papers, 7 of them syntheses that pooled it.
What it found
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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.
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Who cites it
98 citing papers in PubMed, 7 syntheses or guidelines pooled it, 224 citations in OpenAlex.
- Borrelia Infections Under B Cell-Depleting Therapies: A Systematic Review of Diagnostic Challenges and Outcomes With Special Focus on Neurological Forms.European journal of neurology · 2026Pooled it
- Incidence of Lyme Borreliosis in Europe: A Systematic Review (2005-2020).Vector borne and zoonotic diseases (Larchmont, N.Y.) · 2023Pooled it
- A systematic and meta-analysis review on the diagnostic accuracy of antibodies in the serological diagnosis of COVID-19.Systematic reviews · 2021Pooled it
- Diagnostic accuracy of tests for type 2 diabetes and prediabetes: A systematic review and meta-analysis.PloS one · 2020Pooled it
- A systematic review on the impact of gestational Lyme disease in humans on the fetus and newborn.PloS one · 2018Pooled it
- [Neuroborreliosis - Diagnostics, treatment and course].Der Nervenarzt · 2017Pooled it
- The Accuracy of Diagnostic Tests for Lyme Disease in Humans, A Systematic Review and Meta-Analysis of North American Research.PloS one · 2016Pooled it
- Serum Borrelia IgG as a rule-out test in suspected lyme neuroborreliosis: a large retrospective cohort study.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2026Article
- Dynamics of Borrelial Antibodies in European Lyme Borreliosis Patients with Erythema Migrans.Medical sciences (Basel, Switzerland) · 2026Article
- Prevalence and Associated Factors ofMicroorganisms · 2026Review
- Metagenomic surveillance of tick-borne pathogens and microbiomes in Huntingdon County, Pennsylvania.One health (Amsterdam, Netherlands) · 2026Article
- Lyme borreliosis.Nature reviews. Disease primers · 2026Review
- Silent Spread ofHealthcare (Basel, Switzerland) · 2025Article
- The diagnostic potential of proteomics and machine learning in Lyme neuroborreliosis.Nature communications · 2025Article
- Review
- FACE DROPS: A Clinical Risk Assessment Tool for Differentiation of Acute Lyme Disease-Associated Facial Palsy From Bell Palsy.Neurology. Clinical practice · 2025Article
- Diagnostic validation of novel Borrelia antigens discovered by whole-proteome microarray: Advancing early detection and test of cure for Lyme disease.Cell reports. Medicine · 2025Article
- A customizable multiplex protein microarray for antibody testing and its application for tick-borne and other infectious diseases.Scientific reports · 2025Article
- Evaluation of different standard and modified two-tier testing strategies for the laboratory diagnosis of lyme borreliosis in a European setting.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2024Article
- New Epitopes for the Serodiagnosis of Human Borreliosis.Microorganisms · 2024Article
38 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
21 authors at 13 institutions in 5 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundInterpretation of serological assays in Lyme borreliosis requires an understanding of the clinical indications and the limitations of the currently available tests. We therefore systematically reviewed the accuracy of serological tests for the diagnosis of Lyme borreliosis in Europe.
methodsWe searched EMBASE en MEDLINE and contacted experts. Studies evaluating the diagnostic accuracy of serological assays for Lyme borreliosis in Europe were eligible. Study selection and data-extraction were done by two authors independently. We assessed study quality using the QUADAS-2 checklist. We used a hierarchical summary ROC meta-regression method for the meta-analyses. Potential sources of heterogeneity were test-type, commercial or in-house, Ig-type, antigen type and study quality. These were added as covariates to the model, to assess their effect on test accuracy.
resultsSeventy-eight studies evaluating an Enzyme-Linked ImmunoSorbent assay (ELISA) or an immunoblot assay against a reference standard of clinical criteria were included. None of the studies had low risk of bias for all QUADAS-2 domains. Sensitivity was highly heterogeneous, with summary estimates: erythema migrans 50% (95% CI 40% to 61%); neuroborreliosis 77% (95% CI 67% to 85%); acrodermatitis chronica atrophicans 97% (95% CI 94% to 99%); unspecified Lyme borreliosis 73% (95% CI 53% to 87%). Specificity was around 95% in studies with healthy controls, but around 80% in cross-sectional studies. Two-tiered algorithms or antibody indices did not outperform single test approaches.
conclusionsThe observed heterogeneity and risk of bias complicate the extrapolation of our results to clinical practice. The usefulness of the serological tests for Lyme disease depends on the pre-test probability and subsequent predictive values in the setting where the tests are being used. Future diagnostic accuracy studies should be prospectively planned cross-sectional studies, done in settings where the test will be used in practice.
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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.