{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:20:47Z","timestamp":1791930047971,"version":"4.3.4"},"reference-count":44,"publisher":"BMJ","issue":"8","license":[{"start":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T00:00:00Z","timestamp":1660176000000},"content-version":"unspecified","delay-in-days":10,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2022,7,14]]},"published-print":{"date-parts":[[2022,8]]},"abstract":"<jats:sec>\n                    <jats:title>Background\/objectives<\/jats:title>\n                    <jats:p>\n                      Urinary antigen tests have been used for the rapid identification of\n                      <jats:italic>Streptococcus pneumoniae<\/jats:italic>\n                      infection in patients with pneumonia, thereby leading to earlier targeted therapy than when using conventional diagnostic culture methods. This study aimed to update the knowledge on the diagnostic accuracy of urinary antigen tests for\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      among patients with acute respiratory failure suspected of pneumonia based on a systematic review and meta-analysis.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A systematic search was performed using MEDLINE and the Cochrane Central Register of Controlled Trials for studies published up to 3 June 2020. Prospective and retrospective cohort studies (in English) that reported on the diagnostic performance of urinary antigen tests versus culture or smear diagnostic methods in adult patients with clinically diagnosed pneumonia were selected and analysed. The QUADAS-2 tool was used to assess the risk of bias, and a bivariate random effects model was applied to perform a meta-analysis of the selected studies.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 2179 studies were screened, of which 30 met the eligibility criteria for quality assessment and meta-analysis. Overall, data from 12\u2009366 patients, including 1548 patients (12.5%) with the target condition and suspected pneumococcal pneumonia, were included in the analysis. The overall quality of the included studies was determined to be serious. The calculated pooled sensitivity and specificity were of 0.66 (95% CI 0.62 to 0.69) and 0.90 (95% CI 0.85 to 0.93), respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>\n                      The urinary antigen test is useful for achieving a definitive diagnosis of\n                      <jats:italic>S. pneumoniae<\/jats:italic>\n                      infection in patients with pneumonia.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmjopen-2021-057216","type":"journal-article","created":{"date-parts":[[2022,8,11]],"date-time":"2022-08-11T12:01:30Z","timestamp":1660219290000},"page":"e057216","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":20,"title":["Diagnostic accuracy of urinary antigen tests for pneumococcal pneumonia among patients with acute respiratory failure suspected pneumonia: a systematic review and meta-analysis"],"prefix":"10.1136","volume":"12","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-3030-123X","authenticated-orcid":false,"given":"Shunsuke","family":"Yasuo","sequence":"first","affiliation":[{"name":"Department of Emergency and Critical Care Medicine, Kyoto Katsura Hospital, Kyoto, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4331-5729","authenticated-orcid":false,"given":"Maki","family":"Murata","sequence":"additional","affiliation":[{"name":"Department of Emergency medicine and Critical care, National Hospital Organization Kyoto Medical Center, Kyoto, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natsuki","family":"Nakagawa","sequence":"additional","affiliation":[{"name":"Department of Respiratory Medicine, The University of Tokyo Hospital, Bunkyo-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takeshi","family":"Kawasaki","sequence":"additional","affiliation":[{"name":"Department of Respirology, Graduate School of Medicine, Chiba University, Chiba, Chiba, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Takuo","family":"Yoshida","sequence":"additional","affiliation":[{"name":"Department of Intensive Care Medicine, Tokyo Women's Medical University, Shinjuku-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6535-8279","authenticated-orcid":false,"given":"Koichi","family":"Ando","sequence":"additional","affiliation":[{"name":"Division of Respiratory Medicine and Allergology, Department of Medicine, Showa University, School of Medicine, Shinagawa-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Okamori","sequence":"additional","affiliation":[{"name":"Division of Pulmonary Medicine, Department of Medicine, Keio University School of Medicine, Shinjuku-ku, Tokyo, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2266-476X","authenticated-orcid":false,"given":"Yohei","family":"Okada","sequence":"additional","affiliation":[{"name":"Department of Primary Care and Emergency Medicine, Graduate School of Medicine, Kyoto University, Kyoto, Kyoto, Japan"},{"name":"Preventive Services, School of Public Health in the Graduate School of Medicine, Kyoto University, Kyoto, Japan"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"239","published-online":{"date-parts":[[2022,8,11]]},"reference":[{"key":"2025121512151688000_12.8.e057216.1","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)60733-4"},{"key":"2025121512151688000_12.8.e057216.2","first-page":"210","article-title":"Bacteremic and nonbacteremic pneumococcal pneumonia","volume":"79","author":"Musher","year":"2000","journal-title":"A prospective study. 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