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Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy

View Article: PubMed Central - PubMed

ABSTRACT

Background:: The diagnosis of tuberculous pleurisy is difficult and traditional methods are not always helpful. Many studies have focused on the tumor necrosis factor-alpha (TNF-α) assay in pleural effusion for the diagnosis of tuberculous pleurisy, but the results remain controversial. This meta-analysis was conducted to determine the overall diagnostic accuracy of TNF-α.

Methods:: Relevant studies were searched from PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wangfang, and Weipu. We pooled the published results and computed the accuracy measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Receiver operating characteristic curves (SROC) and the area under the curve (AUC) were used to summarize the overall test performance.

Results:: Twelve studies with 1022 patients met the inclusion criteria. The pooled sensitivity and specificity were 0.85 (95%CI, 0.81–0.89) and 0.80 (95% CI, 0.77–0.83) respectively. The area under the SROC curve was 0.89.

Conclusions:: The results of meta-analysis suggested that the TNF-α assay plays a vital role in the diagnosis of tuberculous pleurisy, whereas other test results or clinical findings should be interpreted together with the TNF-α assay to improve the overall diagnostic accuracy.

No MeSH data available.


Related in: MedlinePlus

Forest plots of sensitivity and specificity for TNF-α assay for the diagnosis of TPE. The point estimates of sensitivity and specificity from each study are shown as solid circles. Error bars indicate 95% CI. CI = confidence interval, TNF-α = tumor necrosis factor-alpha, TPE = tuberculous pleural effusion.
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Figure 3: Forest plots of sensitivity and specificity for TNF-α assay for the diagnosis of TPE. The point estimates of sensitivity and specificity from each study are shown as solid circles. Error bars indicate 95% CI. CI = confidence interval, TNF-α = tumor necrosis factor-alpha, TPE = tuberculous pleural effusion.

Mentions: The forest plots of sensitivity and specificity of TNF-α test for the diagnosis of TP are shown in Fig. 3. The sensitivity varied between 0.71 and 0.96 (pooled 0.85, 95% CI, 0.81–0.89), whereas specificity ranged from 0.63 to 0.93 (pooled 0.80, 95% CI, 0.77–0.83). The PLR was 4.12 (95% CI, 3.07–5.53), the NLR was 0.20 (95% CI, 0.15–0.27), and the DOR was 21.93 (95% CI, 12.85–37.43). The I2 values of sensitivity, specificity, PLR, NLR, and DOR were 13.4%, 66.5%, 67.1%, 33.4%, and 52.7% respectively. So the overall sensitivity and NLR were pooled by the mixed-effects model (I2 < 50%), and the others were pooled by the random-effects model to perform the analysis because the heterogeneity across studies showed significant difference (P < 0.05, I2 > 50%).


Diagnostic accuracy of tumor necrosis factor-alpha assay for tuberculous pleurisy
Forest plots of sensitivity and specificity for TNF-α assay for the diagnosis of TPE. The point estimates of sensitivity and specificity from each study are shown as solid circles. Error bars indicate 95% CI. CI = confidence interval, TNF-α = tumor necrosis factor-alpha, TPE = tuberculous pleural effusion.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5134804&req=5

Figure 3: Forest plots of sensitivity and specificity for TNF-α assay for the diagnosis of TPE. The point estimates of sensitivity and specificity from each study are shown as solid circles. Error bars indicate 95% CI. CI = confidence interval, TNF-α = tumor necrosis factor-alpha, TPE = tuberculous pleural effusion.
Mentions: The forest plots of sensitivity and specificity of TNF-α test for the diagnosis of TP are shown in Fig. 3. The sensitivity varied between 0.71 and 0.96 (pooled 0.85, 95% CI, 0.81–0.89), whereas specificity ranged from 0.63 to 0.93 (pooled 0.80, 95% CI, 0.77–0.83). The PLR was 4.12 (95% CI, 3.07–5.53), the NLR was 0.20 (95% CI, 0.15–0.27), and the DOR was 21.93 (95% CI, 12.85–37.43). The I2 values of sensitivity, specificity, PLR, NLR, and DOR were 13.4%, 66.5%, 67.1%, 33.4%, and 52.7% respectively. So the overall sensitivity and NLR were pooled by the mixed-effects model (I2 < 50%), and the others were pooled by the random-effects model to perform the analysis because the heterogeneity across studies showed significant difference (P < 0.05, I2 > 50%).

View Article: PubMed Central - PubMed

ABSTRACT

Background:: The diagnosis of tuberculous pleurisy is difficult and traditional methods are not always helpful. Many studies have focused on the tumor necrosis factor-alpha (TNF-&alpha;) assay in pleural effusion for the diagnosis of tuberculous pleurisy, but the results remain controversial. This meta-analysis was conducted to determine the overall diagnostic accuracy of TNF-&alpha;.

Methods:: Relevant studies were searched from PubMed, Embase, Web of Science, Chinese National Knowledge Infrastructure (CNKI), Wangfang, and Weipu. We pooled the published results and computed the accuracy measures, including sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), and diagnostic odds ratio (DOR). Receiver operating characteristic curves (SROC) and the area under the curve (AUC) were used to summarize the overall test performance.

Results:: Twelve studies with 1022 patients met the inclusion criteria. The pooled sensitivity and specificity were 0.85 (95%CI, 0.81&ndash;0.89) and 0.80 (95% CI, 0.77&ndash;0.83) respectively. The area under the SROC curve was 0.89.

Conclusions:: The results of meta-analysis suggested that the TNF-&alpha; assay plays a vital role in the diagnosis of tuberculous pleurisy, whereas other test results or clinical findings should be interpreted together with the TNF-&alpha; assay to improve the overall diagnostic accuracy.

No MeSH data available.


Related in: MedlinePlus