title: Comparison of QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for diagnosis of latent tuberculosis in haemodialysis (HD) patients: a meta-analysis of κ estimates.
abstract: Diagnosis of latent tuberculosis infection (LTBI) is a concern in haemodialysis (HD) patients. Many studies have compared QuantiFERON-TB Gold In-Tube (QFT-GIT) and tuberculin skin test (TST) for detecting LTBI and reported the κ statistic of agreement between QFT-GIT and TST in HD patients. The present study aimed to systematically review this literature and conduct meta-analysis of individual studies that estimated the κ between QFT-GIT with TST among HD patients. All relevant published studies that were available as full-text were obtained by searching Medline (1950), Web of Sciences (1945), Scopus (1973) through May 2016. The κ was re-estimated from the individual studies and pooled using random effect meta-analysis. Subgroup analysis and meta-regression were applied to evaluate the effect of Bacillus Calmette-Guérin (BCG) vaccination, TST cut-off points, quality of studies, sample size and age on variation of κ estimate. Eight studies involving 901 HD patients were included in meta-analysis. The pooled κ estimate was 0·28 (I 2 = 18·4%, P = 0·239, 95% confidence intervals 0·22-0·34). The discordance of TST-/QFT-GIT+ was more than TST+/QFT-GIT-. History of BCG vaccination, TST cut-off points and age are related to variation of κ estimates. TST and QFT-GIT are not comparable in detecting LTBI in HD patients. The higher TST-/QFT-GIT+ ratio compared with TST+/QFT-GIT- ratio, may indicate the superiority of QFT-GIT over TST for detection LTBI in HD patients.
authors.affiliation: Department of Epidemiology,School of Public Health, Shahid Beheshti University of Medical Sciences,Tehran,Iran.
authors.forename: E
authors.initials: E
authors.lastname: Ayubi
authors.affiliation: Department of Epidemiology,School of Public Health, Hamadan University of Medical sciences,Hamadan,Iran.
authors.forename: A
authors.initials: A
authors.lastname: Doosti-Irani
authors.affiliation: School of Medicine, Shahid Beheshti University of Medical Sciences,Tehran,Iran.
authors.forename: A
authors.initials: A
authors.lastname: Sanjari Moghaddam
authors.affiliation: Department of Epidemiology and Biostatistics,School of Public Health, Tehran University of Medical Sciences,Tehran,Iran.
authors.forename: S
authors.initials: S
authors.lastname: Khazaei
authors.affiliation: Social Determinants of Health Research Center, Kurdistan University of Medical Sciences,Sanandaj,Iran.
authors.forename: K
authors.initials: K
authors.lastname: Mansori
authors.affiliation: Department of Public Health,Managerial Epidemiology Research Center, School of Nursing and Midwifery, Maragheh University of Medical Sciences,Maragheh,Iran.
authors.forename: S
authors.initials: S
authors.lastname: Safiri
authors.affiliation: School of Medicine, Zabol University of Medical Sciences,Zabol,Iran.
authors.forename: M
authors.initials: M
authors.lastname: Sani
authors.affiliation: Research Centre for Emerging and Reemerging infectious diseases, Pasteur Institute of Iran,Tehran,Iran.
authors.forename: E
authors.initials: E
authors.lastname: Mostafavi
mesh_terms: D006801:Humans; D055985:Latent Tuberculosis / Q000175:diagnosis* / Q000382:microbiology; D006435:Renal Dialysis / Q000706:statistics & numerical data; D014374:Tuberculin Test / Q000379:methods*
keywords: 
                 κ statistic; Haemodialysis patients; interferon-γ release tests; meta-analysis; tuberculin skin test