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Accuracy of the Bronchoalveolar Lavage Enzyme-Linked Immunospot Assay for the Diagnosis of Pulmonary Tuberculosis

View Article: PubMed Central - PubMed

ABSTRACT

Assessing of local immune response may improve the accuracy of pulmonary tuberculosis (PTB) diagnosis. Many studies have investigated diagnosing PTB based on enzyme-linked immunospot (ELISPOT) assay of bronchoalveolar lavage (BAL) fluid, but the results have been inconclusive. We meta-analyzed the available evidences on overall diagnostic performance of ELISPOT assay of BAL fluid for diagnosing PTB.

A systematic literature search was performed using PubMed, Embase, Wangfang, Weipu, and CNKI. Data were pooled on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Overall test performance was summarized using summary receiver operating characteristic curves and the area under the curve (AUC). Deeks test was used to test for potential publication bias.

Seven publications with 814 subjects met our inclusion criteria and were included in this meta-analysis. The following pooled estimates for diagnostic parameters were obtained: sensitivity, 0.90 (95% CI: 0.85–0.94); specificity, 0.80 (95% CI: 0.77–0.84); PLR, 5.08 (95% CI: 2.70–9.57); NLR, 0.13 (95% CI: 0.06–0.28); DOR, 49.12 (95% CI: 12.97–186.00); and AUC, 0.96. No publication bias was identified.

The available evidence suggests that ELISPOT assay of BAL fluid is a useful rapid diagnostic test for PTB. The results of this assay should be interpreted in parallel with clinical findings and the results of conventional tests.

No MeSH data available.


Related in: MedlinePlus

Funnel graph to assess risk of publication bias in studies of the bronchoalveolar lavage enzyme-linked immunospot assay. The funnel graph plots the log of the diagnostic odds ratio (DOR) against the standard error of the log of the DOR (an indicator of sample size). Solid circles represent each study in the meta-analysis. The regression line is shown.
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Figure 6: Funnel graph to assess risk of publication bias in studies of the bronchoalveolar lavage enzyme-linked immunospot assay. The funnel graph plots the log of the diagnostic odds ratio (DOR) against the standard error of the log of the DOR (an indicator of sample size). Solid circles represent each study in the meta-analysis. The regression line is shown.

Mentions: Deeks funnel plot asymmetry test was used to assess likelihood of publication bias. Although the funnel plots for publication bias showed some asymmetry due to the limited number of studies (Figure 6), the P value associated with Deeks test was not significant (Pā€Š=ā€Š0.48). This suggests symmetry in the data and low likelihood of publication bias.


Accuracy of the Bronchoalveolar Lavage Enzyme-Linked Immunospot Assay for the Diagnosis of Pulmonary Tuberculosis
Funnel graph to assess risk of publication bias in studies of the bronchoalveolar lavage enzyme-linked immunospot assay. The funnel graph plots the log of the diagnostic odds ratio (DOR) against the standard error of the log of the DOR (an indicator of sample size). Solid circles represent each study in the meta-analysis. The regression line is shown.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4998406&req=5

Figure 6: Funnel graph to assess risk of publication bias in studies of the bronchoalveolar lavage enzyme-linked immunospot assay. The funnel graph plots the log of the diagnostic odds ratio (DOR) against the standard error of the log of the DOR (an indicator of sample size). Solid circles represent each study in the meta-analysis. The regression line is shown.
Mentions: Deeks funnel plot asymmetry test was used to assess likelihood of publication bias. Although the funnel plots for publication bias showed some asymmetry due to the limited number of studies (Figure 6), the P value associated with Deeks test was not significant (Pā€Š=ā€Š0.48). This suggests symmetry in the data and low likelihood of publication bias.

View Article: PubMed Central - PubMed

ABSTRACT

Assessing of local immune response may improve the accuracy of pulmonary tuberculosis (PTB) diagnosis. Many studies have investigated diagnosing PTB based on enzyme-linked immunospot (ELISPOT) assay of bronchoalveolar lavage (BAL) fluid, but the results have been inconclusive. We meta-analyzed the available evidences on overall diagnostic performance of ELISPOT assay of BAL fluid for diagnosing PTB.

A systematic literature search was performed using PubMed, Embase, Wangfang, Weipu, and CNKI. Data were pooled on sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Overall test performance was summarized using summary receiver operating characteristic curves and the area under the curve (AUC). Deeks test was used to test for potential publication bias.

Seven publications with 814 subjects met our inclusion criteria and were included in this meta-analysis. The following pooled estimates for diagnostic parameters were obtained: sensitivity, 0.90 (95% CI: 0.85–0.94); specificity, 0.80 (95% CI: 0.77–0.84); PLR, 5.08 (95% CI: 2.70–9.57); NLR, 0.13 (95% CI: 0.06–0.28); DOR, 49.12 (95% CI: 12.97–186.00); and AUC, 0.96. No publication bias was identified.

The available evidence suggests that ELISPOT assay of BAL fluid is a useful rapid diagnostic test for PTB. The results of this assay should be interpreted in parallel with clinical findings and the results of conventional tests.

No MeSH data available.


Related in: MedlinePlus