title: Diagnostic test accuracy of anti-glycopeptidolipid-core IgA antibodies for Mycobacterium avium complex pulmonary disease: systematic review and meta-analysis.
abstract: Currently, an anti-glycopeptidolipid (GPL)-core IgA antibody assay kit for diagnosing Mycobacterium avium complex (MAC) is commercially available. We conducted this systematic review and meta-analysis to reveal the precise diagnostic accuracy of anti-GPL-core IgA antibodies for MAC pulmonary disease (MAC-PD). We systematically searched reports that could provide data for both sensitivity and specificity by anti-GPL-core IgA antibody for clinically diagnosed MAC-PD. Diagnostic test accuracy was estimated using the bivariate model. Of the 257 articles that we had found through primary search, we finally included 16 reports consisted of 1098 reference positive subjects and 2270 reference negative subjects. The diagnostic odds ratio was 24.8 (95% CI 11.6-52.8, I(2) = 5.5%) and the area under the hierarchical summary receiver operating characteristic curves was 0.873 (95% CI 0.837-0.913). With a cutoff value of 0.7 U/mL, the summary estimates of sensitivity and specificity were 0.696 (95% CI 0.621-0.761) and 0.906 (95% CI 0.836-0.951), respectively. The positive and negative likelihood ratios were 7.4 (95% CI 4.1-13.8) and 0.34 (95% CI 0.26-0.43), respectively. The demanding clinical diagnostic criteria may be a cause of false positive of the index test. The index test had good overall diagnostic accuracy and was useful to ruling in MAC-PD with the cutoff value.
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Yuji
authors.initials: Y
authors.lastname: Shibata
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Nobuyuki
authors.initials: N
authors.lastname: Horita
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Masaki
authors.initials: M
authors.lastname: Yamamoto
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Toshinori
authors.initials: T
authors.lastname: Tsukahara
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Hideyuki
authors.initials: H
authors.lastname: Nagakura
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Ken
authors.initials: K
authors.lastname: Tashiro
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Hiroki
authors.initials: H
authors.lastname: Watanabe
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Nagai
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Kentaro
authors.initials: K
authors.lastname: Nakashima
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Ryota
authors.initials: R
authors.lastname: Ushio
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Misako
authors.initials: M
authors.lastname: Ikeda
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Atsuya
authors.initials: A
authors.lastname: Narita
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Akinori
authors.initials: A
authors.lastname: Kanai
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Sato
authors.affiliation: Department of Pulmonology, Yokohama City University Graduate School of Medicine, 3-9, Fukuura, Kanazawa, Yokohama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kaneko
mesh_terms: D000907:Antibodies, Bacterial / Q000097:blood*; D000942:Antigens, Bacterial / Q000276:immunology; D003951:Diagnostic Errors / Q000517:prevention & control*; D003955:Diagnostic Tests, Routine / Q000379:methods*; D006001:Glycoconjugates / Q000276:immunology; D006801:Humans; D007070:Immunoglobulin A / Q000097:blood*; D008171:Lung Diseases / Q000175:diagnosis*; D015269:Mycobacterium avium Complex / Q000276:immunology*; D015270:Mycobacterium avium-intracellulare Infection / Q000175:diagnosis*; D011237:Predictive Value of Tests; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D000907:Antibodies, Bacterial; D000942:Antigens, Bacterial; D006001:Glycoconjugates; D007070:Immunoglobulin A