title: Interferon-Gamma Release Assays for the Diagnosis of Tuberculosis: A Systematic Review and Meta-analysis.
abstract: We conducted a systematic review and meta-analysis to compare the accuracy of the interferon-gamma release assays (IGRAs) and the tuberculin skin test (TST) for the diagnosis of Mycobacterium tuberculosis infection.
  
  
  
  We systematically searched PubMed, Embase, Cochrane library, and Web of Science databases for relevant published studies in recent decades and calculated pooled estimated sensitivities, specificities, DOR, and SROC curve of the QFT-IT, T-SPOT and TST. Random-effects models were used to assess estimates from studies with significant heterogeneity. Moreover, area under the curve was used to evaluate the accuracy of the tests.
  
  
  
  Overall, 9 studies for QFT-IT, 12 studies for T-SPOT, and 16 studies for TST involving 3586 participants were included in this analysis. We found that sensitivities of the QFT-IT, T-SPOT, and TST were respectively 0.842 (95 % CI 0.811-0.870), 0.840 (95 % CI 0.814-0.864), and 0.665 (CI 0.635-0.693); specificities were respectively 0.745 (95 % CI 0.715-0.775), 0.658 (95 % CI 0.621-0.693), and 0.633 (CI 0.605-0.661); positive likelihood ratios were respectively 3.652 (95 % CI 2.180-6.117), 2.196 (95 % CI 1.727-2.794), and 1.825 (95 % CI 1.351-2.464); negative likelihood ratios were respectively 0.212 (95 % CI 0.109-0.414), 0.246 (95 % CI 0.161-0.377), and 0.556 (95 % CI 0.385-0.804); the SROC curves were 19.205, 10.397, and 3.810.
  
  
  
  The two IGRAs showed better performance than TST for the diagnosis of the tuberculosis. However, neither of them showed stability in the diagnosis of TB.
authors.affiliation: School of Public Health, Nanjing Medical University, Longmiandadao 101, Nanjing, 211166, China.|Department of Chronic Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Jiangsulu 172, Nanjing, 210009, China.
authors.forename: Peng
authors.initials: P
authors.lastname: Lu
authors.affiliation: The Fourth Clinical School of Nanjing Medical University, Jiangsu Cancer Hospital Affiliated to Nanjing Medical University, Baiziting 42, Nanjing, 210009, China.
authors.forename: Xiu
authors.initials: X
authors.lastname: Chen
authors.affiliation: Department of Chronic Infectious Disease, Jiangsu Provincial Center for Disease Control and Prevention Affiliated to Nanjing Medical University, Jiangsulu 172, Nanjing, 210009, China.
authors.forename: Li-Mei
authors.initials: LM
authors.lastname: Zhu
authors.affiliation: Jiangsu Institute of Parasitic Diseases, Yangxiang 117, Wuxi, 214064, China. yanghtjscdc@163.com.|Nanjing Medical University, Longmiandadao 101, Nanjing, 211166, China. yanghtjscdc@163.com.
authors.forename: Hai-Tao
authors.initials: HT
authors.lastname: Yang
mesh_terms: D019540:Area Under Curve; D006801:Humans; D059425:Interferon-gamma Release Tests; D012372:ROC Curve; D014374:Tuberculin Test; D014397:Tuberculosis, Pulmonary / Q000175:diagnosis*
keywords: Diagnosis; Interferon-gamma release assays; Specificity; Tuberculin skin test; Tuberculosis