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Sensitivity and specificity of the Streptococcus pneumoniae urinary antigen test for unconcentrated urine from adult patients with pneumonia: A meta‐analysis
Author(s) -
Horita Nobuyuki,
Miyazawa Naoki,
Kojima Ryota,
Kimura Naoko,
Inoue Miyo,
Ishigatsubo Yoshiaki,
Kaneko Takeshi
Publication year - 2013
Publication title -
respirology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.857
H-Index - 85
eISSN - 1440-1843
pISSN - 1323-7799
DOI - 10.1111/resp.12163
Subject(s) - medicine , confidence interval , pneumonia , streptococcus pneumoniae , meta analysis , publication bias , urine , etiology , urinary system , immunology , gastroenterology , microbiology and biotechnology , biology , antibiotics
Studies on the sensitivity and specificity of the B inax N ow S treptococcus pneumonia urinary antigen test (index test) show considerable variance of results. Those written in E nglish provided sufficient original data to evaluate the sensitivity and specificity of the index test using unconcentrated urine to identify S . pneumoniae infection in adults with pneumonia. Reference tests were conducted with at least one culture and/or smear. We estimated sensitivity and two specificities. One was the specificity evaluated using only patients with pneumonia of identified other aetiologies (‘specificity (other)’). The other was the specificity evaluated based on both patients with pneumonia of unknown aetiology and those with pneumonia of other aetiologies (‘specificity (unknown and other)’) using a fixed model for meta‐analysis. We found 10 articles involving 2315 patients. The analysis of 10 studies involving 399 patients yielded a pooled sensitivity of 0.75 (95% confidence interval: 0.71–0.79) without heterogeneity or publication bias. The analysis of six studies involving 258 patients yielded a pooled specificity (other) of 0.95 (95% confidence interval: 0.92–0.98) without no heterogeneity or publication bias. We attempted to conduct a meta‐analysis with the 10 studies involving 1916 patients to estimate specificity (unknown and other), but it remained unclear due to moderate heterogeneity and possible publication bias. In our meta‐analysis, sensitivity of the index test was moderate and specificity (other) was high; however, the specificity (unknown and other) remained unclear.