Reassessment of the positive predictive value and specificity of Xpert MTB/RIF: a diagnostic accuracy study in the context of community-wide screening for tuberculosis.
Identifieur interne : 003689 ( Ncbi/Merge ); précédent : 003688; suivant : 003690Reassessment of the positive predictive value and specificity of Xpert MTB/RIF: a diagnostic accuracy study in the context of community-wide screening for tuberculosis.
Auteurs : Jennifer Ho [Australie] ; Phuong Thi Bich Nguyen [Viêt Nam] ; Thu Anh Nguyen [Viêt Nam] ; Khoa Hien Tran [Viêt Nam] ; Son Van Nguyen [Viêt Nam] ; Nhung Viet Nguyen [Viêt Nam] ; Hoa Binh Nguyen [France] ; Khanh Boi Luu [Viêt Nam] ; Greg J. Fox [Australie] ; Guy B. Marks [Australie]Source :
- The Lancet. Infectious diseases [ 1474-4457 ] ; 2016.
Descripteurs français
- KwdFr :
- Adolescent, Adulte, Adulte d'âge moyen, Expectoration (microbiologie), Femelle, Humains, Microscopie (), Mycobacterium tuberculosis (génétique), Mycobacterium tuberculosis (isolement et purification), Mâle, Prévalence, Sensibilité et spécificité, Techniques bactériologiques (), Tests diagnostiques courants, Tuberculose pulmonaire (diagnostic), Tuberculose pulmonaire (épidémiologie), Vietnam (épidémiologie), Études transversales.
- MESH :
- diagnostic : Tuberculose pulmonaire.
- génétique : Mycobacterium tuberculosis.
- isolement et purification : Mycobacterium tuberculosis.
- microbiologie : Expectoration.
- épidémiologie : Tuberculose pulmonaire, Vietnam.
- Adolescent, Adulte, Adulte d'âge moyen, Femelle, Humains, Microscopie, Mâle, Prévalence, Sensibilité et spécificité, Techniques bactériologiques, Tests diagnostiques courants, Études transversales.
English descriptors
- KwdEn :
- Adolescent, Adult, Bacteriological Techniques (methods), Cross-Sectional Studies, Diagnostic Tests, Routine, Female, Humans, Male, Microscopy (methods), Middle Aged, Mycobacterium tuberculosis (genetics), Mycobacterium tuberculosis (isolation & purification), Prevalence, Sensitivity and Specificity, Sputum (microbiology), Tuberculosis, Pulmonary (diagnosis), Tuberculosis, Pulmonary (epidemiology), Vietnam (epidemiology).
- MESH :
- diagnosis : Tuberculosis, Pulmonary.
- epidemiology : Tuberculosis, Pulmonary, Vietnam.
- genetics : Mycobacterium tuberculosis.
- isolation & purification : Mycobacterium tuberculosis.
- methods : Bacteriological Techniques, Microscopy.
- microbiology : Sputum.
- Adolescent, Adult, Cross-Sectional Studies, Diagnostic Tests, Routine, Female, Humans, Male, Middle Aged, Prevalence, Sensitivity and Specificity.
Abstract
Community-wide screening for tuberculosis with Xpert MTB/RIF as a primary screening tool overcomes some of the limitations of conventional screening. However, concerns exist about the low positive predictive value of this test in screening settings. We did a cross-sectional assessment of this diagnostic test to directly estimate the actual positive predictive value of Xpert MTB/RIF when used in the setting of community-wide screening for tuberculosis, and to draw an inference about the specificity of the test for tuberculosis detection.
DOI: 10.1016/S1473-3099(16)30067-6
PubMed: 27289387
Links toward previous steps (curation, corpus...)
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pubmed:27289387Le document en format XML
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<term>Adult</term>
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<term>Cross-Sectional Studies</term>
<term>Diagnostic Tests, Routine</term>
<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Microscopy (methods)</term>
<term>Middle Aged</term>
<term>Mycobacterium tuberculosis (genetics)</term>
<term>Mycobacterium tuberculosis (isolation & purification)</term>
<term>Prevalence</term>
<term>Sensitivity and Specificity</term>
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<term>Tuberculosis, Pulmonary (epidemiology)</term>
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<term>Expectoration (microbiologie)</term>
<term>Femelle</term>
<term>Humains</term>
<term>Microscopie ()</term>
<term>Mycobacterium tuberculosis (génétique)</term>
<term>Mycobacterium tuberculosis (isolement et purification)</term>
<term>Mâle</term>
<term>Prévalence</term>
<term>Sensibilité et spécificité</term>
<term>Techniques bactériologiques ()</term>
<term>Tests diagnostiques courants</term>
<term>Tuberculose pulmonaire (diagnostic)</term>
<term>Tuberculose pulmonaire (épidémiologie)</term>
<term>Vietnam (épidémiologie)</term>
<term>Études transversales</term>
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<term>Microscopy</term>
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<keywords scheme="MESH" qualifier="microbiologie" xml:lang="fr"><term>Expectoration</term>
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<keywords scheme="MESH" qualifier="microbiology" xml:lang="en"><term>Sputum</term>
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<term>Adult</term>
<term>Cross-Sectional Studies</term>
<term>Diagnostic Tests, Routine</term>
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<term>Humans</term>
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<term>Adulte</term>
<term>Adulte d'âge moyen</term>
<term>Femelle</term>
<term>Humains</term>
<term>Microscopie</term>
<term>Mâle</term>
<term>Prévalence</term>
<term>Sensibilité et spécificité</term>
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<front><div type="abstract" xml:lang="en">Community-wide screening for tuberculosis with Xpert MTB/RIF as a primary screening tool overcomes some of the limitations of conventional screening. However, concerns exist about the low positive predictive value of this test in screening settings. We did a cross-sectional assessment of this diagnostic test to directly estimate the actual positive predictive value of Xpert MTB/RIF when used in the setting of community-wide screening for tuberculosis, and to draw an inference about the specificity of the test for tuberculosis detection.</div>
</front>
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<pubmed><MedlineCitation Status="MEDLINE" Owner="NLM"><PMID Version="1">27289387</PMID>
<DateCreated><Year>2016</Year>
<Month>09</Month>
<Day>30</Day>
</DateCreated>
<DateCompleted><Year>2017</Year>
<Month>06</Month>
<Day>12</Day>
</DateCompleted>
<DateRevised><Year>2017</Year>
<Month>09</Month>
<Day>26</Day>
</DateRevised>
<Article PubModel="Print-Electronic"><Journal><ISSN IssnType="Electronic">1474-4457</ISSN>
<JournalIssue CitedMedium="Internet"><Volume>16</Volume>
<Issue>9</Issue>
<PubDate><Year>2016</Year>
<Month>Sep</Month>
</PubDate>
</JournalIssue>
<Title>The Lancet. Infectious diseases</Title>
<ISOAbbreviation>Lancet Infect Dis</ISOAbbreviation>
</Journal>
<ArticleTitle>Reassessment of the positive predictive value and specificity of Xpert MTB/RIF: a diagnostic accuracy study in the context of community-wide screening for tuberculosis.</ArticleTitle>
<Pagination><MedlinePgn>1045-1051</MedlinePgn>
</Pagination>
<ELocationID EIdType="pii" ValidYN="Y">S1473-3099(16)30067-6</ELocationID>
<ELocationID EIdType="doi" ValidYN="Y">10.1016/S1473-3099(16)30067-6</ELocationID>
<Abstract><AbstractText Label="BACKGROUND" NlmCategory="BACKGROUND">Community-wide screening for tuberculosis with Xpert MTB/RIF as a primary screening tool overcomes some of the limitations of conventional screening. However, concerns exist about the low positive predictive value of this test in screening settings. We did a cross-sectional assessment of this diagnostic test to directly estimate the actual positive predictive value of Xpert MTB/RIF when used in the setting of community-wide screening for tuberculosis, and to draw an inference about the specificity of the test for tuberculosis detection.</AbstractText>
<AbstractText Label="METHODS" NlmCategory="METHODS">Field staff visited households in 60 randomly selected villages in Ca Mau province, Vietnam. We included people aged 15 years or older who provided written informed consent and were able to produce 0·5 mL or more of sputum, irrespective of reported symptoms. Participants were tested with Xpert MTB/RIF, then those with positive results had two further sputum samples tested for smear microscopy and culture, and underwent chest radiography at the provincial TB Health Center. The positive predictive value of Xpert MTB/RIF was compared against two reference standards for tuberculosis diagnosis-a positive sputum culture for Mycobacterium tuberculosis, and a positive sputum culture or a chest radiograph consistent with active pulmonary tuberculosis. We then calculated the specificity of Xpert MTB/RIF for tuberculosis detection on the basis of these positive predictive values and disease prevalence in this setting.</AbstractText>
<AbstractText Label="FINDINGS" NlmCategory="RESULTS">43 435 adults consented to screening with Xpert MTB/RIF. Sputum samples of 0·5 mL or greater were collected from 23 202 participants, producing 22 673 valid results. 169 participants had positive Xpert MTB/RIF results (0·39% of those screened and 0·75% of those with valid sputum results). The positive predictive value of Xpert MTB/RIF was 61·0% (95% CI 52·8-68·7) when compared against a positive sputum culture and 83·9% (76·8-89·2) when compared against a positive sputum culture or chest radiograph consistent with active tuberculosis. On the basis of these positive predictive values, the specificity of Xpert MTB/RIF was determined to be between 99·78% (95% CI 99·71-99·84) and 99·93% (99·88-99·96).</AbstractText>
<AbstractText Label="INTERPRETATION" NlmCategory="CONCLUSIONS">The positive predictive value and specificity of Xpert MTB/RIF in the context of community-wide screening for tuberculosis is substantially higher than that predicted in previous studies. Our findings support the potential role of Xpert MTB/RIF as a primary screening tool to detect prevalent cases of tuberculosis in the community.</AbstractText>
<AbstractText Label="FUNDING" NlmCategory="BACKGROUND">Australian National Health and Medical Research Council.</AbstractText>
<CopyrightInformation>Copyright © 2016 Elsevier Ltd. All rights reserved.</CopyrightInformation>
</Abstract>
<AuthorList CompleteYN="Y"><Author ValidYN="Y"><LastName>Ho</LastName>
<ForeName>Jennifer</ForeName>
<Initials>J</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia. Electronic address: jennifer.ho@sydney.edu.au.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nguyen</LastName>
<ForeName>Phuong Thi Bich</ForeName>
<Initials>PTB</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, Hanoi, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nguyen</LastName>
<ForeName>Thu Anh</ForeName>
<Initials>TA</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, Hanoi, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Tran</LastName>
<ForeName>Khoa Hien</ForeName>
<Initials>KH</Initials>
<AffiliationInfo><Affiliation>Ca Mau Centre for Social Disease Prevention, Ca Mau, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Van Nguyen</LastName>
<ForeName>Son</ForeName>
<Initials>S</Initials>
<AffiliationInfo><Affiliation>Ca Mau Centre for Social Disease Prevention, Ca Mau, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nguyen</LastName>
<ForeName>Nhung Viet</ForeName>
<Initials>NV</Initials>
<AffiliationInfo><Affiliation>National Tuberculosis Program, Hanoi, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Nguyen</LastName>
<ForeName>Hoa Binh</ForeName>
<Initials>HB</Initials>
<AffiliationInfo><Affiliation>National Tuberculosis Program, Hanoi, Vietnam; Centre for Operational Research, International Union Against Tuberculosis and Lung Disease, Paris, France.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Luu</LastName>
<ForeName>Khanh Boi</ForeName>
<Initials>KB</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, Hanoi, Vietnam.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Fox</LastName>
<ForeName>Greg J</ForeName>
<Initials>GJ</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; Central Clinical School, Sydney Medical School, University of Sydney, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
</Author>
<Author ValidYN="Y"><LastName>Marks</LastName>
<ForeName>Guy B</ForeName>
<Initials>GB</Initials>
<AffiliationInfo><Affiliation>Woolcock Institute of Medical Research, University of Sydney, Sydney, NSW, Australia; South Western Sydney Clinical School, University of New South Wales, Sydney, NSW, Australia.</Affiliation>
</AffiliationInfo>
</Author>
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<Language>eng</Language>
<PublicationTypeList><PublicationType UI="D016428">Journal Article</PublicationType>
<PublicationType UI="D016448">Multicenter Study</PublicationType>
<PublicationType UI="D016449">Randomized Controlled Trial</PublicationType>
</PublicationTypeList>
<ArticleDate DateType="Electronic"><Year>2016</Year>
<Month>06</Month>
<Day>08</Day>
</ArticleDate>
</Article>
<MedlineJournalInfo><Country>United States</Country>
<MedlineTA>Lancet Infect Dis</MedlineTA>
<NlmUniqueID>101130150</NlmUniqueID>
<ISSNLinking>1473-3099</ISSNLinking>
</MedlineJournalInfo>
<CitationSubset>IM</CitationSubset>
<MeshHeadingList><MeshHeading><DescriptorName UI="D000293" MajorTopicYN="N">Adolescent</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D000328" MajorTopicYN="N">Adult</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D001431" MajorTopicYN="N">Bacteriological Techniques</DescriptorName>
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</MeshHeading>
<MeshHeading><DescriptorName UI="D003430" MajorTopicYN="N">Cross-Sectional Studies</DescriptorName>
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<MeshHeading><DescriptorName UI="D003955" MajorTopicYN="N">Diagnostic Tests, Routine</DescriptorName>
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<MeshHeading><DescriptorName UI="D005260" MajorTopicYN="N">Female</DescriptorName>
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<MeshHeading><DescriptorName UI="D006801" MajorTopicYN="N">Humans</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008297" MajorTopicYN="N">Male</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008853" MajorTopicYN="N">Microscopy</DescriptorName>
<QualifierName UI="Q000379" MajorTopicYN="N">methods</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D008875" MajorTopicYN="N">Middle Aged</DescriptorName>
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<MeshHeading><DescriptorName UI="D009169" MajorTopicYN="N">Mycobacterium tuberculosis</DescriptorName>
<QualifierName UI="Q000235" MajorTopicYN="N">genetics</QualifierName>
<QualifierName UI="Q000302" MajorTopicYN="Y">isolation & purification</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D015995" MajorTopicYN="N">Prevalence</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D012680" MajorTopicYN="Y">Sensitivity and Specificity</DescriptorName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D013183" MajorTopicYN="N">Sputum</DescriptorName>
<QualifierName UI="Q000382" MajorTopicYN="Y">microbiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014397" MajorTopicYN="N">Tuberculosis, Pulmonary</DescriptorName>
<QualifierName UI="Q000175" MajorTopicYN="Y">diagnosis</QualifierName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
<MeshHeading><DescriptorName UI="D014744" MajorTopicYN="N">Vietnam</DescriptorName>
<QualifierName UI="Q000453" MajorTopicYN="N">epidemiology</QualifierName>
</MeshHeading>
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<PubmedData><History><PubMedPubDate PubStatus="received"><Year>2016</Year>
<Month>01</Month>
<Day>25</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="revised"><Year>2016</Year>
<Month>04</Month>
<Day>21</Day>
</PubMedPubDate>
<PubMedPubDate PubStatus="accepted"><Year>2016</Year>
<Month>04</Month>
<Day>22</Day>
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<PubMedPubDate PubStatus="entrez"><Year>2016</Year>
<Month>6</Month>
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<PubMedPubDate PubStatus="pubmed"><Year>2016</Year>
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<PubMedPubDate PubStatus="medline"><Year>2017</Year>
<Month>6</Month>
<Day>13</Day>
<Hour>6</Hour>
<Minute>0</Minute>
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</History>
<PublicationStatus>ppublish</PublicationStatus>
<ArticleIdList><ArticleId IdType="pubmed">27289387</ArticleId>
<ArticleId IdType="pii">S1473-3099(16)30067-6</ArticleId>
<ArticleId IdType="doi">10.1016/S1473-3099(16)30067-6</ArticleId>
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<affiliations><list><country><li>Australie</li>
<li>France</li>
<li>Viêt Nam</li>
</country>
<region><li>Nouvelle-Galles du Sud</li>
<li>Île-de-France</li>
</region>
<settlement><li>Paris</li>
<li>Sydney</li>
</settlement>
<orgName><li>Université de Sydney</li>
</orgName>
</list>
<tree><country name="Australie"><region name="Nouvelle-Galles du Sud"><name sortKey="Ho, Jennifer" sort="Ho, Jennifer" uniqKey="Ho J" first="Jennifer" last="Ho">Jennifer Ho</name>
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<name sortKey="Fox, Greg J" sort="Fox, Greg J" uniqKey="Fox G" first="Greg J" last="Fox">Greg J. Fox</name>
<name sortKey="Marks, Guy B" sort="Marks, Guy B" uniqKey="Marks G" first="Guy B" last="Marks">Guy B. Marks</name>
</country>
<country name="Viêt Nam"><noRegion><name sortKey="Nguyen, Phuong Thi Bich" sort="Nguyen, Phuong Thi Bich" uniqKey="Nguyen P" first="Phuong Thi Bich" last="Nguyen">Phuong Thi Bich Nguyen</name>
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<name sortKey="Luu, Khanh Boi" sort="Luu, Khanh Boi" uniqKey="Luu K" first="Khanh Boi" last="Luu">Khanh Boi Luu</name>
<name sortKey="Nguyen, Nhung Viet" sort="Nguyen, Nhung Viet" uniqKey="Nguyen N" first="Nhung Viet" last="Nguyen">Nhung Viet Nguyen</name>
<name sortKey="Nguyen, Thu Anh" sort="Nguyen, Thu Anh" uniqKey="Nguyen T" first="Thu Anh" last="Nguyen">Thu Anh Nguyen</name>
<name sortKey="Tran, Khoa Hien" sort="Tran, Khoa Hien" uniqKey="Tran K" first="Khoa Hien" last="Tran">Khoa Hien Tran</name>
<name sortKey="Van Nguyen, Son" sort="Van Nguyen, Son" uniqKey="Van Nguyen S" first="Son" last="Van Nguyen">Son Van Nguyen</name>
</country>
<country name="France"><region name="Île-de-France"><name sortKey="Nguyen, Hoa Binh" sort="Nguyen, Hoa Binh" uniqKey="Nguyen H" first="Hoa Binh" last="Nguyen">Hoa Binh Nguyen</name>
</region>
</country>
</tree>
</affiliations>
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