Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.

India has been engaged in tuberculosis (TB) control activities for over 50 years and yet TB continues to remain India's important public health problem. The present study was conducted to compare the performance of GeneXpert MTB/RIF (GXpert) assay with composite reference standard in diagnosing...

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Autores principales:	Jyoti Jain, Pooja Jadhao, Shashank Banait, Preetam Salunkhe
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/c595d8f823d04855a704160a95e0ef29
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spelling	oai:doaj.org-article:c595d8f823d04855a704160a95e0ef292021-12-02T20:03:53ZDiagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.1932-620310.1371/journal.pone.0251618https://doaj.org/article/c595d8f823d04855a704160a95e0ef292021-01-01T00:00:00Zhttps://doi.org/10.1371/journal.pone.0251618https://doaj.org/toc/1932-6203India has been engaged in tuberculosis (TB) control activities for over 50 years and yet TB continues to remain India's important public health problem. The present study was conducted to compare the performance of GeneXpert MTB/RIF (GXpert) assay with composite reference standard in diagnosing cases of tubercular pleural effusion (TPE) and to evaluate the reliability of rifampicin resistance. A cross-sectional study was performed in a Department of Medicine of a rural teaching tertiary care hospital in central India. In all consecutive patients with pleural effusion on chest radiograph presenting to Department of Medicine, GXpert assay and composite reference standard was performed to evaluate the diagnostic accuracy of GXpert assay for detecting TPE in comparison to composite reference standard. Standard formulae were used to calculate the sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), positive likelihood ratios (LR+) and negative likelihood ratios (LR-). Mc-Nemar's test was applied to compare variables. All comparisons were two-tailed. We considered the difference to be statistically significant if the P value was less than 0.05. The sensitivity of the GXpert assay in diagnosing TPE was 16.6% among 158 study participants, the specificity was 100% and diagnostic accuracy was 52.5% which was statistically significant (p value < 0.05). It had a PPV of 100% (95%CI: 88.3% - 100%) and a NPV of 47.5% (95%CI: 39.3% - 55.7%). The LR+ and LR-were 23.5 (95%CI: 1.43-38.6) and 0.83 (95%CI: 0.76-0.91) respectively. GXpert assay has a very high specificity in diagnosing TPE but has a low sensitivity. In comparison to composite reference standard Thus its clinical utility is limited when used as a standalone test. A physician's clinical acumen in combination with routine pleural fluid analysis should be the key factor in the diagnosis of TPE in clinically and radiologically suspected patients, especially in high TB burden countries.Jyoti JainPooja JadhaoShashank BanaitPreetam SalunkhePublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 16, Iss 6, p e0251618 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Jyoti Jain Pooja Jadhao Shashank Banait Preetam Salunkhe Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
description	India has been engaged in tuberculosis (TB) control activities for over 50 years and yet TB continues to remain India's important public health problem. The present study was conducted to compare the performance of GeneXpert MTB/RIF (GXpert) assay with composite reference standard in diagnosing cases of tubercular pleural effusion (TPE) and to evaluate the reliability of rifampicin resistance. A cross-sectional study was performed in a Department of Medicine of a rural teaching tertiary care hospital in central India. In all consecutive patients with pleural effusion on chest radiograph presenting to Department of Medicine, GXpert assay and composite reference standard was performed to evaluate the diagnostic accuracy of GXpert assay for detecting TPE in comparison to composite reference standard. Standard formulae were used to calculate the sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), positive likelihood ratios (LR+) and negative likelihood ratios (LR-). Mc-Nemar's test was applied to compare variables. All comparisons were two-tailed. We considered the difference to be statistically significant if the P value was less than 0.05. The sensitivity of the GXpert assay in diagnosing TPE was 16.6% among 158 study participants, the specificity was 100% and diagnostic accuracy was 52.5% which was statistically significant (p value < 0.05). It had a PPV of 100% (95%CI: 88.3% - 100%) and a NPV of 47.5% (95%CI: 39.3% - 55.7%). The LR+ and LR-were 23.5 (95%CI: 1.43-38.6) and 0.83 (95%CI: 0.76-0.91) respectively. GXpert assay has a very high specificity in diagnosing TPE but has a low sensitivity. In comparison to composite reference standard Thus its clinical utility is limited when used as a standalone test. A physician's clinical acumen in combination with routine pleural fluid analysis should be the key factor in the diagnosis of TPE in clinically and radiologically suspected patients, especially in high TB burden countries.
format	article
author	Jyoti Jain Pooja Jadhao Shashank Banait Preetam Salunkhe
author_facet	Jyoti Jain Pooja Jadhao Shashank Banait Preetam Salunkhe
author_sort	Jyoti Jain
title	Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
title_short	Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
title_full	Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
title_fullStr	Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
title_full_unstemmed	Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.
title_sort	diagnostic accuracy of genexpert mtb/rif assay for detection of tubercular pleural effusion.
publisher	Public Library of Science (PLoS)
publishDate	2021
url	https://doaj.org/article/c595d8f823d04855a704160a95e0ef29
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Diagnostic accuracy of GeneXpert MTB/RIF assay for detection of tubercular pleural effusion.

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