TY - JOUR
T1 - Diagnostic test accuracy of Xpert MTB/RIF for tuberculous pericarditis
T2 - A systematic review and meta-analysis
AU - Andrianto, Andrianto
AU - Mertaniasih, Ni Made
AU - Gandi, Parama
AU - Silahooij, Stevanus Immanuel
AU - Al-Farabi, Makhyan Jibril
AU - Azmi, Yusuf
AU - Jonatan, Michael
N1 - Funding Information:
This paper and the research behind it would not have been possible without the exceptional support of Faculty of Medicine Universitas Airlangga, Dr. Soetomo General Academic Hospital and Institute of Tropical Disease, Surabaya, Indonesia.
Funding Information:
Grant information: This work was supported by the Indonesian Endowment Fund for Education (Lembaga Pengelola Dana Pendidikan) [PRJ-1084/LPDP.3/2017; for S.I.S].
Publisher Copyright:
© 2020 Andrianto A et al.
PY - 2020
Y1 - 2020
N2 - Introduction: Xpert MTB/RIF is a rapid diagnostic instrument for pulmonary tuberculosis (TB). However, studies reported varied accuracy of Xpert MTB/RIF in detecting Mycobacterium tuberculosis in pericardial effusion. Methods: We performed a systematic review of literature in PubMed, published up to February 1, 2020, according to PRISMA guidelines. We screened cross-sectional studies, observational cohort studies, and randomized control trials that evaluated the accuracy of Xpert MTB/RIF in diagnosing TB pericarditis. Papers with noninterpretable results of sensitivity and specificity, non-English articles, and unpublished studies were excluded. The primary outcomes were the sensitivity and specificity of Xpert MTB/RIF. We conducted a quality assessment using QUADAS-2 to evaluate the quality of the studies. A bivariate model pooled the overall sensitivity, specificity, positive likelihood ratios (PLRs), and negative likelihood ratios (NLRs) of included studies. Results: In total, 581 subjects from nine studies were analyzed in this meta-analysis. Our pooled analysis showed that the overall sensitivity, specificity, PLRs and NLRs of included studies were 0.676 (95% CI: 0.580-0.759), 0.994 (95% CI: 0.919-1.000), 110.11 (95% CI: 7.65-1584.57) and 0.326 (95% CI: 0.246-0.433), respectively. Conclusions: Xpert MTB/RIF had a robust specificity but unsatisfactory sensitivity in diagnosing TB pericarditis. These findings indicated that although positive Xpert MTB/RIF test results might be valuable in swiftly distinguishing the diagnosis of TB pericarditis, negative test results might not be able to rule out TB pericarditis.
AB - Introduction: Xpert MTB/RIF is a rapid diagnostic instrument for pulmonary tuberculosis (TB). However, studies reported varied accuracy of Xpert MTB/RIF in detecting Mycobacterium tuberculosis in pericardial effusion. Methods: We performed a systematic review of literature in PubMed, published up to February 1, 2020, according to PRISMA guidelines. We screened cross-sectional studies, observational cohort studies, and randomized control trials that evaluated the accuracy of Xpert MTB/RIF in diagnosing TB pericarditis. Papers with noninterpretable results of sensitivity and specificity, non-English articles, and unpublished studies were excluded. The primary outcomes were the sensitivity and specificity of Xpert MTB/RIF. We conducted a quality assessment using QUADAS-2 to evaluate the quality of the studies. A bivariate model pooled the overall sensitivity, specificity, positive likelihood ratios (PLRs), and negative likelihood ratios (NLRs) of included studies. Results: In total, 581 subjects from nine studies were analyzed in this meta-analysis. Our pooled analysis showed that the overall sensitivity, specificity, PLRs and NLRs of included studies were 0.676 (95% CI: 0.580-0.759), 0.994 (95% CI: 0.919-1.000), 110.11 (95% CI: 7.65-1584.57) and 0.326 (95% CI: 0.246-0.433), respectively. Conclusions: Xpert MTB/RIF had a robust specificity but unsatisfactory sensitivity in diagnosing TB pericarditis. These findings indicated that although positive Xpert MTB/RIF test results might be valuable in swiftly distinguishing the diagnosis of TB pericarditis, negative test results might not be able to rule out TB pericarditis.
KW - Extrapulmonary TBC
KW - PCR
KW - Pericardial Effusion
KW - Xpert MTB/RIF
UR - http://www.scopus.com/inward/record.url?scp=85089772028&partnerID=8YFLogxK
U2 - 10.12688/f1000research.22770.1
DO - 10.12688/f1000research.22770.1
M3 - Review article
C2 - 32802321
AN - SCOPUS:85089772028
SN - 2046-1402
VL - 9
JO - F1000Research
JF - F1000Research
M1 - 761
ER -
