Xpert MTB/RIF demonstrated a robust pooled specificity of 0.994 but an unsatisfactory pooled sensitivity of 0.676 in diagnosing tuberculous pericarditis.
Meta-Analysis (n=581)
Does Xpert MTB/RIF accurately diagnose tuberculous pericarditis in patients with pericardial effusion compared to culture?
Xpert MTB/RIF has robust specificity but unsatisfactory sensitivity for diagnosing tuberculous pericarditis, meaning positive results are valuable for ruling in the diagnosis, but negative results cannot rule it out.
Effect estimate: Sensitivity 0.676, Specificity 0.994 (95% CI Sensitivity 0.580-0.759, Specificity 0.919-1.000)
Introduction : Xpert MTB/RIF is a rapid diagnostic instrument for pulmonary tuberculosis (TB). However, studies reported varied accuracy of Xpert MTB/RIF in detecting Mycobacterium tuberculosis in pericardial effusion. Methods : We performed a systematic review of literature in PubMed, published up to February 1, 2020, according to PRISMA guidelines. We screened cross-sectional studies, observational cohort studies, and randomized control trials that evaluated the accuracy of Xpert MTB/RIF in diagnosing TB pericarditis. Papers with noninterpretable results of sensitivity and specificity, non-English articles, and unpublished studies were excluded. The primary outcomes were the sensitivity and specificity of Xpert MTB/RIF. We conducted a quality assessment using QUADAS-2 to evaluate the quality of the studies. A bivariate model pooled the overall sensitivity, specificity, positive likelihood ratios (PLRs), and negative likelihood ratios (NLRs) of included studies. Results : In total, 581 subjects from nine studies were analyzed in this meta-analysis. Our pooled analysis showed that the overall sensitivity, specificity, PLRs and NLRs of included studies were 0.676 (95% CI: 0.580–0.759), 0.994 (95% CI: 0.919–1.000), 110.11 (95% CI: 7.65–1584.57) and 0.326 (95% CI: 0.246–0.433), respectively. Conclusions : Xpert MTB/RIF had a robust specificity but unsatisfactory sensitivity in diagnosing TB pericarditis. These findings indicated that although positive Xpert MTB/RIF test results might be valuable in swiftly distinguishing the diagnosis of TB pericarditis, negative test results might not be able to rule out TB pericarditis. Registration : PROSPERO CRD42020167480 28/04/2020
Andrianto et al. (Wed,) conducted a meta-analysis in Tuberculous pericarditis (n=581). Xpert MTB/RIF vs. Culture (reference standard) was evaluated on Sensitivity and specificity of Xpert MTB/RIF (Sensitivity 0.676, Specificity 0.994, 95% CI Sensitivity 0.580-0.759, Specificity 0.919-1.000). Xpert MTB/RIF demonstrated a robust pooled specificity of 0.994 but an unsatisfactory pooled sensitivity of 0.676 in diagnosing tuberculous pericarditis.