Evidence map›Paper›PMID 31720421›Full record

ArticleJournal of clinical tuberculosis and other mycobacterial diseases2019

Comparative evaluation of Xpert MTB/RIF and the new Xpert MTB/RIF ultra with respiratory and extra-pulmonary specimens for tuberculosis case detection in a low incidence setting.

Claudio Piersimoni, Giancarlo Gherardi, Natascia Gracciotti, Antonella Pocognoli

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

Article in Journal of clinical tuberculosis and other mycobacterial diseases, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 25 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
25citing papers in PubMed, 5 pooled it
4.3field-weighted citation impact, top 5% 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

25 citing papers in PubMed, 5 syntheses or guidelines pooled it, 47 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Article
  7. Clinical management of XpertBMC infectious diseases · 2026
    Observational
  8. Sensitivity and specificity of Gene Xpert Ultra in extrapulmonary tuberculosis (EPTB).Lung India : official organ of Indian Chest Society · 2025
    Article
  9. Infection and drug resistance · 2025
    Article
  10. Article
  11. Observational
  12. Article
  13. Article
  14. Article
  15. Article
  16. Pooling Sputum Samples for Efficient Mass Tuberculosis Screening in Prisons.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022
    Article
  17. Prevalence and interpretation of XpertPublic health action · 2022
    Article
  18. Article
  19. Review
  20. Observational
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

4 authors.

Claudio PiersimoniRegional Reference Mycobacteriology Laboratory, Clinical Pathology Laboratory, United Hospitals, Ancona, Italy.
Giancarlo GherardiRegional Reference Mycobacteriology Laboratory, Clinical Pathology Laboratory, United Hospitals, Ancona, Italy.
Natascia GracciottiRegional Reference Mycobacteriology Laboratory, Clinical Pathology Laboratory, United Hospitals, Ancona, Italy.
Antonella PocognoliRegional Reference Mycobacteriology Laboratory, Clinical Pathology Laboratory, United Hospitals, Ancona, Italy.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe Xpert MTB/RIF assay (Xpert) is an automated molecular test for the detection of tuberculosis and rifampin resistance (RIF-R), but it lacks sensitivity in smear-negative samples and some limitations in determination of RIF-R have also been reported. The new Xpert MTB/RIF Ultra (Ultra) was developed to overcome these limitations. We aimed to compare Ultra and Xpert diagnostic accuracy setting culture and drug susceptibility testing as reference standards.

methodsA retrospective analysis was performed on 359 consecutive, respiratory (269) and extrapulmonary (90) specimens collected from 340 patients investigated for TB along a two-year period. Patients presenting at primary health-care centres and hospitals were recruited on the basis of symptoms and abnormal X-ray imaging. One-hundred seventy-four subjects were identified to have active tuberculosis by culture and 2 were MDR.

findingsSensitivities of Ultra and Xpert were 87% and 75% for the 48 individuals with smear-negative and culture-positive respiratory TB (difference of 12%, 95% CI 3 to 21); 95% and 72% for the 40 individuals with smear-negative and culture-positive extrapulmonary disease (22%, 95% CI 10 to 34); and 95% and 86%, respectively, across all 174 individuals with culture-positive samples (8.5%, 95% CI 4.5 to 12.5). Specificities of Ultra and Xpert for tuberculosis case detection were 98% and 100% (-2.0%, 95% CI -4.3 to +0.3). Ultra and Xpert performed equal in detecting RIF-R.

interpretationSensitivity of Ultra was superior to that of Xpert in all categories of clinical samples. However, improved sensitivity was associated with a modest reduction in specificity.

Indexed as

Case detectionNucleic acid amplificationSensitivitySpecificityTuberculosisXpert MTB/RIF Ultra

Identifiers

PMID31720421
PMCPMC6830143
OpenAlexW2921449457

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC-ND
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.