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Xpert ® MTB / RIF assay for extrapulmonary tuberculosis and rifampicin resistance ( Protocol )

Mikashmi Kohli,I. Schiller,N. Dendukuri,Hannah N. Ryan,K. Dheda,C. Denkinger,S. Schumacher,K. Steingart

Published 2017 in Unknown venue

ABSTRACT

This is a protocol for a Cochrane Review (Diagnostic test accuracy). The objectives are as follows: To determine the diagnostic accuracy of Xpert® MTB/RIF for the detection of extrapulmonary TB by site of disease in people suspected of having extrapulmonary TB. The role of Xpert® MTB/RIF would be a replacement for standard practice. To determine the diagnostic accuracy of Xpert® MTB/RIF for detection of rifampicin resistance in people suspected of having extrapulmonary TB. The role of Xpert® MTB/RIF would be an initial test for replacement for culture-based DST. We plan to investigate the impact of covariates on heterogeneity in estimates of test accuracy across the included studies. Detection of extrapulmonary TB The covariates of interest are: HIV prevalence; condition of the specimen (fresh versus frozen); sample input volume (for liquid specimens); homogenization step (for tissue specimens); smear status of specimen; past history of TB; and prevalence of extrapulmonary TB. In addition, we plan to explore whether the WHO standard operating procedures for a given type of specimen were followed and can explain the observed heterogeneity in accuracy estimates. For TB meningitis we plan to investigate whether the use of a concentration step prior to the use of Xpert® MTB/RIF has an impact on accuracy estimates. In addition, for detection of lymph node TB, pleural TB, and TB meningitis, we plan to adjust accuracy estimates by applying a latent class meta-analysis model to account for the imperfect nature of culture as the reference standard. Detection of rifampicin resistance detection The covariate of interest is the prevalence of rifampicin resistance. 1 Xpert® MTB/RIF assay for extrapulmonary tuberculosis and rifampicin resistance (Protocol) Copyright © 2017 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd.

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