Diagnostic accuracy of adenosine deaminase for tuberculous pericarditis: a meta-analysis.

OBJECTIVE: Many studies suggest that adenosine deaminase is a marker for tuberculous pericarditis, while controversy exists as to its diagnostic utility. This study aims to summarize the overall diagnostic performance of adenosine deaminase for tuberculous pericarditis through a meta-analysis.

MATERIALS AND METHODS: Literatures published before May 2015 were searched in PubMed and EMBASE. The data were retrieved and the sensitivity, specificity, positive/negative likelihood ratio (PLR/NLR), diagnostic odds ratio (DOR) of adenosine deaminase for diagnosing tuberculous pericarditis were pooled, and the summary receiver operating characteristic (SROC) curves were used to examine the overall performance of adenosine deaminase.

RESULTS: In total, 11 studies with 938 subjects were included in the meta-analysis. The summary estimates of adenosine deaminase for diagnosing tuberculous pericarditis were listed as follows: sensitivity of 0.90 (95% CI: 0.86-0.93), specificity of 0.86 (95% CI: 0.83-0.89), PLR of 5.90 (95% CI: 4.46-7.82), NLR of 0.15 (95% CI: 0.09-0.26), and DOR of 42.55 (95% CI: 21.51-84.18). The area under the SROC curve was 0.92, and the Q value was 0.85. No publication bias was identified.

CONCLUSIONS: Adenosine deaminase is a valuable marker with both high sensitivity and specificity in the diagnosis of tuberculous pericarditis. Nevertheless, the results of adenosine deaminase assays should be interpreted in combination with other test results and clinical characteristics of patients.