Table 2.
Xpert MTB/RIF for detection of pulmonary tuberculosis, investigations of heterogeneity
| Type of analysis (number of studies; participants) | Median pooled sensitivity (95% CrI) | Median pooled specificity (95% CrI) | Median predicted sensitivity (95% CrI) | Median predicted specificity (95% CrI) |
| Xpert MTB/RIF accuracy for tuberculosis detection in clinical subgroups | ||||
| Smear positive (45; 4064)a | 98% (97 to 98) | Could not determine | 98% (89 to 100) | Could not determine |
| Smear negative (45; 18,962)a | 67% (62 to 72) | 98% (98 to 99) | 67% (37 to 88) | 98% (80 to 100) |
| HIV negative (14; 3866)a | 88% (83 to 92) | 98% (97 to 99) | 88% (71 to 96) | 98% (92 to 100) |
| HIV positive (14; 4664)a | 81% (75 to 86) | 98% (97 to 99) | 81% (59 to 93) | 98% (92 to 100) |
| Xpert MTB/RIF accuracy for tuberculosis detection based on percentage of participants with a history of previous tuberculosis | ||||
| Previous tuberculosis > 25% (11; 4196) | 82% (74 to 88) | 96% (93 to 98) | 82% (48 to 96) | 96% (78 to 99) |
| Previous tuberculosis ≤ 25% (16; 8205) | 81% (72 to 87) | 98% (97 to 99) | 81% (39 to 97) | 98% (90 to 100) |
| Xpert MTB/RIF accuracy for tuberculosis detection by tuberculosis burdena | ||||
| High tuberculosis burden = Yes (39; 21,965)b | 86% (82 to 89) | 97% (95 to 98) | 86% (57 to 96) | 97% (71 to 100) |
| High tuberculosis burden = No (33; 15,272)b | 85% (81 to 89) | 99% (98 to 99) | 85% (55 to 96) | 99% (89 to 100) |
| Xpert MTB/RIF accuracy for tuberculosis detection by TB/HIV burdena | ||||
| High TB/HIV burden = Yes (42; 24,412)b | 83% (80 to 87) | 97% (95 to 98) | 84% (51 to 96) | 97% (74 to 100) |
| High TB/HIV burden = No (30; 12,825)b | 88% (84 to 90) | 99% (98 to 99) | 88% (67 to 96) | 99% (86 to 100) |
| Xpert MTB/RIF accuracy for tuberculosis detection by setting that ran the test | ||||
| Xpert run at point of care or in a peripheral setting (10; 5816) | 83% (75 to 89) | 97% (93 to 99) | 83% (52 to 96) | 97% (66 to 100) |
| Central or intermediate laboratory (60; 31,421) | 85% (83 to 88) | 98% (97 to 98) | 85% (57 to 96) | 98% (80 to 100) |
| Xpert MTB/RIF accuracy for tuberculosis detection by median tuberculosis prevalence | ||||
| Prevalence > 26% (35; 17,983) | 89% (87 to 91) | 96% (94 to 97) | 89% (69 to 97) | 96% (72 to 100) |
| Prevalence ≤ 26% (35; 19,254) | 79% (75 to 83) | 99% (98 to 99) | 79% (51 to 93) | 99% (89 to 100) |
Abbreviations: CrI: credible interval; HIV: human immunodeficiency virus; TB: tuberculosis. aAccuracy estimates were determined in studies providing data for both subgroups. bSubstudies from Boehme 2010 and Boehme 2011 contributed to both tuberculosis burden categories.