Goto Eita
Department of Medicine, Mizawa Hospital, Hamamatsu 430-0807, Japan.
Rinsho Byori. 2010 Feb;58(2):148-55.
This study evaluated the diagnostic accuracy of Adenoclone, a rapid diagnostic test kit for adenovirus, among Japanese people of published data. Studies were collected by various literature search engines: PubMed (Medline), ICHUSHI, and GeNii(CiNii, Webcat Plus, KAKEN, NII-DRB, JAORO). Relatively high quality studies, scored via QUADAS, were selected. Data on true positive, false positive, true negative, and false negative results were extracted. Meta-DiSc (version 1.4) was employed to calculate the pooled estimates of diagnostic indices. The 15 studies provided a pooled sensitivity of 50.2% (CI: 47.1-53.3), and a pooled specificity of 97.4% (CI: 96.2-98.3) using conjunctiva swabs. The 2 studies about throat swabs provided a pooled sensitivity of 73.5% (CI: 62.7-82.6), and a pooled sensitivity of 100.0% (CI: 96.6-100.0). The 4 studies tested stool samples, providing a pooled sensitivity of 85.1% (CI: 77.2-91.1), and a pooled specificity of 98.7% (CI: 96.9-99.6), a better outcome than using other specimens (p of the relative diagnostic odds ratio = 0.0017). As the low pooled sensitivity indicates, Adenoclone-negative may not rule out Adenoviral infection sufficiently especially when using conjunctive or throat swabs. However, Adenoclone testing stool samples may yield a stronger diagnostic accuracy than using other specimens.
本研究在已发表数据的日本人群中评估了腺病毒快速诊断试剂盒Adenoclone的诊断准确性。通过各种文献搜索引擎收集研究：PubMed（医学索引数据库）、Ichushi和GeNii（CiNii、Webcat Plus、KAKEN、NII-DRB、JAORO）。选择通过QUADAS评分的相对高质量研究。提取真阳性、假阳性、真阴性和假阴性结果的数据。采用Meta-DiSc（1.4版）计算诊断指标的合并估计值。15项研究使用结膜拭子得出合并敏感度为50.2%（95%置信区间：47.1 - 53.3），合并特异度为97.4%（95%置信区间：96.2 - 98.3）。两项关于咽拭子的研究得出合并敏感度为73.5%（95%置信区间：62.7 - 82.6），合并特异度为100.0%（95%置信区间：96.6 - 100.0）。四项检测粪便样本的研究得出合并敏感度为85.1%（95%置信区间：77.2 - 91.1），合并特异度为98.7%（95%置信区间：96.9 - 99.6），这一结果优于使用其他样本（相对诊断比值比的p值 = 0.0017）。正如低合并敏感度所示，Adenoclone检测结果为阴性可能无法充分排除腺病毒感染，尤其是在使用结膜拭子或咽拭子时。然而，Adenoclone检测粪便样本可能比使用其他样本具有更强的诊断准确性。
