ArticleBMC pulmonary medicine2025
Diagnostic performance of adenosine deaminase activity in pleural fluid in tuberculous pleural effusion and relevant factors: a single-center experience with 1,491 consecutive patients.
Article in BMC pulmonary medicine, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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.
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.
Who cites it
3 citing papers in PubMed.
- Development and validation of a diagnostic model for malignant pleural effusion based on random forest.Journal of thoracic disease · 2026Article
- Article
- Role of CBNAAT and ADA in tubercular pleural effusion diagnosis at BMGMC hospital.Bioinformation · 2026Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors.
Funding
Abstract
objectiveAdenosine deaminase (ADA) is a widely-used diagnostic test for tuberculous pleural effusion (TPE), but its accuracy, optimal diagnostic threshold and relevant factors are controversial or unclear. We aimed to reassess these diagnostic variables in a large single center series.
methodThis retrospective study included 1,491 TPE patients and 597 malignant pleural effusion patients seen between 2012 and 2019. Receiver operating characteristic curve (ROC) and multivariate logistic regression analysis were performed for the diagnostic performance and relevant factors of ADA.
resultsThe AUC for ADA was 0.952 (95%CI: 0.942—0.961; p = 0.000) in discrimination of TPE from malignant pleural effusion, with an optimal cut-off value of 26.6 IU/L. While levels > 35 IU/L showed high specificity (97.0%), the significant 20–35 IU/L overlap underscores the need for integrated diagnostic approaches in this gray zone. The accuracy of ADA was significantly correlated with age (OR = 0.97; 95% CI: 0.95–0.99; p = 0.0066), pleural monocyte ratio (OR = 1.02; 95% CI: 1.00–1.04; p = 0.0346) and CD45+ relative count (OR = 0.942; 95% CI: 0.90–0.99; p = 0.015).
conclusionPleural ADA had good accuracy in the diagnosis of TPE. Age, pleural monocyte ratio and CD45+ relative count may affect pleural fluid ADA accuracy, therefore, ADA results should be interpreted with caution in patients aged > 80 years or with a pleural monocyte ratio < 60%. Moreover, for pleural effusions with ADA 20–35 IU/L, combined diagnostic approaches are superior to fixed cutoffs.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
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.