Meta-analysis of studies assessing the diagnostic accuracy of AFB plus NAAT compared with culture
Forest plots showing the sensitivity and specificity for the 38 studies that compared the diagnostic accuracy of AFB microscopy plus NAAT with culture in patients suspected of having TB are shown in Figure 43 and Figure 44 (Appendix D). A summary of meta-analysis of subgroups based on NAAT methodology, specimen type and incidence of TB in the country the study was conducted in is presented in Figure 12. AFB microscopy combined with NAAT was very sensitive (overall: 94%; 95%CI 91, 98) but the specificity was lower (88%; 95%CI 82, 92). Thus, 6% of patients will have a false-negative result for both AFB microscopy and NAAT, and 12% of patients (8% with sputum specimens and 17% with non-sputum specimens) will be falsely-positive for either AFB microscopy or NAAT.
Figure 12 Forest plot showing the pooled sensitivity and specificity values for AFB plus NAAT compared with culture for studies grouped according to the NAAT comparator, specimen type and incidence of TB in the country in which the study was conducted
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