title: Diagnostic accuracy of interferon-gamma release assays for tuberculous meningitis: a meta-analysis.
abstract: OBJECTIVE
  To evaluate the diagnostic accuracy of interferon-gamma release assays (IGRAs) for diagnosing tuberculous meningitis (TBM).
  
  
  METHODS
  The EMBASE and PubMed databases were systematically searched to identify studies published by 2 May 2015 investigating the diagnostic accuracy of IGRA for TBM. The quality of the included studies was assessed using the revised Quality Assessment for Studies of Diagnostic Accuracy (QUADAS-2) method. The overall diagnostic accuracies of an IGRA for cerebrospinal fluid (CSF) or blood were pooled using a bivariate model.
  
  
  RESULTS
  Eight studies using blood IGRA and 6 studies using CSF IGRA were included. The overall sensitivities for blood and CSF IGRA were respectively 0.78 and 0.77, and the specificities were 0.61 and 0.88. The areas under the summary receiver operating characteristic curves were respectively 0.76 and 0.83 for blood and CSF IGRA. The major design weaknesses of the studies included were patient selection bias and exclusion of uninterpretable results.
  
  
  CONCLUSIONS
  The diagnostic accuracy of blood and CSF IGRA in case of TBM is moderate.
authors.affiliation: Department of Pathology, Shandong Medical College, Shandong, China.
authors.forename: J
authors.initials: J
authors.lastname: Yu
authors.affiliation: Department of PhysiologyShandong Medical College, Shandong, China.
authors.forename: Z-J
authors.initials: ZJ
authors.lastname: Wang
authors.affiliation: Department of Pharmacy, Shandong Medical College, Shandong, China.
authors.forename: L-H
authors.initials: LH
authors.lastname: Chen
authors.affiliation: Department of Neurology, Provincial Hospital Affiliated to Shandong University, Ji'nan, China.
authors.forename: H-H
authors.initials: HH
authors.lastname: Li
mesh_terms: D006801:Humans; D059425:Interferon-gamma Release Tests / Q000379:methods*; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000097:blood / Q000134:cerebrospinal fluid / Q000175:diagnosis*