Meta-Analysis
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World J Gastroenterol. Mar 14, 2013; 19(10): 1645-1651
Published online Mar 14, 2013. doi: 10.3748/wjg.v19.i10.1645
Assessment by meta-analysis of interferon-gamma for the diagnosis of tuberculous peritonitis
Si-Biao Su, Shan-Yu Qin, Xiao-Yun Guo, Wei Luo, Hai-Xing Jiang
Si-Biao Su, Shan-Yu Qin, Xiao-Yun Guo, Wei Luo, Hai-Xing Jiang, Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Province, China
Author contributions: Jiang HX designed the study, searched the databases, extracted the data, analyzed the results, and wrote the manuscript; Su SB helped with study design, searched the databases, wrote and revised the manuscript; Qin SY formulated the research question, and helped with database searches and analysis; Guo XY and Luo W helped design the data abstraction form and served as second reviewers in extracting the data.
Correspondence to: Dr. Hai-Xing Jiang, Department of Gastroenterology, the First Affiliated Hospital of Guangxi Medical University, No. 22 Shuangyong Road, Nanning 530021, Guangxi Province, China. jihaxi@163.com
Telephone: +86-771-5356725 Fax: +86-771-5356585
Received: December 25, 2012
Revised: January 21, 2013
Accepted: January 23, 2013
Published online: March 14, 2013
Processing time: 78 Days and 21.7 Hours
Abstract

AIM: To investigate the performance and diagnostic accuracy of interferon-gamma (IFN-γ) for tuberculous peritonitis (TBP) by meta-analysis.

METHODS: A systematic search of English language studies was performed. We searched the following electronic databases: MEDLINE, EMBASE, Web of Science, BIOSIS, LILACS and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IFN-γ concentration in the diagnosis of peritoneal effusion were pooled using random-effects models. Receiver operating characteristic (ROC) curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.

RESULTS: Six studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.92. Analysis of IFN-γ level for TBP diagnosis yielded a summary estimate: sensitivity, 0.93 (95%CI, 0.87-0.97); specificity, 0.99 (95%CI, 0.97-1.00); positive likelihood ratio (PLR), 41.49 (95%CI, 18.80-91.55); negative likelihood ratio (NLR), 0.11 (95%CI, 0.06-0.19); and diagnostic odds ratio (DOR), 678.02 (95%CI, 209.91-2190.09). χ2 values of the sensitivity, specificity, PLR, NLR and DOR were 5.66 (P = 0.3407), 6.37 (P = 0.2715), 1.38 (P = 0.9265), 5.46 (P = 0.3621) and 1.42 (P = 0.9220), respectively. The summary receiver ROC curve was positioned near the desirable upper left corner and the maximum joint sensitivity and specificity was 0.97. The area under the curve was 0.99. The evaluation of publication bias was not significant (P = 0.922).

CONCLUSION: IFN-γ may be a sensitive and specific marker for the accurate diagnosis of TBP. The level of IFN-γ may contribute to the accurate differentiation of tuberculosis (TB) ascites from non-TB ascites.

Keywords: Tuberculosis; Tuberculous peritonitis; Interferon-gamma; Diagnosis; Meta-analysis