title: Assessment by meta-analysis of interferon-gamma for the diagnosis of tuberculous peritonitis.
abstract: OBJECTIVE
  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). χ(2) 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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Gastroenterology, First Affiliated Hospital of Guangxi Medical University, Nanning 530021, Guangxi Province, China.
authors.forename: Si-Biao
authors.initials: SB
authors.lastname: Su
authors.forename: Shan-Yu
authors.initials: SY
authors.lastname: Qin
authors.forename: Xiao-Yun
authors.initials: XY
authors.lastname: Guo
authors.forename: Wei
authors.initials: W
authors.lastname: Luo
authors.forename: Hai-Xing
authors.initials: HX
authors.lastname: Jiang
mesh_terms: D019540:Area Under Curve; D001202:Ascitic Fluid / Q000276:immunology* / Q000382:microbiology; D015415:Biomarkers / Q000032:analysis; D006801:Humans; D007371:Interferon-gamma / Q000032:analysis*; D009169:Mycobacterium tuberculosis / Q000276:immunology; D015588:Observer Variation; D014395:Peritonitis, Tuberculous / Q000175:diagnosis* / Q000188:drug therapy / Q000276:immunology / Q000382:microbiology; D011237:Predictive Value of Tests; D011379:Prognosis; D012372:ROC Curve; D015203:Reproducibility of Results
chemical_list: D015415:Biomarkers; C573415:IFNG protein, human; D007371:Interferon-gamma
keywords: Diagnosis; Interferon-gamma; Meta-analysis; Tuberculosis; Tuberculous peritonitis
references.citation: Ann Intern Med. 1994 Apr 15;120(8):667-76
references.pmid: 8135452
references.citation: BMC Med Res Methodol. 2005 Jun 08;5:20
references.pmid: 15943861
references.citation: BMJ. 2001 Jul 21;323(7305):157-62
references.pmid: 11463691
references.citation: Aliment Pharmacol Ther. 2005 Oct 15;22(8):685-700
references.pmid: 16197489
references.citation: Ann Emerg Med. 2001 May;37(5):453-60
references.pmid: 11326181
references.citation: BMC Med Res Methodol. 2002 Jul 03;2:9
references.pmid: 12097142
references.citation: Arch Bronconeumol. 2008 Oct;44(10):551-66
references.pmid: 19006636
references.citation: J Clin Epidemiol. 2004 May;57(5):461-9
references.pmid: 15196616
references.citation: J Clin Epidemiol. 2003 Nov;56(11):1129-35
references.pmid: 14615004
references.citation: Croat Med J. 2003 Oct;44(5):635-8
references.pmid: 14515428
references.citation: Tubercle. 1991 Sep;72(3):193-7
references.pmid: 1771679
references.citation: J Egypt Soc Parasitol. 1994 Apr;24(1):93-105
references.pmid: 8169454
references.citation: Eur J Gastroenterol Hepatol. 1999 Mar;11(3):337-41
references.pmid: 10333209
references.citation: Br Med J (Clin Res Ed). 1985 Aug 17;291(6493):473-5
references.pmid: 3160432
references.citation: Tuberk Toraks. 2004;52(3):211-7
references.pmid: 15351932
references.citation: Nefrologia. 2011;31(2):169-73
references.pmid: 21461010
references.citation: J Clin Gastroenterol. 2006 Sep;40(8):705-10
references.pmid: 16940883
references.citation: Stat Med. 2001 Dec 15;20(23):3625-33
references.pmid: 11746342
references.citation: FEMS Immunol Med Microbiol. 2004 Mar 8;40(2):139-45
references.pmid: 14987732
references.citation: Am J Gastroenterol. 1993 May;88(5):744-50
references.pmid: 8480741
references.citation: J Infect. 2009 Dec;59(6):409-15
references.pmid: 19778553
references.citation: Chest. 2002 Sep;122(3):900-5
references.pmid: 12226030
references.citation: J Med Case Rep. 2008 Jan 31;2:32
references.pmid: 18237424
references.citation: J Immunol. 1990 Jul 1;145(1):149-54
references.pmid: 2113553
references.citation: Indian J Med Res. 2004 Oct;120(4):316-53
references.pmid: 15520485
references.citation: Arch Pathol Lab Med. 1998 Aug;122(8):675-86
references.pmid: 9701328
references.citation: Indian J Med Res. 2004 Oct;120(4):305-15
references.pmid: 15520484
references.citation: BMJ. 1997 Sep 13;315(7109):629-34
references.pmid: 9310563
references.citation: J Interferon Cytokine Res. 2006 Jul;26(7):484-8
references.pmid: 16800787
references.citation: Arch Intern Med. 1998 Oct 12;158(18):1967-8
references.pmid: 9778194
references.citation: Gastrointest Endosc Clin N Am. 2001 Jan;11(1):79-91
references.pmid: 11175976
references.citation: J Infect. 2009 Dec;59(6):402-8
references.pmid: 19819258
references.citation: Clin Infect Dis. 2007 Dec 15;45(12):1559-67
references.pmid: 18190316
references.citation: J Med Microbiol. 2012 Apr;61(Pt 4):514-519
references.pmid: 22174374
references.citation: Gut. 1995 Mar;36(3):419-21
references.pmid: 7698702
references.citation: BMC Med Res Methodol. 2003 Nov 10;3:25
references.pmid: 14606960
references.citation: Gastrointest Endosc. 1981 May;27(2):66-8
references.pmid: 6453038
references.citation: Int J Tuberc Lung Dis. 2000 Apr;4(4):361-70
references.pmid: 10777087
references.citation: J Clin Lab Anal. 2005;19(2):40-6
references.pmid: 15756707
references.citation: Probl Tuberk Bolezn Legk. 2006;(11):14-8
references.pmid: 17195584
references.citation: Respir Med. 2008 May;102(5):744-54
references.pmid: 18222681
references.citation: Gut. 1986 Sep;27(9):1049-53
references.pmid: 3758818