Bahr 2015
| Study characteristics | |||
| Patient sampling | Cross‐sectional, prospective, and consecutive | ||
| Patient characteristics and setting | Presenting signs and symptoms: HIV‐infected patients presenting with symptoms of meningitis being evaluated for cryptococcal meningitis. All persons who were CSF cryptococcal antigen‐negative had a TB workup Age: median 40 years (IQR 30 to 45) Sex, female: 34% Children: no HIV infection: 98% Clinical setting: tertiary care centre (Inpatient) Past history of TB: 22% Participants on anti‐TB treatment: yes, 11% Number of specimens evaluated: 80 Laboratory level: central Country: Uganda World Bank Income Classification: low income TB incidence rate: 201 per 100,000 Per cent MDR‐TB among new TB cases: 1.6%; among retreatment cases: 12% (source: WHO Global TB Report, 2017) |
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| Index tests | Xpert® MTB/RIF WHO SOP or manufacturer's protocol followed: yes Manufacturer's involvement: no |
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| Target condition and reference standard(s) | Target condition: TB meningitis Reference standard for TB detection: LJ and MGIT Reference standard for rifampicin resistance: MGIT‐DST Speciation: yes Decontamination: no |
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| Flow and timing | |||
| Comparative | |||
| Notes | Reference standards were culture and a TB meningitis uniform case definition | ||
| Methodological quality | |||
| Item | Authors' judgement | Risk of bias | Applicability concerns |
| DOMAIN 1: Patient Selection | |||
| Was a consecutive or random sample of patients enrolled? | Yes | ||
| Was a case‐control design avoided? | Yes | ||
| Did the study avoid inappropriate exclusions? | Yes | ||
| Low | High | ||
| DOMAIN 2: Index Test All tests | |||
| Were the index test results interpreted without knowledge of the results of the reference standard? | Yes | ||
| If a threshold was used, was it pre‐specified? | Yes | ||
| Low | Low | ||
| DOMAIN 3: Reference Standard | |||
| Is the reference standards likely to correctly classify the target condition? | Yes | ||
| Were the reference standard results interpreted without knowledge of the results of the index tests? | Yes | ||
| For rifampicin resistance testing, were the reference standard results interpreted without knowledge of the results of the index test? | Yes | ||
| Low | Low | ||
| DOMAIN 4: Flow and Timing | |||
| Was there an appropriate interval between index test and reference standard? | Yes | ||
| Did all patients receive the same reference standard? | Yes | ||
| Were all patients included in the analysis? | Yes | ||
| Low | |||