Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?

Background: Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of adenosine deaminase (ADA) in pleural fluid for the early diagnosis of tuberculous pleuresy. We conducted a metaanalysis to determine the accuracy of A...

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Autores principales:	Herrera R,Cristian, Aravena L,Carlos
Lenguaje:	Spanish / Castilian
Publicado:	Sociedad Médica de Santiago 2009
Acceso en línea:	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000200019
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spelling	oai:scielo:S0034-988720090002000192009-06-10Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?Herrera R,CristianAravena L,CarlosBackground: Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of adenosine deaminase (ADA) in pleural fluid for the early diagnosis of tuberculous pleuresy. We conducted a metaanalysis to determine the accuracy of ADA measurements in the diagnosis of tuberculous pleurisy. Methods: After a systematic review of English ¡anguage studies, sensitivity, speciñcity and other measures of accuracy of ADA concentration in the diagnosis of pleural effusion were pooled using random effects models. Summary receiver operating characteristic curves were used to summarize overall test performance. Results: Sixty-three studies met our inclusión criteria. The summary estimates for ADA in the diagnosis of tuberculous pleurisy in the studies included were sensitivity 0.92 (95% confidence interval 0.90-0.93), speciñcity 0.90 (95% confidence interval 0.89-0.91), positive likelihood ratio 9.03 (95% confidence interval 7.19-11.35), negative likelihood ratio 0.10 (95% confidence interval 0.07-0.14), and diagnostic odds ratio 110.08 (95% confidence interval 69.96-173.20). Conclusions: ADA determination is a relative sensitive and speciñc test for the diagnosis of tuberculous pleurisy. Measurement of ADA in pleural effusion is thus likely to be a useful diagnostic tool for tuberculous plerisy. The results of ADA assays should be interpreted in parallel with clinical findings and the results of conventional testsinfo:eu-repo/semantics/openAccessSociedad Médica de SantiagoRevista médica de Chile v.137 n.2 20092009-02-01text/htmlhttp://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000200019es10.4067/S0034-98872009000200019
institution	Scielo Chile
collection	Scielo Chile
language	Spanish / Castilian
description	Background: Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of adenosine deaminase (ADA) in pleural fluid for the early diagnosis of tuberculous pleuresy. We conducted a metaanalysis to determine the accuracy of ADA measurements in the diagnosis of tuberculous pleurisy. Methods: After a systematic review of English ¡anguage studies, sensitivity, speciñcity and other measures of accuracy of ADA concentration in the diagnosis of pleural effusion were pooled using random effects models. Summary receiver operating characteristic curves were used to summarize overall test performance. Results: Sixty-three studies met our inclusión criteria. The summary estimates for ADA in the diagnosis of tuberculous pleurisy in the studies included were sensitivity 0.92 (95% confidence interval 0.90-0.93), speciñcity 0.90 (95% confidence interval 0.89-0.91), positive likelihood ratio 9.03 (95% confidence interval 7.19-11.35), negative likelihood ratio 0.10 (95% confidence interval 0.07-0.14), and diagnostic odds ratio 110.08 (95% confidence interval 69.96-173.20). Conclusions: ADA determination is a relative sensitive and speciñc test for the diagnosis of tuberculous pleurisy. Measurement of ADA in pleural effusion is thus likely to be a useful diagnostic tool for tuberculous plerisy. The results of ADA assays should be interpreted in parallel with clinical findings and the results of conventional tests
author	Herrera R,Cristian Aravena L,Carlos
spellingShingle	Herrera R,Cristian Aravena L,Carlos Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
author_facet	Herrera R,Cristian Aravena L,Carlos
author_sort	Herrera R,Cristian
title	Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
title_short	Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
title_full	Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
title_fullStr	Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
title_full_unstemmed	Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?
title_sort	análisis crítico de un artículo: ¿es confiable la medición de adenosin deaminasa (ada) para el diagnóstico de derrame pleural tuberculoso?
publisher	Sociedad Médica de Santiago
publishDate	2009
url	http://www.scielo.cl/scielo.php?script=sci_arttext&pid=S0034-98872009000200019
work_keys_str_mv	AT herrerarcristian analisiscriticodeunarticuloesconfiablelamediciondeadenosindeaminasaadaparaeldiagnosticodederramepleuraltuberculoso AT aravenalcarlos analisiscriticodeunarticuloesconfiablelamediciondeadenosindeaminasaadaparaeldiagnosticodederramepleuraltuberculoso
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Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso?

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