Nucleic acid amplification tests for diagnosis of tuberculous meningitis

Since tuberculous meningitis has no single gold-standard test, Pai and colleagues formed three types of imperfect standards. Cell culturing is commonly believed to have near-perfect specificity, but inadequate sensitivity. [...]ignoring the imperfect nature of culture (class 1 reference in this pape...

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Bibliographic Details
Published in:The Lancet infectious diseases 2004-01, Vol.4 (1), p.9-10
Main Authors: Hadgu, Alula, Sternberg, Maya
Format: Article
Language:English
Subjects:
Diagnostic tests
Estimates
Humans
Infectious diseases
Medical diagnosis
Meningitis
Meta-analysis
Meta-Analysis as Topic
Mycobacterium tuberculosis - genetics
Mycobacterium tuberculosis - isolation & purification
Nucleic Acid Amplification Techniques
Nucleic acids
Reference Standards
ROC Curve
Sample Size
Sensitivity and Specificity
Studies
Systematic review
Tuberculosis
Tuberculosis, Meningeal - diagnosis
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Summary:Since tuberculous meningitis has no single gold-standard test, Pai and colleagues formed three types of imperfect standards. Cell culturing is commonly believed to have near-perfect specificity, but inadequate sensitivity. [...]ignoring the imperfect nature of culture (class 1 reference in this paper) and estimating sensitivity and specificity of an NAA test by directly comparing its performance with cell culture results in biased sensitivity and specificity estimates, which, in turn, biases the pooled estimates of sensitivity and specificity from the meta-analysis. What is the direction of the bias for the pooled sensitivity estimate based on an imperfect reference test?
ISSN:1473-3099
1474-4457
DOI:10.1016/S1473-3099(03)00852-1