Diagnostic accuracy of interferon gamma-induced protein 10 for tuberculosis: a meta-analysis.

The diagnostic accuracy of tuberculosis (TB) remains a clinical challenge, and a number of studies have used the interferon gamma-induced protein 10 (IP-10) in the diagnosis of TB. The aim of the present meta-analysis was to determine the overall accuracy of IP-10 in the diagnosis of TB. A systematic review of studies published in English from Medline, Embase and Cochrane Library was conducted and the data concerning the accuracy of IP-10 in the diagnosis of TB were pooled. The methodological quality of each study was assessed by QUADAS (quality assessment for studies of diagnostic accuracy). Statistical analysis was performed by employing Meta-Disc 1.4 soft-ware and STATA. The overall test performance was summarized using receiver operating characteristic curves. 14 studies, based on 2075 subjects, met the inclusion criteria. The summary estimates for IP-10 in the diagnosis of TB were: sensitivity 0.73 (95% CI, 0.71-0.76), specificity 0.83 (95% CI, 0.81-0.86), positive likelihood ratio 7.08 (95% CI, 3.94-12.72), negative likelihood ratio 0.26 (95% CI, 0.20-0.35) and diagnostic odds ratio 29.50 (95% CI, 14.43-60.30), and the area under the curve was 0.88. Our findings suggest that IP-10 may improve the accuracy of TB diagnosis, while the results of IP-10 assays should be interpreted in parallel with conventional test results and other clinical findings.

Diagnostic performance of lung ultrasound in the diagnosis of pneumonia: a bivariate meta-analysis.

BACKGROUND AND OBJECTIVE: Pneumonia is a common disease with both high morbidity and mortality, the diagnosis of pneumonia remains a clinical challenge. Many studies have been conducted to identify the usefulness of lung ultrasound for the diagnosis of pneumonia, but with inconsistent and inconclusive results. The present study aimed to establish the overall diagnostic accuracy of lung ultrasound in diagnosing pneumonia. METHODS: Based on a comprehensive search of the Pubmed, Embase, and the Cochrane database, we identified out-come data from all articles estimating diagnostic accuracy with lung ultrasound for pneumonia. Quality was assessed with the Quality Assessment for Diagnostic Accuracy Studies. Results from different studies were pooled using a bivariate meta-analysis. Summary receiver operating characteristic curve was used to assess the overall performance of lung ultrasound-based assays. RESULTS: Nine studies containing 1080 subjects were included in this meta-analysis. The summary estimates for lung ultrasound in the diagnosis of pneumonia in the studies included were as follows: sensitivity, 0.97 (95% CI: 0.93-0.99); specificity, 0.94 (95% CI: 0.85-0.98); DOR, 507.99 (95% CI: 128.11-2014.34); positive likelihood ratio, 15.62 (95% CI: 6.31-38.68); negative likelihood ratio, 0.03 (95% CI: 0.01-0.08); The area under the summary receiver operating characteristic curve was 0.99 (95% CI: 0.98-1.00). CONCLUSION: Lung ultrasound is a capable of diagnosing pneumonia with high accuracy and is a promising attractive alternative to chest radiography and thoracic CT scan.

Diagnostic accuracy of adenosine deaminase for tuberculous peritonitis: a meta-analysis.

INTRODUCTION: Tuberculous peritonitis remains a diagnostic challenge for clinicians. Many studies have investigated the usefulness of adenosine deaminase (ADA) in ascites for the diagnosis of tuberculous peritonitis; however, the overall diagnostic accuracy of ADA for tuberculous peritonitis remains unclear. The aim of the present meta-analysis was to determine the overall accuracy of ADA measurements in the diagnosis of tuberculous peritonitis. MATERIAL AND METHODS: We performed a systematic search in PubMed and Embase to identify published studies that evaluated the diagnostic role of ADA for tuberculous peritonitis. Quality was assessed according to standardized Quality Assessment of Diagnostic Accuracy Studies criteria. Sensitivity, specificity and other measures of accuracy of ADA assay in order to diagnose tuberculous peritonitis were pooled using random effects models. Summary receiver operating characteristic curve (SROC) was used to summarize overall test performance. RESULTS: Sixteen studies met inclusion criteria for the present meta-analysis. The pooled sensitivity and specificity for diagnosing tuberculous peritonitis were 0.93 (95% CI: 0.89-0.95) and 0.96 (95% CI: 0.94-0.97), respectively. The positive likelihood ratio was 15.80 (95% CI: 10.87-22.95), negative likelihood ratio was 0.09 (95% CI: 0.05-0.16) and diagnostic odds ratio was 249.28 (95% CI: 113.11-549.39). The area under the SROC was 0.98. CONCLUSIONS: Ascitic ADA determination is a relatively sensitive and specific test for the diagnosis of tuberculous peritonitis. Measurement of ADA in ascites is thus likely to be a useful diagnostic method for tuberculous peritonitis.

The 2518 A/G polymorphism in the MCP-1 gene and cancer risk: a meta-analysis.

BACKGROUND: The 2518 A/G polymorphism in the MCP-1 gene has been extensively studied for associations with cancer; however, results from replication studies have been inconsistent. The aim of this investigation was to determine links with risk of cancer by meta-analysis. METHODS: We searched Pubmed, Embase, CNKI, Weipu and Wanfang databases, covering all case-control studies until March, 2013. Statistical analyses were performed using the Revman 5.0 software. RESULTS: A total of 11 case-control studies met our inclusion criteria, including 1,422 cases and 2,237 controls. The results indicated that the MCP-1 2518 gene polymorphism had no association with cancer risk overall (GG vs.GA+ AA: OR = 0.89, 95%CI = 0.61-1.28, P = 0.52). However, in the subgroup analysis by ethnicity, a decrease of cancer risk was found in Asian populations (GG vs.GA+ AA: OR = 0.79, 95%CI = 0.63-0.99, P = 0.04). CONCLUSION: This meta-analysis suggested that the 2518A/G polymorphism of MCP-1 gene is associated with risk of cancer among Asian, but not in Caucasian populations.

Diagnostic accuracy of neutrophil CD64 expression in neonatal infection: a meta-analysis.

OBJECTIVE: The aim of the present study was to establish the predictive values of neutrophil CD64 expression in diagnosing neonatal infection. METHODS: A comprehensive search of the PubMed and Embase® literature databases identified outcome data from published studies estimating the diagnostic accuracy of neutrophil CD64 expression for neonatal infection. Summary estimates for sensitivity, specificity, diagnostic odds ratios (DOR) and the area under the summary receiver operating characteristic curve (AUC) were calculated using a bivariate random-effects approach. RESULTS: Twelve studies including 1915 neonates were analysed. Summary estimates (95% confidence intervals) for CD64 expression in the diagnosis of neonatal infection were: sensitivity, 0.78 (0.75, 0.81); specificity, 0.81 (0.78, 0.83); DOR, 21.27 (11.71, 38.65); positive-likelihood ratio, 4.53 (3.22, 6.36); negative-likelihood ratio, 0.23 (0.14, 0.37); AUC, 0.89. CONCLUSIONS: Neutrophil CD64 expression can be used as an additional test in the diagnosis of neonatal infection. Results of a CD64 assay should not be used alone to diagnose such infections, but should be interpreted in combination with other test results and clinical findings.