title: Diagnostic accuracy of T-cell interferon-γ release assays in tuberculous pleurisy: a meta-analysis.
abstract: OBJECTIVE
  The diagnosis of tuberculous pleurisy by analysis of pleural fluid using standard diagnostic tools is difficult. Recently, T-cell interferon-γ release assays (IGRA) have been introduced for the diagnosis of tuberculous pleurisy. The aim of the present meta-analysis was to establish the overall diagnostic accuracy of IGRA on both pleural fluid and peripheral blood, for diagnosing tuberculous pleurisy.
  
  
  METHODS
  A systematic review was performed of English language publications. Sensitivity, specificity and other measures of the accuracy of IGRA for the diagnosis tuberculous pleurisy using both pleural fluid and blood were pooled using a random-effects model or a fixed-effects model. Receiver operating characteristic curves were used to summarize overall test performance.
  
  
  RESULTS
  Seven out of eight studies met the inclusion criteria. The summary estimates of sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, positive predictive value, negative predictive value and diagnostic odds ratio were, for pleural fluid: 0.75, 0.82, 3.49, 0.24, 0.85, 0.70 and 19.04, respectively; and for blood: 0.80, 0.72, 2.86, 0.28, 0.78, 0.74 and 11.06, respectively.
  
  
  CONCLUSIONS
  As almost 20% of non-tuberculosis patients would be erroneously treated for tuberculosis and 25% of patients with tuberculous pleurisy would be missed, pleural fluid IGRA are not useful for the clinical diagnosis of tuberculous pleurisy.
authors.affiliation: Department of Respiratory Diseases, Union Hospital, Key Lab of Pulmonary Diseases of Health Ministry, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
authors.forename: Qiong
authors.initials: Q
authors.lastname: Zhou
authors.forename: Yi-Qiang
authors.initials: YQ
authors.lastname: Chen
authors.forename: Shou-Ming
authors.initials: SM
authors.lastname: Qin
authors.forename: Xiao-Nan
authors.initials: XN
authors.lastname: Tao
authors.forename: Jian-Bao
authors.initials: JB
authors.lastname: Xin
authors.forename: Huan-Zhong
authors.initials: HZ
authors.lastname: Shi
mesh_terms: D006801:Humans; D007371:Interferon-gamma / Q000097:blood / Q000276:immunology*; D010996:Pleural Effusion / Q000097:blood / Q000175:diagnosis; D012372:ROC Curve; D012680:Sensitivity and Specificity; D013601:T-Lymphocytes / Q000276:immunology*; D014396:Tuberculosis, Pleural / Q000097:blood / Q000175:diagnosis*
chemical_list: D007371:Interferon-gamma