title: Diagnostic test accuracy of adenosine deaminase for tuberculous meningitis: A systematic review and meta-analysis.
abstract: The measurement of adenosine deaminase (ADA) level in cerebrospinal fluid (CSF) has generated as a suitable test for tuberculous meningitis (TBM) diagnosis. The main objective in the present meta-analysis focused on analyzing the ADA test accuracy in order to diagnose TBM.
  
  
  
  We searched several databases including Medline, Embase and Cochrane databases to identify studies addressing the diagnosis of TBM. The quality of included reports were assessed by RevMan5 software (via QUADS2 checklist). Accuracy measures of ADA test (sensitivity, specificity and others) pooled with random effects models. In addition, the data was elicited by using midas and metan packages in stata (version 12).
  
  
  
  Twenty studies were eligible for inclusion within the meta-analysis. The pooled sensitivity and specificity for TBM diagnosis hallmarks were 89% (95% CI: 0.84-0.92) and 91% (95% CI: 0.87-0.93), respectively. The positive likelihood ratio was 9.4 (95% CI: 7-12.8), negative likelihood ratio was 0.12 (95% CI: 0.09-0.17), and diagnostic odds ratio was 77 (95% CI: 45-132). Indeed, the area under the summary receiver operating characteristic (SROC) was 0.96.
  
  
  
  It was magnificently attained that ADA test had a relatively high accuracy for TBM diagnosis.
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: pormohammadali@yahoo.com.
authors.forename: Ali
authors.initials: A
authors.lastname: Pormohammad
authors.affiliation: Department of Epidemiology, Birjand University of Medical Sciences, Birjand, Iran; Department of Epidemiology, Faculty of Health, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: riahim61@gmail.com.
authors.forename: Seyed-Mohammad
authors.initials: SM
authors.lastname: Riahi
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: mj.nasiri@hotmail.com.
authors.forename: Mohammad Javad
authors.initials: MJ
authors.lastname: Nasiri
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: fafallah@sbmu.ac.ir.
authors.forename: Fatemeh
authors.initials: F
authors.lastname: Fallah
authors.affiliation: Department of Medical Microbiology, Faculty of Medicine, Tabriz University of Medical Sciences, Tabriz, Iran. Electronic address: aghazadehm@gmail.com.
authors.forename: Mohammad
authors.initials: M
authors.lastname: Aghazadeh
authors.affiliation: Department of Microbiology, School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: f_doustdar@yahoo.com.
authors.forename: Farahnoosh
authors.initials: F
authors.lastname: Doustdar
authors.affiliation: School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. Electronic address: ramin.pourk@gmail.com.
authors.forename: Ramin
authors.initials: R
authors.lastname: Pouriran
mesh_terms: D000243:Adenosine Deaminase / Q000134:cerebrospinal fluid*; D004796:Clinical Enzyme Tests; D006801:Humans; D016017:Odds Ratio; D012372:ROC Curve; D012680:Sensitivity and Specificity; D014390:Tuberculosis, Meningeal / Q000175:diagnosis* / Q000201:enzymology / Q000382:microbiology
chemical_list: D000243:Adenosine Deaminase
keywords: Adenosine deaminase; Meningitis; Meta-analysis; Test accuracy; Tuberculous