Evidence map›Paper›PMID 30674379›Full record

SynthesisThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease2019

Treatment outcomes, diagnostic and therapeutic impact: Xpert vs. smear. A systematic review and meta-analysis.

T Agizew, R Boyd, A F Auld, L Payton, S L Pals, P Lekone, V Chihota, A Finlay

Abstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 23 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
23citing papers in PubMed, 1 pooled it
–field-weighted citation impact
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

23 citing papers in PubMed, 1 synthesis or guideline pooled it.

  1. Pooled it
  2. Trial
  3. Article
  4. Article
  5. Article
  6. Article
  7. Article
  8. Article
  9. Article
  10. Evaluating the impact of XpertPublic health action · 2022
    Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Performance of XpertPublic health action · 2020
    Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Ensuring that XpertThe international journal of tuberculosis and lung disease : the official journal of the International Union against Tuberculosis and Lung Disease · 2019
    Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors.

T AgizewCenters for Disease Control and Prevention (CDC), Gaborone, Botswana, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, Faculty of Medicine, University of Botswana, Gaborone, Botswana.
R BoydCenters for Disease Control and Prevention (CDC), Gaborone, Botswana, Division of Tuberculosis Elimination.
A F AuldDivision of Global HIV and Tuberculosis, CDC, Atlanta, Georgia, USA.
L PaytonCenters for Disease Control and Prevention (CDC), Gaborone, Botswana.
S L PalsDivision of Global HIV and Tuberculosis, CDC, Atlanta, Georgia, USA.
P LekoneCenters for Disease Control and Prevention (CDC), Gaborone, Botswana.
V ChihotaFaculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa, Aurum Institute, Johannesburg, South Africa.
A FinlayCenters for Disease Control and Prevention (CDC), Gaborone, Botswana, Division of Tuberculosis Elimination.

Funding

Intramural CDC HHS CC999999PEPFAR
6 · The paper itself

Abstract

backgroundCompared with smear microscopy, Xpert

methodsCitations (2000-2016) reporting treatment outcomes of patients diagnosed using Xpert compared with smear were selected from PubMed, Scopus and conference abstracts. We conducted a systematic review and meta-analysis. Favorable (cured, completed) and unfavorable (failure, death, loss to follow-up) outcomes were pooled for meta-analysis; we also reviewed the number of TB cases diagnosed, time to treatment and empiric treatment. The Mantel-Haenszel method with a fixed-effect model was used;

resultsFrom 13 citations, 43 594 TB patients were included and 4825 were with known TB treatment outcome. From the pooled analysis, an unfavorable outcomes among those diagnosed using Xpert compared with smear was 20.2%, 541/2675 vs. 21.9%, 470/2150 (risk ratio 0.92, 95%CI 0.82-1.02). Statistical heterogeneity was low (

conclusionsXpert implementation showed no discernible impact on treatment outcomes compared with conventional smear despite reduced time to diagnosis, time to treatment or reduced level of empiric treatment. Further research is required to learn more about gaps in the existing health system.

Indexed as

Antibiotics, AntitubercularHumansMolecular Diagnostic TechniquesMycobacterium tuberculosisTime-to-TreatmentTreatment OutcomeTuberculosisAntibiotics, Antitubercular

Identifiers

PMID30674379
PMCPMC6872902

What OpenQuestion holds

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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.