{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,8]],"date-time":"2026-09-08T15:31:33Z","timestamp":1788881493298,"version":"build-2803163510"},"reference-count":71,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2023,1,20]],"date-time":"2023-01-20T00:00:00Z","timestamp":1674172800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Tropical Med Int Health"],"published-print":{"date-parts":[[2023,3]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To comprehensively evaluate the diagnostic efficacy of adenosine deaminase in cerebrospinal fluid (CSF) for tuberculous meningitis (TBM), and the potential influence of patients' age groups and cutoffs of measured adenosine deaminase.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Systematic review and meta\u2010analysis of relevant studies retrieved from PubMed, Embase, and Web of Science databases. Pooled sensitivity and specificity were calculated with a random\u2010effect model.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Overall, 43 studies with 1653 patients with TBM and 3417 controls without were included. Pooled results showed that adenosine deaminase in CSF is associated with satisfactory diagnostic efficacy for TBM, with a pooled sensitivity of 0.86 (95% confidence interval [CI]: 0.82\u20130.90), specificity of 0.89 (95% CI: 0.86\u20130.91), positive likelihood ratio of 7.70 (95% CI: 6.16\u20139.63), and negative likelihood ratio of 0.15 (95% CI: 0.12\u20130.20). The pooled receiver operating characteristic (AUC) was 0.94 (95% CI: 0.91\u20130.96), suggesting good performance. Subgroup analyses showed good diagnostic efficacies of adenosine deaminase in CSF for both adults (AUC 0.95) and children (AUC 0.96) with TBM. AUCs indicating the diagnostic accuracies of adenosine deaminase in CSF for TBM were 0.93 for studies with cutoffs &lt;10\u00a0U\/L and and 0.94 for a cutoff =10\u00a0U\/L, but only 0.90 for studies with cutoffs &gt;10\u00a0U\/L.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Measuring adenosine deaminase of CSF shows satisfactory diagnostic efficacy for TBM in children and adults, particularly if using a cutoff \u226410\u00a0U\/L.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/tmi.13849","type":"journal-article","created":{"date-parts":[[2023,1,2]],"date-time":"2023-01-02T06:23:38Z","timestamp":1672640618000},"page":"175-185","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Adenosine deaminase from the cerebrospinal fluid for the diagnosis of tuberculous meningitis: A meta\u2010analysis"],"prefix":"10.1111","volume":"28","author":[{"given":"Qin","family":"Ye","sequence":"first","affiliation":[{"name":"Department of Pulmonary Medicine, Ningbo HwaMei Hospital, Ningbo Institute of Life and Health Industry University of Chinese Academy of Sciences  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wang","family":"Yan","sequence":"additional","affiliation":[{"name":"Department of Neurology, Ningbo HwaMei Hospital University of Chinese Academy of Sciences  Ningbo China"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2023,1,20]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(19)30308-3"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00415-022-11052-8"},{"key":"e_1_2_7_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(21)00435-X"},{"issue":"1","key":"e_1_2_7_5_1","first-page":"259","article-title":"An overview on epidemiology of tuberculosis","volume":"28","author":"Khan MK","year":"2019","journal-title":"Mymensingh Med J"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1097\/QCO.0000000000000648"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1038\/nrneurol.2017.120"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1474-4422(19)30154-1"},{"key":"e_1_2_7_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.neurol.2019.07.007"},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70138-9"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.42.1.378-379.2004"},{"issue":"9","key":"e_1_2_7_12_1","first-page":"1761","article-title":"Extrapulmonary tuberculosis: an overview","volume":"72","author":"Golden MP","year":"2005","journal-title":"Am Fam Physician"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.3109\/00365540903428158"},{"issue":"11","key":"e_1_2_7_14_1","first-page":"1382","article-title":"Diagnostic value of adenosine deaminase in cerebrospinal fluid for tuberculous meningitis: a meta\u2010analysis","volume":"14","author":"Xu HB","year":"2010","journal-title":"Int J Tuberc Lung Dis"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jinf.2017.02.012"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12879-017-2221-3"},{"issue":"5","key":"e_1_2_7_17_1","first-page":"339","article-title":"Cerebrospinal fluid adenosine deaminase and its dynamic changes in tuberculous meningitis","volume":"40","author":"Li XL","year":"2017","journal-title":"Zhonghua Jie He He Hu Xi Za Zhi"},{"issue":"4","key":"e_1_2_7_18_1","first-page":"OC22","article-title":"Determination and validation of a lower cut off value of cerebrospinal fluid adenosine deaminase (CSF\u2010ADA) activity in diagnosis of tuberculous meningitis","volume":"11","author":"Raviraj","year":"2017","journal-title":"J Clin Diagn Res"},{"key":"e_1_2_7_19_1","doi-asserted-by":"publisher","DOI":"10.4103\/npmj.npmj_21_17"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jiac.2018.03.016"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.12669\/pjms.345.13585"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.18-0947"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1136\/jclinpath-2019-206397"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41182-021-00322-2"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1080\/01616412.2021.2004366"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n71"},{"key":"e_1_2_7_27_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.n160"},{"key":"e_1_2_7_28_1","unstructured":"HigginsJ ThomasJ ChandlerJ CumpstonM LiT PageM et al.Cochrane handbook for systematic reviews of interventions version 6.2. 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