| Title |
Diagnostic accuracy of nucleic acid amplification tests (NAATs) in urine for genitourinary tuberculosis: a systematic review and meta-analysis
|
|---|---|
| Published in |
BMC Infectious Diseases, June 2017
|
| DOI | 10.1186/s12879-017-2476-8 |
| Pubmed ID | |
| Authors |
Carlos Altez-Fernandez, Victor Ortiz, Majid Mirzazadeh, Luis Zegarra, Carlos Seas, Cesar Ugarte-Gil |
| Abstract |
Genitourinary tuberculosis is the third most common form of extrapulmonary tuberculosis. Diagnosis is difficult because of unspecific clinical manifestations and low accuracy of conventional tests. Unfortunately, the delayed diagnosis impacts the urinary tract severely. Nucleic acid amplification tests yield fast results, and among these, new technologies can also detect drug resistance. There is lack of consensus regarding the use of these tests in genitourinary tuberculosis; we therefore aimed to assess the accuracy of nucleic acid amplification tests in the diagnosis of genitourinary tuberculosis and to evaluate the heterogeneity between studies. We did a systematic review and meta-analysis of research articles comparing the accuracy of a reference standard and a nucleic acid amplification test for diagnosis of urinary tract tuberculosis. We searched Medline, EMBASE, Web of Science, LILACS, Cochrane Library, and Scopus for articles published between Jan 1, 1990, and Apr 14, 2016. Two investigators identified eligible articles and extracted data for individual study sites. We analyzed data in groups with the same index test. Then, we generated pooled summary estimates (95% CIs) for sensitivity and specificity by use of random-effects meta-analysis when studies were not heterogeneous. We identified eleven relevant studies from ten articles, giving information on PCR, LCR and Xpert MTB/RIF tests. All PCR studies were "in-house" tests, with different gene targets and had several quality concerns therefore we did not proceed with a pooled analysis. Only one study used LCR. Xpert studies were of good quality and not heterogeneous, pooled sensitivity was 0·87 (0·66-0·96) and specificity was 0·91 (0·84-0·95). PCR studies were highly heterogeneous. Among Xpert MTB/RIF studies, specificity was favorable with an acceptable confidence interval, however new studies can update meta-analysis and get more precise estimates. Further high-quality studies are urgently needed to improve diagnosis of genitourinary tuberculosis. PROSPERO CRD42016039020. |
X Demographics
The data shown below were collected from the profiles of 8 X users who shared this research output. Click here to find out more about how the information was compiled.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 1 | 13% |
| Venezuela, Bolivarian Republic of | 1 | 13% |
| Unknown | 6 | 75% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 4 | 50% |
| Scientists | 3 | 38% |
| Practitioners (doctors, other healthcare professionals) | 1 | 13% |
Mendeley readers
The data shown below were compiled from readership statistics for 80 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 80 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Researcher | 13 | 16% |
| Student > Ph. D. Student | 10 | 13% |
| Student > Master | 10 | 13% |
| Student > Bachelor | 6 | 8% |
| Student > Postgraduate | 4 | 5% |
| Other | 13 | 16% |
| Unknown | 24 | 30% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 35 | 44% |
| Biochemistry, Genetics and Molecular Biology | 4 | 5% |
| Nursing and Health Professions | 3 | 4% |
| Immunology and Microbiology | 3 | 4% |
| Arts and Humanities | 2 | 3% |
| Other | 6 | 8% |
| Unknown | 27 | 34% |
Attention Score in Context
This research output has an Altmetric Attention Score of 4. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 29 September 2017.
All research outputs
#6,478,886
of 22,977,819 outputs
Outputs from BMC Infectious Diseases
#2,031
of 7,715 outputs
Outputs of similar age
#104,538
of 317,195 outputs
Outputs of similar age from BMC Infectious Diseases
#51
of 169 outputs
Altmetric has tracked 22,977,819 research outputs across all sources so far. This one has received more attention than most of these and is in the 70th percentile.
So far Altmetric has tracked 7,715 research outputs from this source. They typically receive more attention than average, with a mean Attention Score of 9.7. This one has gotten more attention than average, scoring higher than 72% of its peers.
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We're also able to compare this research output to 169 others from the same source and published within six weeks on either side of this one. This one has gotten more attention than average, scoring higher than 68% of its contemporaries.