Evidence map›Paper›PMID 31887127›Full record

Observational studyPloS one2019

Use of GeneXpert and the role of an expert panel in improving clinical diagnosis of smear-negative tuberculosis cases.

Jovilia Abong, Victoria Dalay, Ivor Langley, Ewan Tomeny, Danaida Marcelo, Victor Mendoza, Arvin Christian Aquino, Anna Marie Celina Garfin, Bertie Squire, Charles Yu

Open access · goldAbstract readComparative StudyMulticenter StudyObservational Study
In one paragraph

Observational study in PloS one, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 2 pooled it
1.0field-weighted citation impact, top 25% 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

5 citing papers in PubMed, 2 syntheses or guidelines pooled it, 8 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Article
  4. Article
  5. Article
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

10 authors at 3 institutions in 2 countries.

Jovilia AbongResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.ORCID 0000-0003-4220-1495
Victoria DalayResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.
Ivor LangleyCollaboration for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Ewan TomenyCollaboration for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Danaida MarceloResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.
Victor MendozaResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.
Arvin Christian AquinoResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.ORCID 0000-0002-4544-7821
Anna Marie Celina GarfinNational TB Control Program, Department of Health, Manila, Metro Manila, Philippines.
Bertie SquireCollaboration for Applied Health Research & Delivery, Liverpool School of Tropical Medicine, Liverpool, United Kingdom.
Charles YuResearch Division, De La Salle Medical and Health Sciences Institute, Dasmariñas City, Cavite, Philippines.
De La Salle University – Dasmariñas · PHLiverpool School of Tropical Medicine · GBDepartment of Health · PH

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

settingA high proportion of notified tuberculosis cases in the Philippines are clinically diagnosed (63%) as opposed to bacteriologically confirmed. Better understanding of this phenomenon is required to improve tuberculosis control.

objectivesTo determine the percentage of smear negative presumptive tuberculosis patients that would be diagnosed by GeneXpert; compare clinical characteristics of patients diagnosed as tuberculosis cases; and review the impact that the current single government physician and a reconstituted Tuberculosis Diagnostic committee (expert panel) may have on tuberculosis over-diagnosis.

designThis a cross-sectional study of 152 patients 15-85 years old with two negative Direct Sputum Smear Microscopy results, with abnormal chest X-ray who underwent GeneXpert testing and review by an expert panel.

resultsThirty-two percent (48/152) of the sample were Xpert positive and 93% (97/104) of GeneXpert negatives were clinically diagnosed by a single physician. Typical symptoms and X-ray findings were higher in bacteriologically confirmed tuberculosis. When compared to the GeneXpert results the Expert panel's sensitivity for active tuberculosis was high (97.5%, 39/40), specificity was low (40.2%, 35/87).

conclusionUsing the GeneXpert would increase the level of bacteriologically confirmed tuberculosis substantially among presumptive tuberculosis. An expert panel will greatly reduce over-diagnosis usually seen when a decision is made by a single physician.

Indexed as

AdolescentAdultAgedAged, 80 and overCross-Sectional StudiesDNA, BacterialFeasibility StudiesFemaleHumansLungMaleMiddle AgedMycobacterium tuberculosisNucleic Acid Amplification TechniquesPhilippinesPulmonologistsDNA, Bacterial

Identifiers

PMID31887127
PMCPMC6936841
OpenAlexW2945588274

What OpenQuestion holds

Textmetadata
LicenceCC BY
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.