Evidence map›Paper›PMID 35588942›Full record

SynthesisThe Journal of infection2022

Diagnostic accuracy of WHO screening criteria to guide lateral-flow lipoarabinomannan testing among HIV-positive inpatients: A systematic review and individual participant data meta-analysis.

Ashar Dhana, Yohhei Hamada, Andre P Kengne, Andrew D Kerkhoff, Tobias Broger, Claudia M Denkinger, Molebogeng X Rangaka, Ankur Gupta-Wright, Katherine Fielding, Robin Wood and 10 more

Open access · greenAbstract readMeta-AnalysisSystematic Review
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of infection, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
12citing papers in PubMed, 1 pooled it
2.5field-weighted citation impact, top 10% 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

12 citing papers in PubMed, 1 synthesis or guideline pooled it, 17 citations in OpenAlex.

  1. Pooled it
  2. Trial
  3. Article
  4. Observational
  5. Article
  6. Article
  7. Review
  8. Article
  9. Review
  10. Review
  11. Review
  12. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

20 authors at 11 institutions in 9 countries.

Ashar DhanaDepartment of Medicine, University of Cape Town, Cape Town, South Africa.
Yohhei HamadaCentre for International Cooperation and Global TB Information, The Research Institute of Tuberculosis, Japan Anti-Tuberculosis Association, Tokyo, Japan; Institute for Global Health, University College London, London, UK.
Andre P KengneNon-communicable Diseases Research Unit, South African Medical Research Council, Cape Town, South Africa.
Andrew D KerkhoffDivision of HIV, Infectious Diseases and Global Medicine, Zuckerberg San Francisco General Hospital and Trauma Center, University of California San Francisco, San Francisco, CA, USA.
Tobias BrogerDivision of Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany; FIND, Geneva, Switzerland.
Claudia M DenkingerDivision of Infectious Disease and Tropical Medicine, Center for Infectious Diseases, Heidelberg University Hospital, Heidelberg, Germany; German Center of Infection Research, Heidelberg, Germany; FIND, Geneva, Switzerland.
Molebogeng X RangakaInstitute for Global Health, University College London, London, UK; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Ankur Gupta-WrightInstitute for Global Health, University College London, London, UK; Clinical Research Department, London School of Hygiene and Tropical Medicine, London, UK.
Katherine FieldingTB Centre, London School of Hygiene & Tropical Medicine, London, UK.
Robin WoodInstitute of Infectious Disease and Molecular Medicine (IDM), Faculty of Health Sciences, University of Cape Town, Cape Town, South Africa.
Helena HuergaField Epidemiology Department, Epicentre, Paris, France.
Sekai Chenai Mathabire RückerField Epidemiology Department, Epicentre, Paris, France.
Stephanie BjerrumDepartment of Clinical Research, Infectious Diseases, University of Southern Denmark, Odense, Denmark.
Isik S JohansenResearch Unit for Infectious Diseases, Odense University Hospital, University of Southern Denmark, Odense, Denmark.
Swe Swe ThitDepartment of Medicine, University of Medicine 2, Yangon, Yangon Division, Myanmar.
Mar Mar KyiDepartment of Medicine, University of Medicine 2, Yangon, Yangon Division, Myanmar.
Josh HansonThe Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
David A BarrInstitute of Infection and Global Health, University of Liverpool, Liverpool, UK.
Graeme MeintjesDepartment of Medicine, University of Cape Town, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa.
Gary MaartensDepartment of Medicine, University of Cape Town, Cape Town, South Africa; Wellcome Centre for Infectious Diseases Research in Africa (CIDRI-Africa), Institute of Infectious Disease and Molecular Medicine, University of Cape Town, Cape Town, South Africa. Electronic address: gary.maartens@uct.ac.za.
University of Cape Town · ZAFIND · CHUniversity of Medicine 2 Yangon · MMUniversity of Southern Denmark · DKJapan Anti Tuberculosis Association · JPLondon School of Hygiene & Tropical Medicine · GBSan Francisco General Hospital · USSouth African Medical Research Council · ZAUniversity of Liverpool · GBUniversity of London · GBUNSW Sydney · AU

Funding

HIV-associated Tuberculosis Training Program (HATTP)D43TW010559 · FIC · UNIVERSITY OF CAPE TOWN · PI Graeme Ayton Meintjes · 2017 to 2026
$3.0M
FIC NIH HHS D43 TW010559Medical Research Council MR/M007375/1Wellcome TrustWellcome Trust 203135/Z/16/ZWellcome Trust 214321/Z/18/Z
6 · The paper itself

Abstract

backgroundWHO recommends urine lateral-flow lipoarabinomannan (LF-LAM) testing with AlereLAM in HIV-positive inpatients only if screening criteria are met. We assessed the performance of WHO screening criteria and alternative screening tests/strategies to guide LF-LAM testing and compared diagnostic accuracy of the WHO AlereLAM algorithm (WHO screening criteria followed by AlereLAM if screen positive) with AlereLAM and FujiLAM (a novel LF-LAM test) testing in all HIV-positive inpatients.

methodsWe searched MEDLINE, Embase, and Cochrane Library from Jan 1, 2011 to March 1, 2020 for studies among adult/adolescent HIV-positive inpatients regardless of tuberculosis signs and symptoms. The reference standards were (1) AlereLAM or FujiLAM for screening tests/strategies and (2) culture or Xpert for AlereLAM/FujiLAM. We determined proportion of inpatients eligible for AlereLAM using WHO screening criteria; assessed accuracy of WHO criteria and alternative screening tests/strategies to guide LF-LAM testing; compared accuracy of WHO AlereLAM algorithm with AlereLAM/FujiLAM testing in all; and determined diagnostic yield of AlereLAM, FujiLAM, and Xpert MTB/RIF (Xpert). We estimated pooled proportions with a random-effects model, assessed diagnostic accuracy using random-effects bivariate models, and assessed diagnostic yield descriptively.

findingsWe obtained data from all 5 identified studies (n = 3,504). The pooled proportion of inpatients eligible for AlereLAM using WHO criteria was 93% (95%CI 91, 95). Among screening tests/strategies to guide LF-LAM testing, WHO criteria, C-reactive protein (≥5 mg/L), and CD4 count (<200 cells/μL) had high sensitivities but low specificities; cough (≥2 weeks), hemoglobin (<8 g/dL), body mass index (<18.5 kg/m

interpretationWHO criteria and alternative screening tests/strategies have limited utility in guiding LF-LAM testing, suggesting that AlereLAM testing in all HIV-positive medical inpatients be implemented. Routine FujiLAM may improve tuberculosis diagnosis.

fundingNone.

Indexed as

HIV InfectionsHIV SeropositivityMycobacterium tuberculosisTuberculosisAdolescentAdultHumansInpatientsLipopolysaccharidesSensitivity and SpecificitySputumWorld Health OrganizationlipoarabinomannanLipopolysaccharidesDiagnosisHuman immunodeficiency virusInpatientLAMLipoarabinomannanScreeningSensitivitySpecificityTuberculosis

Identifiers

PMID35588942
PMCPMC10152564
OpenAlexW4280627477

What OpenQuestion holds

Textmetadata
LicenceTDM
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.