Análisis crítico de un artículo: ¿Es confiable la medición de adenosin deaminasa (ADA) para el diagnóstico de derrame pleural tuberculoso? / Critically appraised article: Diagnostic accuracy of adenosine deaminase in tuberculous pleurisy: A metaanalyses
Rev. méd. Chile
;
137(2): 308-311, feb. 2009. tab
Artículo
en Español
|
LILACS-Express
| LILACS
| ID: lil-516100
ABSTRACT
Background:
Conventional tests are not always helpful in making a diagnosis of tuberculous pleurisy. Many studies have investigated the usefulness of adenosine deaminase (ADA) in pleural fluid for the early diagnosis of tuberculous pleuresy. We conducted a metaanalysis to determine the accuracy of ADA measurements in the diagnosis of tuberculous pleurisy.Methods:
After a systematic review of English language studies, sensitivity, specificity, and other measures of accuracy of ADA concentration in the diagnosis of pleural effusion were pooled using random effects models. Summary receiver operating characteristic curves were used to summarize overall test performance.Results:
Sixty-three studies met our inclusion criteria. The summary estimates for ADA in the diagnosis of tuberculous pleurisy in the studies included were sensitivity 0.92 (95% confidence interval 0.90-0.93), specificity 0.90 (95% confidence interval 0.89-0.91), positive likelihood ratio 9.03 (95% confidence interval 7.19-11.35), negative likelihood ratio 0.10 (95% confidence interval 0.07-0.14), and diagnostic odds ratio 110.08 (95% confidence interval 69.96- 173.20).Conclusions:
ADA determination is a relative sensitive and specific test for the diagnosis of tuberculous pleurisy. Measurement of ADA in pleural effusion is thus likely to be a useful diagnostic tool for tuberculous plerisy. The results of ADA assays should be interpreted in parallel with clinical findings and the results of conventional tests.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Tipo de estudio:
Estudio diagnóstico
/
Estudio pronóstico
/
Estudio de tamizaje
/
Revisiones Sistemáticas Evaluadas
Idioma:
Español
Revista:
Rev. méd. Chile
Asunto de la revista:
Medicina
Año:
2009
Tipo del documento:
Artículo
País de afiliación:
Chile
Institución/País de afiliación:
Pontificia Universidad Católica de Chile/CL
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