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Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis
by
Dhooria, Sahajal
, Aggarwal, Ashutosh Nath
, Sehgal, Inderpaul Singh
, Agarwal, Ritesh
in
Accuracy
/ Adenosine
/ Adenosine deaminase
/ Adenosine Deaminase - analysis
/ Analysis
/ Animals
/ Bias
/ Biology and Life Sciences
/ Biopsy
/ Bivariate analysis
/ Clinical decision making
/ Decision making
/ Diagnosis
/ Diagnostic systems
/ Diagnostic tests
/ English language
/ Female
/ Humans
/ Male
/ Medical diagnosis
/ Medical research
/ Medical tests
/ Medicine
/ Medicine and Health Sciences
/ Meta-analysis
/ Patients
/ Physical Sciences
/ Pleural effusion
/ Pleural Effusion - diagnosis
/ Pleural Effusion - enzymology
/ Pleural fluid
/ Research and Analysis Methods
/ Sensitivity
/ Systematic review
/ Tuberculosis
/ Tuberculosis, Pleural - pathology
2019
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Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis
by
Dhooria, Sahajal
, Aggarwal, Ashutosh Nath
, Sehgal, Inderpaul Singh
, Agarwal, Ritesh
in
Accuracy
/ Adenosine
/ Adenosine deaminase
/ Adenosine Deaminase - analysis
/ Analysis
/ Animals
/ Bias
/ Biology and Life Sciences
/ Biopsy
/ Bivariate analysis
/ Clinical decision making
/ Decision making
/ Diagnosis
/ Diagnostic systems
/ Diagnostic tests
/ English language
/ Female
/ Humans
/ Male
/ Medical diagnosis
/ Medical research
/ Medical tests
/ Medicine
/ Medicine and Health Sciences
/ Meta-analysis
/ Patients
/ Physical Sciences
/ Pleural effusion
/ Pleural Effusion - diagnosis
/ Pleural Effusion - enzymology
/ Pleural fluid
/ Research and Analysis Methods
/ Sensitivity
/ Systematic review
/ Tuberculosis
/ Tuberculosis, Pleural - pathology
2019
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Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis
by
Dhooria, Sahajal
, Aggarwal, Ashutosh Nath
, Sehgal, Inderpaul Singh
, Agarwal, Ritesh
in
Accuracy
/ Adenosine
/ Adenosine deaminase
/ Adenosine Deaminase - analysis
/ Analysis
/ Animals
/ Bias
/ Biology and Life Sciences
/ Biopsy
/ Bivariate analysis
/ Clinical decision making
/ Decision making
/ Diagnosis
/ Diagnostic systems
/ Diagnostic tests
/ English language
/ Female
/ Humans
/ Male
/ Medical diagnosis
/ Medical research
/ Medical tests
/ Medicine
/ Medicine and Health Sciences
/ Meta-analysis
/ Patients
/ Physical Sciences
/ Pleural effusion
/ Pleural Effusion - diagnosis
/ Pleural Effusion - enzymology
/ Pleural fluid
/ Research and Analysis Methods
/ Sensitivity
/ Systematic review
/ Tuberculosis
/ Tuberculosis, Pleural - pathology
2019
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Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis
Journal Article
Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis
2019
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Overview
Pleural fluid adenosine deaminase (ADA) is a useful diagnostic test for tuberculous pleural effusion (TPE), but its exact threshold and accuracy in clinical decision-making is unclear. We aimed to assess diagnostic performance of ADA in TPE and to clarify its optimal diagnostic threshold.
We searched PubMed, Embase, and Cochrane Library databases for articles indexed up to October 2018. We included English language studies that provided both sensitivity and specificity of ADA in TPE diagnosis. Summary estimates for sensitivity and specificity were obtained through bivariate random effects model, both overall and at prespecified threshold ranges of <36, 40±4, 45-65 and >65 IU/L.
We retrieved 2162 citations, and included 174 publications with 27009 patients. All studies showed high risk of bias. Summary sensitivity, specificity and diagnostic odds ratio estimates were 0.92 (95% CI 0.90-0.93), 0.90 (95% CI 0.88-0.91) and 97.42 (95% CI 74.90-126.72) respectively. 65 studies with ADA threshold of 40±4 IU/L showed summary sensitivity and specificity of 0.93 (95% CI 0.90-0.95) and 0.90 (95% CI 0.87-0.91) respectively. Four studies with ADA threshold >65 IU/L showed summary sensitivity and specificity of 0.86 (95% CI 0.61-0.96) and 0.94 (95% CI 0.80-0.99) respectively.
ADA levels in pleural fluid show good diagnostic accuracy in diagnosis of TPE; however, all included studies showed high risk of bias. It was not possible to derive any firm inference on relative clinical utility of different diagnostic thresholds.
Publisher
Public Library of Science,Public Library of Science (PLoS)
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