Evidence map›Paper›PMID 36661222›Full record

SynthesisThe Journal of infectious diseases2023

Underascertainment of Respiratory Syncytial Virus Infection in Adults Due to Diagnostic Testing Limitations: A Systematic Literature Review and Meta-analysis.

Chukwuemeka Onwuchekwa, Laura Mora Moreo, Sonia Menon, Belen Machado, Daniel Curcio, Warren Kalina, Jessica E Atwell, Bradford D Gessner, Mariana Siapka, Neha Agarwal and 6 more

Open access · hybridAbstract readSystematic ReviewMeta-Analysis
PubMed Full text at PMC Publisher
In one paragraph

Synthesis in The Journal of infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 126 papers, 9 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
126citing papers in PubMed, 9 pooled it
37.5field-weighted citation impact, top 1% 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

126 citing papers in PubMed, 9 syntheses or guidelines pooled it, 176 citations in OpenAlex.

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66 more citing papers are in PubMed but not listed here.

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

16 authors at 3 institutions in 3 countries.

Chukwuemeka OnwuchekwaP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Laura Mora MoreoP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Sonia MenonP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Belen MachadoP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Daniel CurcioPfizer Vaccine, Ireland.
Warren KalinaPfizer Vaccine, Ireland.
Jessica E AtwellPfizer Vaccine, Ireland.
Bradford D GessnerPfizer Vaccine, Ireland.
Mariana SiapkaP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Neha AgarwalP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Michelle RubbrechtP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Harish NairUsher Institute, University of Edinburgh, Edinburgh, United Kingdom.ORCID 0000-0002-9432-9100
Mark RozenbaumPfizer Inc, Capelle aan den Ijssel, The Netherlands.
Zuleika Aponte-TorresP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Hilde VrolingP95 Epidemiology and Pharmacovigilance, Leuven, Belgium.
Elizabeth BegierPfizer Vaccine, Ireland.ORCID 0000-0002-1287-5416
Pfizer (Ireland) · IEPfizer (Netherlands) · NLUniversity of Edinburgh · GB

Funding

Pfizer Inc
6 · The paper itself

Abstract

backgroundMost observational population-based studies identify respiratory syncytial virus (RSV) by nasal/nasopharyngeal swab reverse transcriptase real-time PCR (RT-PCR) only. We conducted a systematic review and meta-analyses to quantify specimen and diagnostic testing-based underascertainment of adult RSV infection.

methodsEMBASE, PubMed, and Web of Science were searched (January 2000-December 2021) for studies including adults using/comparing >1 RSV testing approach. We quantified test performance and RSV detection increase associated with using multiple specimen types.

resultsAmong 8066 references identified, 154 met inclusion. Compared to RT-PCR, other methods were less sensitive: rapid antigen detection test (RADT; pooled sensitivity, 64%), direct fluorescent antibody (DFA; 83%), and viral culture (86%). Compared to singleplex PCR, multiplex PCR's sensitivity was lower (93%). Compared to nasal/nasopharyngeal swab RT-PCR alone, adding another specimen type increased detection: sputum RT-PCR, 52%; 4-fold rise in paired serology, 44%; and oropharyngeal swab RT-PCR, 28%. Sensitivity was lower in estimates limited to only adults (for RADT, DFA, and viral culture), and detection rate increases were largely comparable.

conclusionsRT-PCR, particularly singleplex testing, is the most sensitive RSV diagnostic test in adults. Adding additional specimen types to nasopharyngeal swab RT-PCR testing increased RSV detection. Synergistic effects of using ≥3 specimen types should be assessed, as this approach may improve the accuracy of adult RSV burden estimates.

Indexed as

Respiratory Syncytial Virus, HumanRespiratory Syncytial Virus InfectionsAdultDiagnostic Techniques and ProceduresHumansNasopharynxReverse Transcriptase Polymerase Chain ReactionSensitivity and Specificityadultsdiagnosisepidemiologyrespiratory syncytial virus infectionssensitivity and specificity

Identifiers

PMID36661222
PMCPMC10345483
OpenAlexW4317567014

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.