Diagnostic accuracy of the Xpert® MTB/RIF cycle threshold level to predict smear positivity: a meta-analysis

Simple item page
dc.contributor.authorLange, B
dc.contributor.authorKhan, P
dc.contributor.authorKalmambetova, G
dc.contributor.authorAl-Darraji, HA
dc.contributor.authorAlland, D
dc.contributor.authorAntonenka, U
dc.contributor.authorBrown, T
dc.contributor.authorBalcells, ME
dc.contributor.authorBlakemore, R
dc.contributor.authorDenkinger, CM
dc.contributor.authorDheda, K
dc.contributor.authorHoffmann, H
dc.contributor.authorKadyrov, A
dc.contributor.authorLemaitre, N
dc.contributor.authorMiller, MB
dc.contributor.authorNikolayevskyy, V
dc.contributor.authorNtinginya, EN
dc.contributor.authorOzkutuk, N
dc.contributor.authorPalacios, JJ
dc.contributor.authorPopowitch, EB
dc.contributor.authorPorcel, JM
dc.contributor.authorTeo, J
dc.contributor.authorTheron, G
dc.contributor.authorKranzer, K
dc.date.accessioned2024-07-18T12:08:35Z
dc.date.available2024-07-18T12:08:35Z
dc.description.abstractSETTING: Xpert (R) MTB/RIF is the most widely used molecular assay for rapid diagnosis of tuberculosis (TB). The number of polymerase chain reaction cycles after which detectable product is generated (cycle threshold value, C-T) correlates with the bacillary burden. OBJECTIVE: To investigate the association between Xpert C-T values and smear status through a systematic review and individual-level data meta-analysis. DESIGN: Studies on the association between C-T values and smear status were included in a descriptive systematic review. Authors of studies including smear, culture and Xpert results were asked for individual-level data, and receiver operating characteristic curves were calculated. RESULTS: Of 918 citations, 10 were included in the descriptive systematic review. Fifteen data sets from studies potentially relevant for individual-level data meta-analysis provided individual-level data (7511 samples from 4447 patients); 1212 patients had positive Xpert results for at least one respiratory sample (1859 samples overall). ROC analysis revealed an area under the curve (AUC) of 0.85 (95%CI 0.82-0.87). Cut-off C-T values of 27.7 and 31.8 yielded sensitivities of 85% (95%CI 83-87) and 95% (95%C1 94-96) and specificities of 67% (95%CI 66-77) and 35% (95%CI 30-41) for smear-positive samples. CONCLUSION: Xpert CT values and smear status were strongly associated. However, diagnostic accuracy at set cut-off C-T values of 27.7 or 31.8 would not replace smear microscopy. How C-T values compare with smear microscopy in predicting infectiousness remains to be seen.
dc.identifier.issn1027-3719
dc.identifier.other1815-7920
dc.identifier.urihttp://akademikarsiv.cbu.edu.tr:4000/handle/123456789/10990
dc.language.isoEnglish
dc.publisherINT UNION AGAINST TUBERCULOSIS LUNG DISEASE (I U A T L D)
dc.subjectACID AMPLIFICATION ASSAYS
dc.subjectREAL-TIME PCR
dc.subjectMYCOBACTERIUM-TUBERCULOSIS
dc.subjectPERFORMANCE
dc.subjectPULMONARY
dc.subjectTRANSMISSION
dc.subjectSPECIMENS
dc.subjectBIOMARKER
dc.subjectLOAD
dc.titleDiagnostic accuracy of the Xpert® MTB/RIF cycle threshold level to predict smear positivity: a meta-analysis
dc.typeArticle

Files

Collections

Web of Science Koleksiyonu