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• W2948492785 abstract "Xpert MTB/RIF (Xpert MTB/RIF) and Xpert MTB/RIF Ultra (Xpert Ultra), the newest version, are the only World Health Organization (WHO)-recommended rapid tests that simultaneously detect tuberculosis and rifampicin resistance in persons with signs and symptoms of tuberculosis, at lower health system levels. A previous Cochrane Review found Xpert MTB/RIF sensitive and specific for tuberculosis (Steingart 2014). Since the previous review, new studies have been published. We performed a review update for an upcoming WHO policy review.To determine diagnostic accuracy of Xpert MTB/RIF and Xpert Ultra for tuberculosis in adults with presumptive pulmonary tuberculosis (PTB) and for rifampicin resistance in adults with presumptive rifampicin-resistant tuberculosis.We searched the Cochrane Infectious Diseases Group Specialized Register, MEDLINE, Embase, Science Citation Index, Web of Science, Latin American Caribbean Health Sciences Literature, Scopus, the WHO International Clinical Trials Registry Platform, the International Standard Randomized Controlled Trial Number Registry, and ProQuest, to 11 October 2018, without language restriction.Randomized trials, cross-sectional, and cohort studies using respiratory specimens that evaluated Xpert MTB/RIF, Xpert Ultra, or both against the reference standard, culture for tuberculosis and culture-based drug susceptibility testing or MTBDRplus for rifampicin resistance.Four review authors independently extracted data using a standardized form. When possible, we also extracted data by smear and HIV status. We assessed study quality using QUADAS-2 and performed meta-analyses to estimate pooled sensitivity and specificity separately for tuberculosis and rifampicin resistance. We investigated potential sources of heterogeneity. Most analyses used a bivariate random-effects model. For tuberculosis detection, we first estimated accuracy using all included studies and then only the subset of studies where participants were unselected, i.e. not selected based on prior microscopy testing.We identified in total 95 studies (77 new studies since the previous review): 86 studies (42,091 participants) evaluated Xpert MTB/RIF for tuberculosis and 57 studies (8287 participants) for rifampicin resistance. One study compared Xpert MTB/RIF and Xpert Ultra on the same participant specimen.Tuberculosis detectionOf the total 86 studies, 45 took place in high tuberculosis burden and 50 in high TB/HIV burden countries. Most studies had low risk of bias.Xpert MTB/RIF pooled sensitivity and specificity (95% credible Interval (CrI)) were 85% (82% to 88%) and 98% (97% to 98%), (70 studies, 37,237 unselected participants; high-certainty evidence). We found similar accuracy when we included all studies.For a population of 1000 people where 100 have tuberculosis on culture, 103 would be Xpert MTB/RIF-positive and 18 (17%) would not have tuberculosis (false-positives); 897 would be Xpert MTB/RIF-negative and 15 (2%) would have tuberculosis (false-negatives).Xpert Ultra sensitivity (95% confidence interval (CI)) was 88% (85% to 91%) versus Xpert MTB/RIF 83% (79% to 86%); Xpert Ultra specificity was 96% (94% to 97%) versus Xpert MTB/RIF 98% (97% to 99%), (1 study, 1439 participants; moderate-certainty evidence).Xpert MTB/RIF pooled sensitivity was 98% (97% to 98%) in smear-positive and 67% (62% to 72%) in smear-negative, culture-positive participants, (45 studies). Xpert MTB/RIF pooled sensitivity was 88% (83% to 92%) in HIV-negative and 81% (75% to 86%) in HIV-positive participants; specificities were similar 98% (97% to 99%), (14 studies).Rifampicin resistance detectionXpert MTB/RIF pooled sensitivity and specificity (95% Crl) were 96% (94% to 97%) and 98% (98% to 99%), (48 studies, 8020 participants; high-certainty evidence).For a population of 1000 people where 100 have rifampicin-resistant tuberculosis, 114 would be positive for rifampicin-resistant tuberculosis and 18 (16%) would not have rifampicin resistance (false-positives); 886 would be would be negative for rifampicin-resistant tuberculosis and four (0.4%) would have rifampicin resistance (false-negatives).Xpert Ultra sensitivity (95% CI) was 95% (90% to 98%) versus Xpert MTB/RIF 95% (91% to 98%); Xpert Ultra specificity was 98% (97% to 99%) versus Xpert MTB/RIF 98% (96% to 99%), (1 study, 551 participants; moderate-certainty evidence).We found Xpert MTB/RIF to be sensitive and specific for diagnosing PTB and rifampicin resistance, consistent with findings reported previously. Xpert MTB/RIF was more sensitive for tuberculosis in smear-positive than smear-negative participants and HIV-negative than HIV-positive participants. Compared with Xpert MTB/RIF, Xpert Ultra had higher sensitivity and lower specificity for tuberculosis and similar sensitivity and specificity for rifampicin resistance (1 study). Xpert MTB/RIF and Xpert Ultra provide accurate results and can allow rapid initiation of treatment for multidrug-resistant tuberculosis." @default.
• W2948492785 created "2019-06-14" @default.
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• W2948492785 date "2019-06-07" @default.
• W2948492785 modified "2023-10-06" @default.
• W2948492785 title "Xpert MTB/RIF and Xpert MTB/RIF Ultra for pulmonary tuberculosis and rifampicin resistance in adults" @default.
• W2948492785 cites W1234780476 @default.
• W2948492785 cites W1522670941 @default.
• W2948492785 cites W1533265244 @default.
• W2948492785 cites W1560700498 @default.
• W2948492785 cites W1578908651 @default.
• W2948492785 cites W1606105143 @default.
• W2948492785 cites W164125159 @default.
• W2948492785 cites W164474866 @default.
• W2948492785 cites W1775118259 @default.
• W2948492785 cites W1782173299 @default.
• W2948492785 cites W1832123290 @default.
• W2948492785 cites W1863711633 @default.
• W2948492785 cites W1869352573 @default.
• W2948492785 cites W1966395500 @default.
• W2948492785 cites W1966673339 @default.
• W2948492785 cites W1967603374 @default.
• W2948492785 cites W1968038365 @default.
• W2948492785 cites W1969939375 @default.
• W2948492785 cites W1974091486 @default.
• W2948492785 cites W1975085565 @default.
• W2948492785 cites W1975793467 @default.
• W2948492785 cites W1977032598 @default.
• W2948492785 cites W1977366125 @default.
• W2948492785 cites W1980376034 @default.
• W2948492785 cites W1982993547 @default.
• W2948492785 cites W1988784973 @default.
• W2948492785 cites W1991218330 @default.
• W2948492785 cites W1993914792 @default.
• W2948492785 cites W1994158325 @default.
• W2948492785 cites W1994558484 @default.
• W2948492785 cites W1994666903 @default.
• W2948492785 cites W1995266967 @default.
• W2948492785 cites W1996530875 @default.
• W2948492785 cites W2001613191 @default.
• W2948492785 cites W2001663746 @default.
• W2948492785 cites W2002550486 @default.
• W2948492785 cites W2005453709 @default.
• W2948492785 cites W2008035378 @default.
• W2948492785 cites W2011453849 @default.
• W2948492785 cites W2011564248 @default.
• W2948492785 cites W2011699240 @default.
• W2948492785 cites W2018083981 @default.
• W2948492785 cites W2020664091 @default.
• W2948492785 cites W2024168923 @default.
• W2948492785 cites W2024177078 @default.
• W2948492785 cites W2028219354 @default.
• W2948492785 cites W2029641610 @default.
• W2948492785 cites W2030039400 @default.
• W2948492785 cites W2031833727 @default.
• W2948492785 cites W2032903368 @default.
• W2948492785 cites W2032989933 @default.
• W2948492785 cites W2033084566 @default.
• W2948492785 cites W2035972107 @default.
• W2948492785 cites W2038397946 @default.
• W2948492785 cites W2039092574 @default.
• W2948492785 cites W2040957894 @default.
• W2948492785 cites W2041835415 @default.
• W2948492785 cites W2043611574 @default.
• W2948492785 cites W2044132732 @default.
• W2948492785 cites W2045632613 @default.
• W2948492785 cites W2045683766 @default.
• W2948492785 cites W2045746414 @default.
• W2948492785 cites W2046150396 @default.
• W2948492785 cites W2047451111 @default.
• W2948492785 cites W2047703746 @default.
• W2948492785 cites W2048078358 @default.
• W2948492785 cites W2050135352 @default.
• W2948492785 cites W2051892159 @default.
• W2948492785 cites W2052422622 @default.
• W2948492785 cites W2062771440 @default.
• W2948492785 cites W2062775631 @default.
• W2948492785 cites W2062921655 @default.
• W2948492785 cites W2063243106 @default.
• W2948492785 cites W2067195947 @default.
• W2948492785 cites W2067694494 @default.
• W2948492785 cites W2073695590 @default.
• W2948492785 cites W2077124916 @default.
• W2948492785 cites W2078092644 @default.
• W2948492785 cites W2080110289 @default.
• W2948492785 cites W2080700350 @default.
• W2948492785 cites W2080927440 @default.
• W2948492785 cites W2080938989 @default.
• W2948492785 cites W2082069895 @default.
• W2948492785 cites W2083262622 @default.
• W2948492785 cites W2084001183 @default.

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