A systematic review of high quality diagnostic tests for Chagas disease.
There is significant heterogeneity in reported sensitivities and specificities of diagnostic serological assays for Chagas disease, as might be expected from studies that vary widely according to setting, research design, antigens employed, and reference standard. The purpose of this study is to sum...
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ftdoajarticles:oai:doaj.org/article:e619b0d0881b4c959b929e1fa053b777 2023-05-15T15:11:05+02:00 A systematic review of high quality diagnostic tests for Chagas disease. Anna M Afonso Mark H Ebell Rick L Tarleton 2012-01-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0001881 https://doaj.org/article/e619b0d0881b4c959b929e1fa053b777 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC3493394?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001881 https://doaj.org/article/e619b0d0881b4c959b929e1fa053b777 PLoS Neglected Tropical Diseases, Vol 6, Iss 11, p e1881 (2012) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2012 ftdoajarticles https://doi.org/10.1371/journal.pntd.0001881 2022-12-31T13:43:33Z There is significant heterogeneity in reported sensitivities and specificities of diagnostic serological assays for Chagas disease, as might be expected from studies that vary widely according to setting, research design, antigens employed, and reference standard. The purpose of this study is to summarize the reported accuracy of serological assays and to identify sources of heterogeneity including quality of research design. To avoid associated spectrum bias, our analysis was limited to cohort studies.We completed a search of PubMed, a bibliographic review of potentially relevant articles, and a review of articles identified by a study author involved in this area of research. Studies were limited to prospective cohort studies of adults published since 1985. Measures of diagnostic accuracy were pooled using a Der Simonian Laird Random Effects Model. A subgroup analysis and meta regression were employed to identify sources of heterogeneity. The QUADAS tool was used to assess quality of included studies and Begg's funnel plot was used to assess publication bias.Eighteen studies and 61 assays were included in the final analysis. Significant heterogeneity was found in all pre-determined subgroups. Overall sensitivity was 90% (95% CI: 89%-91%) and overall specificity was 98% (95% CI: 98%-98%).Sensitivity and specificity of serological assays for the diagnosis of Chagas disease appear less accurate than previously thought. Suggestions to improve the accuracy of reporting include the enrollment of patients in a prospective manner, double blinding, and providing an explicit method of addressing subjects that have an indeterminate diagnosis by either the reference standard or index test. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic Laird ENVELOPE(162.450,162.450,-81.683,-81.683) PLoS Neglected Tropical Diseases 6 11 e1881 |
institution |
Open Polar |
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Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
spellingShingle |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Anna M Afonso Mark H Ebell Rick L Tarleton A systematic review of high quality diagnostic tests for Chagas disease. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
There is significant heterogeneity in reported sensitivities and specificities of diagnostic serological assays for Chagas disease, as might be expected from studies that vary widely according to setting, research design, antigens employed, and reference standard. The purpose of this study is to summarize the reported accuracy of serological assays and to identify sources of heterogeneity including quality of research design. To avoid associated spectrum bias, our analysis was limited to cohort studies.We completed a search of PubMed, a bibliographic review of potentially relevant articles, and a review of articles identified by a study author involved in this area of research. Studies were limited to prospective cohort studies of adults published since 1985. Measures of diagnostic accuracy were pooled using a Der Simonian Laird Random Effects Model. A subgroup analysis and meta regression were employed to identify sources of heterogeneity. The QUADAS tool was used to assess quality of included studies and Begg's funnel plot was used to assess publication bias.Eighteen studies and 61 assays were included in the final analysis. Significant heterogeneity was found in all pre-determined subgroups. Overall sensitivity was 90% (95% CI: 89%-91%) and overall specificity was 98% (95% CI: 98%-98%).Sensitivity and specificity of serological assays for the diagnosis of Chagas disease appear less accurate than previously thought. Suggestions to improve the accuracy of reporting include the enrollment of patients in a prospective manner, double blinding, and providing an explicit method of addressing subjects that have an indeterminate diagnosis by either the reference standard or index test. |
format |
Article in Journal/Newspaper |
author |
Anna M Afonso Mark H Ebell Rick L Tarleton |
author_facet |
Anna M Afonso Mark H Ebell Rick L Tarleton |
author_sort |
Anna M Afonso |
title |
A systematic review of high quality diagnostic tests for Chagas disease. |
title_short |
A systematic review of high quality diagnostic tests for Chagas disease. |
title_full |
A systematic review of high quality diagnostic tests for Chagas disease. |
title_fullStr |
A systematic review of high quality diagnostic tests for Chagas disease. |
title_full_unstemmed |
A systematic review of high quality diagnostic tests for Chagas disease. |
title_sort |
systematic review of high quality diagnostic tests for chagas disease. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2012 |
url |
https://doi.org/10.1371/journal.pntd.0001881 https://doaj.org/article/e619b0d0881b4c959b929e1fa053b777 |
long_lat |
ENVELOPE(162.450,162.450,-81.683,-81.683) |
geographic |
Arctic Laird |
geographic_facet |
Arctic Laird |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 6, Iss 11, p e1881 (2012) |
op_relation |
http://europepmc.org/articles/PMC3493394?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0001881 https://doaj.org/article/e619b0d0881b4c959b929e1fa053b777 |
op_doi |
https://doi.org/10.1371/journal.pntd.0001881 |
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PLoS Neglected Tropical Diseases |
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6 |
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11 |
container_start_page |
e1881 |
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