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Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis: an updated meta-analysis

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European Journal of Clinical Microbiology & Infectious Diseases Aims and scope Submit manuscript

An Erratum to this article was published on 27 February 2013

Abstract

The objective of this investigation was to systematically evaluate the diagnostic accuracy of interferon-gamma release assays (IGRAs) for tuberculosis disease. Both English and Chinese databases were searched for relevant articles through January 2012. We included studies that were restricted to diagnostic applications of IGRAs in patients with active tuberculosis and excluded studies performed in the immune-compromised population. We used Meta-DiSc software to handle the data. We calculated the sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic odds ratio (DOR), and 95 % confidence interval (CI) for each study. We also calculated the pooled sensitivity, specificity, PLR, NLR, DOR, and produced forest plots and summary receiver operating characteristic (SROC) curves. A total of 61 papers (73 studies) were eligible for meta-analysis, including 36 published in English and 25 published in the Chinese language. The overall sensitivity, specificity, PLR, NLR, DOR, and 95 % CI of IGRAs were 0.85 (95 % CI: 0.84–0.86), 0.84 (95 % CI: 0.83–0.85), 7.82 (95 % CI: 6.01–10.19), 0.17 (95 % CI: 0.14–0.21), and 59.27 (95 % CI: 40.19–87.42), respectively. For ten studies evaluating T-SPOT.TB in China, the combined sensitivity, specificity, PLR, NLR, DOR, and 95 % CI were 0.88 (95 % CI: 0.86–0.91), 0.89 (95 % CI: 0.86–0.92), 8.86 (95 % CI: 5.42–14.46), 0.13 (95 % CI: 0.10–0.17), and 88.15 (95 % CI: 41.76–186.07), respectively. The SROC area under the curve (AUC) was 0.9548 (95 % CI: 0.9323–0.9773). Though IGRAs showed good sensitivity and specificity for the detection of tuberculosis in this meta-analysis, the decision to use an IGRA should be based on the local prevalence of the disease and the country guidelines, as well as resources and logistical considerations.

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Acknowledgments

This study is partly supported by the National Natural Science Foundation of China (81072351), National S&T Major Project Foundation of China (2011ZX10004-902), Jiangsu Science Supported Planning/Social Development Foundation (BE2011841), and Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD). We thank Professor Kathryn DeRiemer (University of California, Davis, CA, USA) for providing feedback on an earlier version of the manuscript.

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The authors declare that they have no conflict of interest.

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Authors and Affiliations

  1. Department of Epidemiology and Biostatistics, School of Public Health, Nanjing Medical University, Nanjing, 210029, People’s Republic of China

    Y. Dai, Y. Feng, R. Xu & J. Wang

  2. Department of Chronic Infectious Diseases, Jiangsu Provincial Center for Disease Prevention and Control, Nanjing, People’s Republic of China

    W. Xu & W. Lu

Authors
  1. Y. Dai
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  2. Y. Feng
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  3. R. Xu
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  4. W. Xu
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  5. W. Lu
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  6. J. Wang
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Corresponding author

Correspondence to J. Wang.

Additional information

Yaoyao Dai and Yan Feng contributed equally to this paper.

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Dai, Y., Feng, Y., Xu, R. et al. Evaluation of interferon-gamma release assays for the diagnosis of tuberculosis: an updated meta-analysis. Eur J Clin Microbiol Infect Dis 31, 3127–3137 (2012). https://doi.org/10.1007/s10096-012-1674-y

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  • DOI: https://doi.org/10.1007/s10096-012-1674-y

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