Table 5.
Systematic reviews on the diagnostic accuracy of Xpert MTB/RIF for pulmonary tuberculosis and rifampicin resistance
| Author, year | Date searched up to | No. studies (participants) | PTB, summary estimates (95% CI) | No. studies | Rifampicin resistance, summary estimates (95% CrI) | ||
| Sensitivity | Specificity | Sensitivity | Specificity | ||||
| Chang 2012 | October 2011 |
15 (8117) | 90% (89 to 91) | 98% (98 to 99) | 7 | see note | see note |
|
Walusimbi 2013b (smear‐negative) |
May 2012 | 15 (2046) | 67% (62 to 71) | 98% (97 to 99) | NA | NA | NA |
| Steingart 2014 | December 2013 | 27 (6026) | 89% (85 to 92) | 99% (98 to 99) | sensitivity: 17 specificity: 24 | 95% (90 to 97) | 98% (97 to 99) |
| Yan 2016 | not reported | 12 (8122) | 89% (87 to 90) | 98% (98 to 99) | NA | NA | NA |
| Li 2017 | June 2015 | 24 (2486) | 87% (83 to 90) | 97% (96 to 98) | NA | NA | NA |
| Alvis‐Zakzuk 2017 | December 2015 | NA | NA | NA | 8 | see note | see note |
| Horne 2019 | January 2018 | 85 (41,965) | 85% (82 to 87) | 98% (97 to 98) | 48 (8020) | 96% (94 to 97) | 98% (98 to 99) |
Abbreviations: CI: confidence interval; Crl: credible interval; NA: not applicable; PTB: pulmonary tuberculosis.
Chang 2012 included adults and children; Xpert for detection of rifampicin resistance, sensitivity range 17% to 100%, specificity range 72% to 100%. Walusimbi 2013b only included smear‐negative participants. Steingart 2014 is the previous Cochrane Review. Yan 2016 only included studies that provided data by smear and HIV status. Li 2017 106 studies (52,410 specimens) for both PTB and extrapulmonary tuberculosis. Alvis‐Zakzuk 2017 2017 summarized accuracy of Xpert for detection of rifampicin resistance, sensitivity range 33% to 100%; specificity range 91% to 100%. Horne 2019 is this updated Cochrane Review.
Systematic reviews not included in this table:
Kaur 2016 did not provide summary sensitivity and specificity estimates. Lange 2017 provided sensitivity and specificity with respect to Xpert cycle threshold (Ct) values. Maynard‐Smith 2014 provided accuracy estimates for PTB on gastric aspirates and stool. Wang 2015 only included children.