Evidence map›Paper›PMID 28100546›Full record

SynthesisThe European respiratory journal2017

Accuracy of line probe assays for the diagnosis of pulmonary and multidrug-resistant tuberculosis: a systematic review and meta-analysis.

Ruvandhi R Nathavitharana, Patrick G T Cudahy, Samuel G Schumacher, Karen R Steingart, Madhukar Pai, Claudia M Denkinger

Open access · bronzeAbstract readMeta-AnalysisSystematic Review
In one paragraph

Synthesis in The European respiratory journal, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
84citing papers in PubMed, 12 pooled it
11.5field-weighted citation impact, top 1% 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

84 citing papers in PubMed, 12 syntheses or guidelines pooled it, 156 citations in OpenAlex.

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  7. Effectiveness of interventions for reducing TB incidence in countries with low TB incidence: a systematic review of reviews.European respiratory review : an official journal of the European Respiratory Society · 2019
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  12. XpertThe Cochrane database of systematic reviews · 2018
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24 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

6 authors at 5 institutions in 4 countries.

Ruvandhi R NathavitharanaDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA rnathavi@bidmc.harvard.edu.ORCID 0000-0002-3544-5021
Patrick G T CudahyDivision of Infectious Diseases, Yale University School of Medicine, New Haven, CT, USA.
Samuel G SchumacherFIND, Geneva, Switzerland.
Karen R SteingartCochrane Infectious Diseases Group, Liverpool School of Tropical Medicine, Liverpool, UK.
Madhukar PaiMcGill International TB Centre, McGill University, Montreal, QC, Canada.
Claudia M DenkingerDivision of Infectious Diseases, Beth Israel Deaconess Medical Center, Boston, MA, USA.
FIND · CHBeth Israel Deaconess Medical Center · USLiverpool School of Tropical Medicine · GBMcGill University · CAYale University · US

Funding

The impact of HIV viral diversity and cellular immunity on HIV pathogenesisP30AI060354 · NIAID · HARVARD UNIVERSITY (MEDICAL SCHOOL) · PI ROBERT A. PARKER · 2004 to 2026
$94.4M
Research Mentoring and Building Capacity of underrepresented Minority Research Scientists in India.D43TW010540 · FIC · YALE UNIVERSITY · PI MICHELE BARRY, Eva Harris · 2017 to 2026
$15.5M
TRAINING IN THE PATHOGENESIS OF INFECTIOUS DISEASEST32AI007517 · NIAID · YALE UNIVERSITY · PI Jaimie Meyer, Albert C Shaw · 1997 to 2026
$6.1M
FIC NIH HHS D43 TW010540NIAID NIH HHS P30 AI060354NIAID NIH HHS T32 AI007517Wellcome Trust
6 · The paper itself

Abstract

Only 25% of multidrug-resistant tuberculosis (MDR-TB) cases are currently diagnosed. Line probe assays (LPAs) enable rapid drug-susceptibility testing for rifampicin (RIF) and isoniazid (INH) resistance and Mycobacterium tuberculosis detection. Genotype MTBDRplusV1 was WHO-endorsed in 2008 but newer LPAs have since been developed.This systematic review evaluated three LPAs: Hain Genotype MTBDRplusV1, MTBDRplusV2 and Nipro NTM+MDRTB. Study quality was assessed with QUADAS-2. Bivariate random-effects meta-analyses were performed for direct and indirect testing. Results for RIF and INH resistance were compared to phenotypic and composite (incorporating sequencing) reference standards. M. tuberculosis detection results were compared to culture.74 unique studies were included. For RIF resistance (21 225 samples), pooled sensitivity and specificity (with 95% confidence intervals) were 96.7% (95.6-97.5%) and 98.8% (98.2-99.2%). For INH resistance (20 954 samples), pooled sensitivity and specificity were 90.2% (88.2-91.9%) and 99.2% (98.7-99.5%). Results were similar for direct and indirect testing and across LPAs. Using a composite reference standard, specificity increased marginally. For M. tuberculosis detection (3451 samples), pooled sensitivity was 94% (89.4-99.4%) for smear-positive specimens and 44% (20.2-71.7%) for smear-negative specimens.In patients with pulmonary TB, LPAs have high sensitivity and specificity for RIF resistance and high specificity and good sensitivity for INH resistance. This meta-analysis provides evidence for policy and practice.

Indexed as

Antitubercular AgentsDNA ProbesDrug Resistance, Multiple, BacterialHumansIsoniazidMicrobial Sensitivity TestsMycobacterium tuberculosisNucleic Acid Amplification TechniquesRifampinSensitivity and SpecificitySputumTuberculosis, Multidrug-ResistantTuberculosis, PulmonaryAntitubercular AgentsDNA ProbesIsoniazidRifampin

Identifiers

PMID28100546
PMCPMC5898952
OpenAlexW2579229649

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.