{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T02:36:08Z","timestamp":1792722968529,"version":"4.5.0"},"reference-count":63,"publisher":"Public Library of Science (PLoS)","issue":"6","license":[{"start":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T00:00:00Z","timestamp":1624492800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["www.plosone.org"],"crossmark-restriction":false},"short-container-title":["PLoS ONE"],"abstract":"<jats:sec id=\"sec001\"><jats:title>Objective<\/jats:title><jats:p>We compared diagnostic accuracy of pleural fluid adenosine deaminase (ADA) and interferon-gamma (IFN-\u03b3) in diagnosing tuberculous pleural effusion (TPE) through systematic review and comparative meta-analysis.<\/jats:p><\/jats:sec><jats:sec id=\"sec002\"><jats:title>Methods<\/jats:title><jats:p>We queried PubMed and Embase databases to identify studies providing paired data for sensitivity and specificity of both pleural fluid ADA and IFN-\u03b3 for diagnosing TPE. We used hierarchical summary receiver operating characteristic (HSROC) plots and HSROC meta-regression to model individual and comparative diagnostic performance of the two tests.<\/jats:p><\/jats:sec><jats:sec id=\"sec003\"><jats:title>Results<\/jats:title><jats:p>We retrieved 376 citations and included 45 datasets from 44 publications (4974 patients) in our review. Summary estimates for sensitivity and specificity for ADA were 0.88 (95% CI 0.85\u20130.91) and 0.91 (95% CI 0.89\u20130.92), while for IFN-\u03b3 they were 0.91 (95% CI 0.89\u20130.94) and 0.96 (95% CI 0.94\u20130.97), respectively. HSROC plots showed consistently greater diagnostic accuracy for IFN-\u03b3 over ADA across the entire range of observations. HSROC meta-regression using test-type as covariate yielded a relative diagnostic odds ratio of 2.22 (95% CI 1.68\u20132.94) in favour of IFN-\u03b3, along with better summary sensitivity and specificity figures. No prespecified subgroup variable significantly influenced the summary diagnostic accuracy estimates.<\/jats:p><\/jats:sec><jats:sec id=\"sec004\"><jats:title>Conclusion<\/jats:title><jats:p>Pleural fluid IFN-\u03b3 estimation has better diagnostic accuracy than ADA estimation for diagnosis of TPE.<\/jats:p><\/jats:sec>","DOI":"10.1371\/journal.pone.0253525","type":"journal-article","created":{"date-parts":[[2021,6,24]],"date-time":"2021-06-24T17:28:47Z","timestamp":1624555727000},"page":"e0253525","update-policy":"https:\/\/doi.org\/10.1371\/journal.pone.corrections_policy","source":"Crossref","is-referenced-by-count":22,"title":["Comparative accuracy of pleural fluid unstimulated interferon-gamma and adenosine deaminase for diagnosing pleural tuberculosis: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"16","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8556-3600","authenticated-orcid":true,"given":"Ashutosh 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Singh","family":"Sehgal","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Valliappan","family":"Muthu","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2021,6,24]]},"reference":[{"key":"pone.0253525.ref001","first-page":"172","article-title":"Effusions related to TB","volume":"2020","author":"JA Shaw","year":"2020","journal-title":"ERS Monograph"},{"issue":"3","key":"pone.0253525.ref002","doi-asserted-by":"crossref","first-page":"e0213728","DOI":"10.1371\/journal.pone.0213728","article-title":"Adenosine deaminase for diagnosis of tuberculous pleural effusion: A systematic review and meta-analysis","volume":"14","author":"AN Aggarwal","year":"2019","journal-title":"PLoS One"},{"key":"pone.0253525.ref003","article-title":"Unstimulated pleural fluid interferon-gamma for diagnosis of tuberculous pleural effusion: a systematic review and 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