title: Meta-analyses of the sensitivity and specificity of ante-mortem and post-mortem diagnostic tests for bovine tuberculosis in the UK and Ireland.
abstract: Bovine Tuberculosis (bTB) in cattle is a global health problem and eradication of the disease requires accurate estimates of diagnostic test performance to optimize their efficiency. The objective of this study was, through statistical meta-analyses, to obtain estimates of sensitivity (Se) and specificity (Sp), for 14 different ante-mortem and post-mortem diagnostic tests for bTB in cattle. Using data from a systematic review of the scientific literature (published 1934-2009) diagnostic Se and Sp were estimated using Bayesian logistic regression models adjusting for confounding factors. Random effect terms were used to account for unexplained heterogeneity. Parameters in the models were implemented using Markov Chain Monte Carlo (MCMC), and posterior distributions for the diagnostic parameters with adjustment for covariates (confounding factors) were obtained using the inverse logit function. Estimates for Se and/or Sp of the tuberculin skin tests and the IFN-γ blood test were compared with estimates published 2010-2015. Median Se for the single intradermal comparative cervical tuberculin skin (SICCT) test (standard interpretation) was 0.50 and Bayesian credible intervals (CrI) were wide (95% CrI 0.26, 0.78). Median Sp for the SICCT test was 1.00 (95% CrI 0.99, 1.00). Estimates for the IFN-γ blood test Bovine Purified Protein Derivative (PPD)-Avian PPD and Early Secreted Antigen target 6 and Culture Filtrate Protein 10 (ESAT-6/CFP10) ESAT6/CFP10 were 0.67 (95% CrI 0.49, 0.82) and 0.78 (95% CrI 0.60, 0.90) respectively for Se, and 0.98 (95% CrI 0.96, 0.99) and 0.99 (95% CrI 0.99, 1.00) for Sp. The study provides an overview of the accuracy of a range of contemporary diagnostic tests for bTB in cattle. Better understanding of diagnostic test performance is essential for the design of effective control strategies and their evaluation.
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Javier
authors.initials: J
authors.lastname: Nuñez-Garcia
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom. Electronic address: sara.down@apha.gsi.gov.uk.
authors.forename: Sara H
authors.initials: SH
authors.lastname: Downs
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Jessica E
authors.initials: JE
authors.lastname: Parry
authors.affiliation: Veterinary Service, Department of Agriculture and Rural Development, Belfast BT4 3SB, United Kingdom; Faculty of Veterinary Science, University of Pretoria, South Africa.
authors.forename: Darrell A
authors.initials: DA
authors.lastname: Abernethy
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Jennifer M
authors.initials: JM
authors.lastname: Broughan
authors.affiliation: AusVet Animal Health Services Pty Ltd., PO Box 3180, South Brisbane, Qld 4101, Australia.
authors.forename: Angus R
authors.initials: AR
authors.lastname: Cameron
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom; Department of Veterinary Epidemiology, School of Veterinary Medicine, University of Surrey, GU2 7AL, United Kingdom.
authors.forename: Alasdair J
authors.initials: AJ
authors.lastname: Cook
authors.affiliation: Advice Services, APHA, and Bovine Tuberculosis Programme, Department for Environment, Food and Rural Affairs, London SW1P 3JR, United Kingdom.
authors.forename: Ricardo
authors.initials: R
authors.lastname: de la Rua-Domenech
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Anthony V
authors.initials: AV
authors.lastname: Goodchild
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Jane
authors.initials: J
authors.lastname: Gunn
authors.affiliation: Centre for Veterinary Epidemiology and Risk Analysis, UCD School of Veterinary Medicine, University College Dublin, Belfield, Dublin 4, Ireland.
authors.forename: Simon J
authors.initials: SJ
authors.lastname: More
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Shelley
authors.initials: S
authors.lastname: Rhodes
authors.affiliation: Office of the Chief Veterinary Officer, Welsh Government, Cardiff CF10 3NQ, United Kingdom.
authors.forename: Simon
authors.initials: S
authors.lastname: Rolfe
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Sharp
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Paul A
authors.initials: PA
authors.lastname: Upton
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: H Martin
authors.initials: HM
authors.lastname: Vordermeier
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom; National Milk Laboratories, Wiltshire SN15 1BN, United Kingdom.
authors.forename: Eamon
authors.initials: E
authors.lastname: Watson
authors.affiliation: Veterinary Sciences Division, Agri-Food & Biosciences Institute (AFBI), Belfast BT4 3SD, United Kingdom; CSO SISAF Ltd., Northern Ireland Science Park, Unit 15A The Innovation Centre, Belfast BT3 9DT, United Kingdom.
authors.forename: Michael
authors.initials: M
authors.lastname: Welsh
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom; Microbiology, Dstl, Porton Down, SP4 0JQ, United Kingdom.
authors.forename: Adam O
authors.initials: AO
authors.lastname: Whelan
authors.affiliation: The Roslin Institute, Roslin Biocentre, Roslin, Midlothian EH25 9PS, United Kingdom.
authors.forename: John A
authors.initials: JA
authors.lastname: Woolliams
authors.affiliation: Animal and Plant Health Agency (APHA), Weybridge, Surrey KT15 3NB, United Kingdom.
authors.forename: Richard S
authors.initials: RS
authors.lastname: Clifton-Hadley
authors.affiliation: Federal Institute for Risk assessment (BfR), D-10589 Berlin, and Veterinary University Hannover, Foundation, Germany.
authors.forename: Matthias
authors.initials: M
authors.lastname: Greiner
mesh_terms: D000818:Animals; D001499:Bayes Theorem; D002417:Cattle; D003955:Diagnostic Tests, Routine / Q000592:standards / Q000662:veterinary*; D007371:Interferon-gamma; D007494:Ireland; D009163:Mycobacterium bovis; D012680:Sensitivity and Specificity; D014374:Tuberculin Test; D014380:Tuberculosis, Bovine / Q000175:diagnosis*; D006113:United Kingdom
chemical_list: D007371:Interferon-gamma
keywords: Bovine tuberculosis; Diagnostic tests; Meta-analysis; Performance; Sensitivity; Specificity