Bruning Andrea H L, Leeflang Mariska M G, Vos Johanna M B W, Spijker Rene, de Jong Menno D, Wolthers Katja C, Pajkrt Dasja
Department of Pediatric Infectious Diseases, Emma Children's Hospital.
Department of Clinical Epidemiology, Biostatistics and Bioinformatics.
Clin Infect Dis. 2017 Sep 15;65(6):1026-1032. doi: 10.1093/cid/cix461.
Rapid diagnosis of respiratory virus infections contributes to patient care. This systematic review evaluates the diagnostic accuracy of rapid tests for the detection of respiratory viruses. We searched Medline and EMBASE for studies evaluating these tests against polymerase chain reaction as the reference standard. Of 179 studies included, 134 evaluated rapid tests for influenza viruses, 32 for respiratory syncytial virus (RSV), and 13 for other respiratory viruses. We used the bivariate random effects model for quantitative meta-analysis of the results. Most tests detected only influenza viruses or RSV. Summary sensitivity and specificity estimates of tests for influenza were 61.1% and 98.9%. For RSV, summary sensitivity was 75.3%, and specificity, 98.7%. We assessed the quality of studies using the Quality Assessment of Diagnostic Accuracy Studies (QUADAS-2) checklist. Because of incomplete reporting, the risk of bias was often unclear. Despite their intended use at the point of care, 26.3% of tests were evaluated in a laboratory setting. Although newly developed tests seem more sensitive, high-quality evaluations of these tests are lacking.
呼吸道病毒感染的快速诊断有助于患者护理。本系统评价评估了用于检测呼吸道病毒的快速检测方法的诊断准确性。我们检索了Medline和EMBASE数据库，查找以聚合酶链反应作为参考标准评估这些检测方法的研究。在纳入的179项研究中，134项评估了流感病毒的快速检测方法，32项评估了呼吸道合胞病毒（RSV）的快速检测方法，13项评估了其他呼吸道病毒的快速检测方法。我们使用双变量随机效应模型对结果进行定量Meta分析。大多数检测方法仅能检测流感病毒或RSV。流感检测方法的汇总敏感性和特异性估计值分别为61.1%和98.9%。对于RSV，汇总敏感性为75.3%，特异性为98.7%。我们使用诊断准确性研究质量评估（QUADAS-2）清单评估研究质量。由于报告不完整，偏倚风险往往不明确。尽管这些检测方法旨在用于即时护理，但26.3%的检测是在实验室环境中进行评估的。尽管新开发的检测方法似乎更敏感，但缺乏对这些检测方法的高质量评估。
