SynthesisPloS one2019
Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis.
Synthesis in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 84 papers, 5 of them syntheses that pooled it.
What it found
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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
84 citing papers in PubMed, 5 syntheses or guidelines pooled it, 186 citations in OpenAlex.
- Performance of adenosine deaminase in detecting paediatric pleural tuberculosis: a systematic review and meta-analysis.Annals of medicine · 2022Pooled it
- Pooled it
- Diagnostic accuracy of the cancer ratio for the prediction of malignant pleural effusion: evidence from a validation study and meta-analysis.Annals of medicine · 2021Pooled it
- Unstimulated Pleural Fluid Interferon Gamma for Diagnosis of Tuberculous Pleural Effusion: a Systematic Review and Meta-analysis.Journal of clinical microbiology · 2021Pooled it
- Pooled it
- An ultra-sensitive cell-free DNA-based diagnostic assay for Tuberculous pleurisy utilizing the CRISPR-Cas13a system.Annals of clinical microbiology and antimicrobials · 2026Trial
- Distinguishing Polymorphonuclear Leukocyte-Predominant Tuberculous Pleural Effusion from Parapneumonic Effusion in Patients with Elevated Serum C-Reactive Protein.Journal of clinical medicine · 2026Article
- Biochemical Markers in Pleural Fluid for the Diagnosis of Tuberculous Pleural Effusion: A Retrospective Study.Diseases (Basel, Switzerland) · 2026Article
- Development of a diagnostic nomogram for tuberculous pleural effusion.Journal of clinical tuberculosis and other mycobacterial diseases · 2026Article
- Current and Emerging Diagnostic Approaches for Tuberculosis in People Living with HIV: Challenges and Future Perspectives.Tropical medicine and infectious disease · 2026Review
- Infected Thoracic Aneurysm with Progressive Exudative Unilateral Pleural Effusion: A Case Report and Literature Review.Internal medicine (Tokyo, Japan) · 2026Review
- Diagnostic value of biochemical ratios in the differential diagnosis of tuberculous and malignant pleural effusions.BMC pulmonary medicine · 2026Article
- A survey of respiratory physicians on investigating and managing tuberculous pleuritis.Scientific reports · 2026Article
- Article
- Pembrolizumab-Associated Polyserositis with Eosinophilic Pleural Effusion During Adjuvant Therapy for Clear Cell Renal Cell Carcinoma: A Case Report and Targeted Review.Current oncology (Toronto, Ont.) · 2026Review
- Derivation and validation of a clinical prediction model incorporating the pleural fluid ADA-to-LDH ratio for differentiating tuberculous from malignant pleural effusions: a multi-center study.BMC pulmonary medicine · 2026Article
- Development and validation of a simplified machine learning model based on T-SPOT.TB and routine clinical data for the diagnosis of tuberculous pleural effusion.Journal of thoracic disease · 2026Article
- Article
- Diagnostic utility of pleural fluid adenosine deaminase in tuberculous pleural effusion in patients with exudative effusion: a retrospective multicenter study (ADATPE).Journal of thoracic disease · 2026Article
- Machine learning algorithms for identifying tuberculous pericardial effusion: insights from a retrospective study in Vietnam.BMC medical informatics and decision making · 2026Article
24 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
4 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivePleural fluid adenosine deaminase (ADA) is a useful diagnostic test for tuberculous pleural effusion (TPE), but its exact threshold and accuracy in clinical decision-making is unclear. We aimed to assess diagnostic performance of ADA in TPE and to clarify its optimal diagnostic threshold.
methodsWe searched PubMed, Embase, and Cochrane Library databases for articles indexed up to October 2018. We included English language studies that provided both sensitivity and specificity of ADA in TPE diagnosis. Summary estimates for sensitivity and specificity were obtained through bivariate random effects model, both overall and at prespecified threshold ranges of <36, 40±4, 45-65 and >65 IU/L.
resultsWe retrieved 2162 citations, and included 174 publications with 27009 patients. All studies showed high risk of bias. Summary sensitivity, specificity and diagnostic odds ratio estimates were 0.92 (95% CI 0.90-0.93), 0.90 (95% CI 0.88-0.91) and 97.42 (95% CI 74.90-126.72) respectively. 65 studies with ADA threshold of 40±4 IU/L showed summary sensitivity and specificity of 0.93 (95% CI 0.90-0.95) and 0.90 (95% CI 0.87-0.91) respectively. Four studies with ADA threshold >65 IU/L showed summary sensitivity and specificity of 0.86 (95% CI 0.61-0.96) and 0.94 (95% CI 0.80-0.99) respectively.
conclusionADA levels in pleural fluid show good diagnostic accuracy in diagnosis of TPE; however, all included studies showed high risk of bias. It was not possible to derive any firm inference on relative clinical utility of different diagnostic thresholds.
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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.