Table 5.

Accuracy of MTBDRsl for detection of extensively drug-resistant TB, by reference standard and type of testing, direct comparisons

Type of testing	Number of participants (studies)	Number of resistant cases (TPs + FNs)	Pooled sensitivity (95% CI)	Pooled specificity (95% CI)
Culture testing
Indirect	880 (8 studies)	173	70.9% (42.9 to 88.8)	98.8% (96.1, 99.6)
Direct	644 (3 studies)	50	*	*
Genetic testing
Indirect	541 (3 studies)	66	100.0% (94.6 to 100.0)‡	97.5% (95.6 to 98.7)‡
Direct	0 (0 studies)	0	Not applicable	Not applicable
Genetic and culture testing
Indirect	435 (2 studies)	102	58.8% (49.1 to 67.9)	98.8% (96.8 to 99.5)
Direct	0 (0 studies)	0	Not applicable	Not applicable
Culture followed by genetic testing of discordant results
Indirect	0 (0 studies)	0	Not applicable	Not applicable
Direct	516 (1 study)	26	92.3% (74.9 to 99.1)	99.6% (98.5 to 100.0)

^*We observed considerable heterogeneity and did not pool results.

^‡We observed little heterogeneity and determined summary estimates of sensitivity and specificity separately using a fixed-effect model.

TP = true positive; FN = false negative.