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. 2019 Oct 21;2019(10):CD011420. doi: 10.1002/14651858.CD011420.pub3

Drain 2016.

Study characteristics
Patient sampling Cross‐sectional, prospective and consecutive enrolment
Patient characteristics and setting Presenting signs and symptoms: HIV‐infected and HIV‐uninfected adults suspected of tuberculosis included if smear microscopy negative x 2; Presenting with at least two of four tuberculosis‐related symptoms: cough, fever, weight loss, night sweats for at least two weeks and a Karnofsky performance score >50
 Age: mean 37 (SD 9)
 Sex, female: 49%
 HIV infection: 93%
 Median CD4 cell count per µL: 168 (IQR 89 to 256)
History of tuberculosis: not stated
 Sample size: 90
 Clinical setting: outpatient
 Country: South Africa
 Tuberculosis incidence rate: 567 per 100,000
 Number (proportion) of tuberculosis cases in the study: 57 (63%)
Index tests LF‐LAM
Target condition and reference standard(s) Target: pulmonary tuberculosis
Reference standard: any of sputum mycobacterial culture (solid and liquid) or nucleic acid amplification test; no extrapulmonary specimens tested
Flow and timing All patients were included in the analysis
Comparative  
Notes The study authors performed sputum induction for individuals who could not expectorate. They excluded individuals without some respiratory specimen available and did not attempt to identify extrapulmonary tuberculosis
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? No    
    High 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? No    
Were the reference standard results interpreted without knowledge of the results of the index tests? Yes    
    High 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