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Original ResearchPleural TuberculosisDiagnostic Value of Interferon-γ in Tuberculous Pleurisy: A Metaanalysis
Section snippets
Search Strategy and Study Selection
Since the present study was a metaanalysis that was based on published articles, we did not include the consents of patients and the approval of internal review boards. We searched the following electronic databases: Medline (1980 to 2006); Embase (1980 to 2006); Web of Science (1990 to 2006); BIOSIS (1993 to 2006); and LILACS (1980 to 2006). We also reviewed the Cochrane Library to find relevant articles. All searches were up to date as of October 2006. The search terms used were
Results
After independent review, 34 publications dealing with pleural IFN-γ concentrations for the diagnosis of TPE were considered to be eligible for inclusion in the analysis.16171819202122232425262728293031323334353637383940414243444546474849 Of these publications, two studies3839 were excluded because IFN-γ concentration was determined only in TPE patients, two studies4041 were excluded because they recruited < 10 patients with confirmed TPE, four studies42434445 were excluded because they did not
Discussion
Making a differential diagnosis between TPE and non-TPE is a critical clinical problem, and the conventional methods, such as the direct examination of pleural fluid by Ziehl-Neelsen staining, culture of the pleural fluid, and pleural biopsy, are not always helpful in making the diagnosis since they have limitations. Findings of microscopy of the pleural fluid is rarely positive (< 5%).505152 Culture of pleural fluid has low sensitivity (24 to 58%), and several weeks are required to grow M
ACKNOWLEDGMENT
We are grateful to the following authors who sent additional information on their primary studies: A. Kaya, C. F. Wong, E. Ribera, K. Ogawa, K. Shimokata, L. Valdés, N. G. Saravia, S. K. Sharma, S. Wongtim, T. Morimoto, T. Pettersson, V. Villena, W. H. Hsu, Y. C. Kim, Y. Aoki, Y. Yamada, and Z. C. Gao.
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Dr. Shi designed the study, searched the databases, extracted the data, analyzed the results, and wrote the manuscript. Dr. Jiang helped with study design, searching the databases, and writing and revising the manuscript. Dr. Liang formulated the research question, and helped with database searches and analysis. Drs. S.-M. Qin and X.-J. Qin helped to design the data abstraction form and served as second reviewers in extracting the data. All authors read and approved the final manuscript.
The authors have reported to the ACCP that no significant conflicts of interest exist with any companies/organizations whose products or services may be discussed in this article.
This study was supported in part by research grant 30660064 from National Natural Science Foundation of China, in part by Program NCET-04–0835 for New Century Excellent Talents in Chinese Universities, and in part by research grant 0639044 from the Natural Science Foundation of Guangxi Zhuang Autonomous Zone, People's Republic of China.