Table 4.
Accuracy of MTBDRsl for detection of resistance to fluoroquinolones and second-line injectable drugs, by reference standard and type of testing, direct comparisons
| Pooled sensitivity (95% CI) | Pooled specificity (95% CI) |
Pooled sensitivity (95% CI) |
Pooled specificity (95% CI) |
Pooled sensitivity P value1 |
Pooled specificity P value1 |
|
Fluoroquinolone, culture, indirect testing (6 studies, 873 participants) |
Fluoroquinolone, genetic sequencing, indirect testing (6 studies, 873 participants) |
||||
| 82.4% (77.6 to 86.3) | 98.8% (94.3 to 99.8) | 99.3% (81.2 to 100) | 99.3% (90.8 to 100) | < 0.001 | 0.971 |
|
Fluoroquinolone, culture, indirect testing (7 studies, 1211 participants) |
Fluoroquinolone, genetic sequencing and culture, indirect testing (7 studies, 1211 participants) |
||||
| 81.8% (77.2 to 85.7) | 99.0% (95.0 to 99.8) | 82.0% (77.7 to 85.6) | 99.8% (98.5 to 100) | 0.795 | < 0.001 |
|
Second-line injectable drugs, culture, indirect testing (6 studies, 873 participants) |
Second-line injectable drugs, genetic sequencing, indirect testing (6 studies, 873 participants) |
||||
| 74.6% (66.2 to 81.5) | 99.9% (71.8 to 100) | 97.0% (77.0 to 99.7) | 99.5% (94.5 to 100) | 0.053* | 0.349* |
|
Second-line injectable drugs, culture, indirect testing (6 studies, 1159 participants) |
Second-line injectable drugs, genetic sequencing and culture, indirect testing (6 studies, 1159 participants) |
||||
| 70.5% (52.0 to 84.1) | 99.8% (93.8 to 100) | 61.3% (45.8 to 74.8%) | 99.9% (99.0 to 100) | 0.729 | 0.015 |
|
Amikacin, culture, indirect testing (6 studies, 618 participants) |
Capreomycin, culture, indirect testing (6 studies, 618 participants) |
||||
| 87.1% (77.0 to 93.1) | 99.9% (80.8 to 100) | 85.6% (78.0 to 90.9) | 96.8% (94.8 to 98.0) | 0.989 | 0.029 |
|
Kanamycin, culture, indirect testing (6 studies, 1086 participants) |
Capreomycin, culture, indirect testing (6 studies, 1086 participants) |
||||
| 54.3% (34.5 to 72.8) | 98.3% (94.8 to 99.5) | 69.7% (38.0 to 89.6) | 96.1% (93.3 to 97.8) | 0.594 | 0.188 |
A direct comparison uses only studies that directly compared the two evaluations. Direct statistical comparisons for the purpose of determining pooled accuracy estimates are not to be confused with direct testing that pertains to the method for testing with MTBDRsl.
*
Indicates the model allowed the variances of the random effects to be associated with the covariate.
1
Likelihood ratio test for evidence of a significant difference between accuracy estimates.