Document Detail

Effectiveness of interferon-gamma release assays for differentiating intestinal tuberculosis from Crohn's disease: a meta-analysis.
MedLine Citation:
PMID:  24307809     Owner:  NLM     Status:  MEDLINE    
AIM: To investigate the clinical usefulness of interferon-gamma release assays (IGRAs) in the differential diagnosis of intestinal tuberculosis (ITB) from Crohn's disease (CD) by meta-analysis.
METHODS: A systematic search of English language studies was performed. We searched the following databases: Medline, Embase, Web of Science and the Cochrane Library. The Standards for Reporting Diagnostic Accuracy initiative and Quality Assessment for Studies of Diagnostic Accuracy tool were used to assess the methodological quality of the studies. Sensitivity, specificity, and other measures of the accuracy of IGRAs in the differential diagnosis of ITB from CD were pooled and analyzed using random-effects models. Receiver operating characteristic curves were applied to summarize overall test performance. Two reviewers independently judged study eligibility while screening the citations.
RESULTS: Five studies met the inclusion criteria. The average inter-rater agreement between the two reviewers for items in the quality checklist was 0.95. Analysis of IGRAs for the differential diagnosis of ITB from CD produced summary estimates as follows: sensitivity, 0.74 (95%CI: 0.68-0.80); specificity, 0.87 (95%CI: 0.82-0.90); positive likelihood ratio, 5.98 (95%CI: 3.79-9.43); negative likelihood ratio, 0.28 (95%CI: 0.18-0.43); and diagnostic odds ratio, 26.21 (95%CI: 14.15-48.57). The area under the curve was 0.92. The evaluation of publication bias was not significant (P = 0.235).
CONCLUSION: Although IGRAs are not sensitive enough, they provide good specificity for the accurate diagnosis of ITB, which may be helpful in the differential diagnosis of ITB from CD.
Wen Chen; Jun-Hua Fan; Wei Luo; Peng Peng; Si-Biao Su
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Publication Detail:
Type:  Journal Article; Meta-Analysis; Review    
Journal Detail:
Title:  World journal of gastroenterology : WJG     Volume:  19     ISSN:  2219-2840     ISO Abbreviation:  World J. Gastroenterol.     Publication Date:  2013 Nov 
Date Detail:
Created Date:  2013-12-05     Completed Date:  2014-05-02     Revised Date:  2014-05-20    
Medline Journal Info:
Nlm Unique ID:  100883448     Medline TA:  World J Gastroenterol     Country:  China    
Other Details:
Languages:  eng     Pagination:  8133-40     Citation Subset:  IM    
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MeSH Terms
Area Under Curve
Chi-Square Distribution
Crohn Disease / diagnosis*,  immunology
Diagnosis, Differential
Interferon-gamma Release Tests*
Intestinal Diseases / diagnosis*,  immunology,  microbiology
Odds Ratio
Predictive Value of Tests
ROC Curve
Tuberculosis, Gastrointestinal / diagnosis*,  immunology,  microbiology

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