A meta-analysis of the accuracy of Xpert MTB/RIF in diagnosing intestinal tuberculosis.

Laboratory medicine Pub Date : 2024-03-07 DOI:10.1093/labmed/lmad072

Yuan-Lin Ding, Rui-Chao Yan, Hao-Kai Chen, Xu-Guang Guo

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Abstract

Objective: A detection method with high efficiency and accuracy is urgently needed in clinical work. The purpose of our study was to determine the diagnostic accuracy of the Xpert MTB/RIF assay for intestinal tuberculosis (ITB).

Methods: We searched PubMed and 4 other databases from their establishment to July 19, 2022, for published essays of diagnostic performance in which Xpert MTB/RIF was used to test patients with clinically suspected ITB. An assessment of the quality of the selected literature was conducted using QUADAS-2. We built forest plots by MetaDiSc software.

Results: The pooled Xpert MTB/RIF sensitivity was 48%, and the specificity was 99%. Moreover, the positive likelihood ratio for ITB diagnosis was 21.61. The negative likelihood ratio was 0.54. There were substantial variations between the study estimates of sensitivity (I2 = 87.6%) and specificity (I2 = 82.4%).

Conclusion: Intestinal TB is detected with limited diagnostic sensitivity by Xpert MTB/RIF but with high specificity. An Xpert-positive result may facilitate the rapid identification of ITB cases. Nevertheless, a negative result has less certainty in excluding the disease.

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Xpert MTB/RIF 诊断肠结核准确性的荟萃分析。

目的：临床工作迫切需要一种高效、准确的检测方法。我们的研究旨在确定 Xpert MTB/RIF 检测法对肠结核（ITB）的诊断准确性：方法：我们检索了 PubMed 和其他 4 个数据库从建立到 2022 年 7 月 19 日期间发表的有关 Xpert MTB/RIF 用于检测临床疑似 ITB 患者的诊断结果的文章。我们使用 QUADAS-2 对所选文献的质量进行了评估。我们使用 MetaDiSc 软件绘制了森林图：汇总的 Xpert MTB/RIF 敏感性为 48%，特异性为 99%。此外，ITB 诊断的阳性似然比为 21.61。阴性似然比为 0.54。各研究对灵敏度（I2 = 87.6%）和特异度（I2 = 82.4%）的估计值存在很大差异：结论：Xpert MTB/RIF 检测肠结核的诊断灵敏度有限，但特异性很高。Xpert 阳性结果有助于快速识别肠结核病例。然而，阴性结果在排除该疾病方面的确定性较低。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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Laboratory medicine

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