{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,3]],"date-time":"2026-11-03T22:52:04Z","timestamp":1793746324376,"version":"4.6.1"},"reference-count":46,"publisher":"European Respiratory Society (ERS)","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Eur Respir J"],"accepted":{"date-parts":[[2014,3,8]]},"published-print":{"date-parts":[[2014,8]]},"abstract":"<jats:p>Xpert MTB\/RIF (Cepheid, Sunnyvale, CA, USA) is endorsed for the detection of pulmonary tuberculosis (TB). We performed a systematic review and meta-analysis to assess the accuracy of Xpert for the detection of extrapulmonary TB.<\/jats:p>\n                  <jats:p>We searched multiple databases to October 15, 2013. We determined the accuracy of Xpert compared with culture and a composite reference standard (CRS). We grouped data by sample type and performed meta-analyses using a bivariate random-effects model. We assessed sources of heterogeneity using meta-regression for predefined covariates.<\/jats:p>\n                  <jats:p>\n                    We identified 18 studies involving 4461 samples. Sample processing varied greatly among the studies. Xpert sensitivity differed substantially between sample types. In lymph node tissues or aspirates, Xpert pooled sensitivity was 83.1% (95% CI 71.4\u201390.7%)\n                    <jats:italic>versus<\/jats:italic>\n                    culture and 81.2% (95% CI 72.4\u201387.7%)\n                    <jats:italic>versus<\/jats:italic>\n                    CRS. In cerebrospinal fluid, Xpert pooled sensitivity was 80.5% (95% CI 59.0\u201392.2%) against culture and 62.8% (95% CI 47.7\u201375.8%) against CRS. In pleural fluid, pooled sensitivity was 46.4% (95% CI 26.3\u201367.8%) against culture and 21.4% (95% CI 8.8\u201333.9%) against CRS. Xpert pooled specificity was consistently &gt;98.7% against CRS across different sample types.\n                  <\/jats:p>\n                  <jats:p>Based on this systematic review, the World Health Organization now recommends Xpert over conventional tests for diagnosis of TB in lymph nodes and other tissues, and as the preferred initial test for diagnosis of TB meningitis.<\/jats:p>","DOI":"10.1183\/09031936.00007814","type":"journal-article","created":{"date-parts":[[2014,4,2]],"date-time":"2014-04-02T21:52:38Z","timestamp":1396475558000},"page":"435-446","source":"Crossref","is-referenced-by-count":444,"title":["Xpert MTB\/RIF assay for the diagnosis of extrapulmonary tuberculosis: a systematic review and meta-analysis"],"prefix":"10.1183","volume":"44","author":[{"given":"Claudia M.","family":"Denkinger","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel G.","family":"Schumacher","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Catharina C.","family":"Boehme","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nandini","family":"Dendukuri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Madhukar","family":"Pai","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen R.","family":"Steingart","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"81","published-online":{"date-parts":[[2014,4,2]]},"reference":[{"key":"2024102022434200000_44.2.435.1","unstructured":"World Health Organization. Global tuberculosis report 2012. Geneva, WHO, 2012."},{"key":"2024102022434200000_44.2.435.2","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm\/148.5.1292"},{"key":"2024102022434200000_44.2.435.3","first-page":"636","article-title":"Global epidemiology of childhood tuberculosis","volume":"8","author":"Nelson","year":"2004","journal-title":"Int J Tuberc Lung Dis"},{"key":"2024102022434200000_44.2.435.4","doi-asserted-by":"publisher","DOI":"10.3310\/hta11030"},{"key":"2024102022434200000_44.2.435.5","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(10)70138-9"},{"key":"2024102022434200000_44.2.435.6","doi-asserted-by":"publisher","DOI":"10.1016\/S1473-3099(03)00772-2"},{"key":"2024102022434200000_44.2.435.7","doi-asserted-by":"publisher","DOI":"10.1002\/14651858.CD009593.pub2"},{"key":"2024102022434200000_44.2.435.8","unstructured":"World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF system. Geneva, WHO, 2011."},{"key":"2024102022434200000_44.2.435.9","unstructured":"US Food and Drug Administration. Press release: FDA permits marketing of first U.S. test labeled for simultaneous detection of tuberculosis bacteria and resistance to the antibiotic rifampin. www.fda.gov\/NewsEvents\/Newsroom\/PressAnnouncements\/ucm362602.htm Date last updated: July 25, 2013."},{"key":"2024102022434200000_44.2.435.10","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00157212"},{"key":"2024102022434200000_44.2.435.11","unstructured":"World Health Organization. Automated real-time nucleic acid amplification technology for rapid and simultaneous detection of tuberculosis and rifampicin resistance: Xpert MTB\/RIF system for the diagnosis of pulmonary and extrapulmonary TB in adults and children. 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London, The Cochrane Collaboration, 2010"},{"key":"2024102022434200000_44.2.435.14","first-page":"1100","article-title":"Evaluation of direct detection of Mycobacterium tuberculosis complex in respiratory and non-respiratory clinical specimens using the Cepheid Gene Xpert\u00ae system","volume":"33","author":"Al-Ateah","year":"2012","journal-title":"Saudi Med J"},{"key":"2024102022434200000_44.2.435.15","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02157-10"},{"key":"2024102022434200000_44.2.435.16","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.00491-11"},{"key":"2024102022434200000_44.2.435.17","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00103213"},{"key":"2024102022434200000_44.2.435.18","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.05454-11"},{"key":"2024102022434200000_44.2.435.19","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.11.0394"},{"key":"2024102022434200000_44.2.435.20","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02268-10"},{"key":"2024102022434200000_44.2.435.21","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01310-11"},{"key":"2024102022434200000_44.2.435.22","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.10.0497"},{"key":"2024102022434200000_44.2.435.23","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.06467-11"},{"key":"2024102022434200000_44.2.435.24","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01834-13"},{"key":"2024102022434200000_44.2.435.25","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1001536"},{"key":"2024102022434200000_44.2.435.26","doi-asserted-by":"publisher","DOI":"10.5588\/ijtld.13.0178"},{"key":"2024102022434200000_44.2.435.27","first-page":"6","article-title":"Zastosowanie wybranych komercyjnych testow molekularnych w mikrobiologicznej diagnostyce gruzlicy [Two selected commercially based nucleic acid amplification tests for the diagnosis of tuberculosis]","volume":"80","author":"Safianowska","year":"2012","journal-title":"Pneumonol Alergol Pol"},{"key":"2024102022434200000_44.2.435.28","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.00176311"},{"key":"2024102022434200000_44.2.435.29","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.02319-10"},{"key":"2024102022434200000_44.2.435.30","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-013-1890-0"},{"key":"2024102022434200000_44.2.435.31","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.05434-11"},{"key":"2024102022434200000_44.2.435.32","doi-asserted-by":"publisher","DOI":"10.1059\/0003-4819-155-8-201110180-00009"},{"key":"2024102022434200000_44.2.435.33","doi-asserted-by":"crossref","first-page":"252","DOI":"10.1093\/ajcp\/93.2.252","article-title":"Evaluating diagnostic tests with imperfect standards","volume":"93","author":"Valenstein","year":"1990","journal-title":"Am J Clin Pathol"},{"key":"2024102022434200000_44.2.435.34","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.f5605"},{"key":"2024102022434200000_44.2.435.35","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2009.02.005"},{"key":"2024102022434200000_44.2.435.36","doi-asserted-by":"publisher","DOI":"10.1111\/j.1541-0420.2012.01773.x"},{"key":"2024102022434200000_44.2.435.37","unstructured":"Cepheid. 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