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Free Content Diagnostic accuracy of interferon-gamma release assays for tuberculous meningitis: a meta-analysis

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OBJECTIVE: To evaluate the diagnostic accuracy of interferon-gamma release assays (IGRAs) for diagnosing tuberculous meningitis (TBM).

DESIGN: The EMBASE and PubMed databases were systematically searched to identify studies published by 2 May 2015 investigating the diagnostic accuracy of IGRA for TBM. The quality of the included studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) method. The overall diagnostic accuracies of an IGRA for cerebrospinal fluid (CSF) or blood were pooled using a bivariate model.

RESULTS: Eight studies using blood IGRA and 6 studies using CSF IGRA were included. The overall sensitivities for blood and CSF IGRA were respectively 0.78 and 0.77, and the specificities were 0.61 and 0.88. The areas under the summary receiver operating characteristic curves were respectively 0.76 and 0.83 for blood and CSF IGRA. The major design weaknesses of the studies included were patient selection bias and exclusion of uninterpretable results.

CONCLUSION: The diagnostic accuracy of blood and CSF IGRA in case of TBM is moderate.
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Keywords: diagnosis; meta-analysis; systematic review; tuberculous meningitis

Document Type: Research Article

Affiliations: 1: *Department of Pathology 2: Department of Physiology 3: Department of Pharmacy, Shandong Medical College, Shandong 4: §Department of Neurology, Provincial Hospital Affiliated to Shandong University, Ji'nan, China.

Publication date: April 1, 2016

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  • The International Journal of Tuberculosis and Lung Disease publishes articles on all aspects of lung health, including public health-related issues such as training programmes, cost-benefit analysis, legislation, epidemiology, intervention studies and health systems research. The IJTLD is dedicated to the continuing education of physicians and health personnel and the dissemination of information on tuberculosis and lung health world-wide.

    Certain IJTLD articles are selected for translation into French, Spanish, Chinese or Russian. They are available on the Union website

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