Table 2.
CSF Test | N | Sensitivity vs. composite microbiologic endpoint a, b | P-value c | Sensitivity vs. case definition d,e | P-value d | NPV vs. case definition e | Specificity vs. case definition e |
---|---|---|---|---|---|---|---|
Xpert Ultra | 204 | 92.9% (39/42) [80.5 – 98.5%] | - | 76.5% (39/51) [62.5 – 87.2%] | - | 92.7% (153/165) [87.6 – 96.2%] | 100% (153/153) [97.6 – 100%] |
Xpert MTB/Rif | 166 | 65.8% (25/38) [48.6 – 80.4%] | 0.006 | 55.6% (25/45) [44.0 – 70.4%] | 0.001 | 85.8% (121/141) [78.9 – 91.1%] | 100% (121/121) [97.0 – 100%] |
MGIT Culture | 142 | 72.2% (27/37) [55.9 – 86.2%] | 0.09 | 61.4% (27/44) [45.5 – 75.6%] | 0.02 | 85.2% (98/115) [77.4 – 91.1%] | 100% (98/98) [96.3 – 100%] |
Values are percent (numerator/denominator) and [95% Confidence Interval]
Composite microbiological endpoint included any positive CSF test including ZN stain microscopy, Xpert, Xpert Ultra, or MGIT culture.
Specificity (and positive predictive value) versus the composite endpoint is by definition 100% as the index test is included in the reference standard of ‘definite’ TBM. If the Ultra result is excluded when assigning the case definition, the specificity of Ultra is 96% (153/160, 95% CI 91-98%) and the PPV is 82% (32/39, (5% CI 66-93%).
McNemar’s test comparing the sensitivity of Xpert or MGIT culture to Xpert Ultra.
Cochran–Mantel–Haenszel test comparing the distribution of Xpert or MGIT to Xpert Ultra results versus the uniform clinical standard of definite/probable TBM or not.
Composite case definition for probable or definite TBM is as per the published uniform definition
PPV: positive predictive value, NPV, negative predictive value