Evidence map›Paper›PMID 37005928›Full record

ArticleEuropean spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society2023

Utility of clinicoradiological, microbiological, histopathological, and molecular methods in the diagnosis of spinal tuberculosis.

Akash Jain, Pankaj Kandwal, Bhaskar Sarkar, Samarth Mittal, Vanya Singh, Vishal Verma, Vikas Maheshwari

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Article in European spine journal : official publication of the European Spine Society, the European Spinal Deformity Society, and the European Section of the Cervical Spine Research Society, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 1 pooled it
3.2field-weighted citation impact, top 8% 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

7 citing papers in PubMed, 1 synthesis or guideline pooled it, 10 citations in OpenAlex.

  1. Pooled it
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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

7 authors at 3 institutions in 1 country.

Akash JainDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID http://orcid.org/0000-0001-9445-6452
Pankaj KandwalDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India. pankajkandwal27@gmail.com.ORCID http://orcid.org/0000-0002-8801-6909
Bhaskar SarkarDepartment of Trauma Surgery, All, India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID http://orcid.org/0000-0002-1317-534X
Samarth MittalBLK MAX Superspeciality Hospital, Rajinder Nagar, New Delhi, Delhi, India.ORCID http://orcid.org/0000-0002-3677-8610
Vanya SinghMax Healthcare Dehradun, Dehradun, India.ORCID http://orcid.org/0000-0002-5537-2499
Vishal VermaDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.
Vikas MaheshwariDepartment of Orthopaedics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.ORCID http://orcid.org/0000-0002-8631-6334
All India Institute of Medical Sciences Rishikesh · INBLK Super Speciality Hospital · INMax Healthcare · IN

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe diagnosis of STB is mainly based on clinicoradiological observations substantiated by bacterial culture, staining, Gene Xpert, and histopathology. The purpose of the study was to correlate these methods to evaluate the effectiveness in the diagnosis of STB.

methodsA total of 178 clinicoradiologically suspected cases of STB were included in the study. The specimens for diagnostic workup were collected either during surgery or by CT-guided biopsy. All these specimens were tested for tuberculosis through ZN staining, solid culture, histopathology, and PCR. The sensitivity, specificity, PPV, and NPV of each test were calculated using histopathology as a gold standard.

resultsOut of the 178 cases, a total of 15 cases were excluded from this study. Among the remaining 163 cases, TB was diagnosed in 143 [87.73%] on histopathology, 130 [79.75%] on Gene Xpert, 40 [24.53%] on culture, and 23 [14.11%] on ZN stain. The sensitivity, specificity, PPV, and NPV of Gene Xpert were 86.71, 70, 95.38, and 42.42%, respectively. The sensitivity, specificity, PPV, and NPV of AFB culture were 27.97, 100, 100, and 16.26%, respectively. The sensitivity, specificity, PPV, and NPV of AFB stain were 16.08, 100, 100, and 14.29%, respectively. Gene Xpert showed a moderate agreement [Ƙc = 0.4432] with histopathology.

conclusionNo single diagnostic modality can ascertain the diagnosis, and it is desirable to have a combination of diagnostic batteries for better results. A combination of Gene Xpert and histopathology aids in early and reliable diagnosis of STB.

Indexed as

Mycobacterium tuberculosisTuberculosis, SpinalHumansPolymerase Chain ReactionRifampinSensitivity and SpecificityRifampinCultureDiagnosisGene XpertPott’s spineSpinal tuberculosis

Identifiers

PMID37005928
OpenAlexW4362506580

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Registered trials

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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.