AI Article Synopsis
- This study evaluated the effectiveness of the pleural fluid LDH/ADA ratio in diagnosing tuberculous pleural effusion (TPE) compared to ADA alone.
- Two patient cohorts were analyzed to measure diagnostic accuracy using ROC curves, showing that while both tests had moderate accuracy, the LDH/ADA ratio performed slightly worse than ADA in some cases.
- The findings indicate that the LDH/ADA ratio does not offer any additional diagnostic value beyond what ADA provides, suggesting it should not be used for TPE diagnosis.
Article Abstract
Background: This study aimed to evaluate the diagnostic accuracy of pleural fluid (PF) lactate dehydrogenase (LDH) to adenosine deaminase (ADA) (LDH/ADA) ratio for tuberculous pleural effusion (TPE). Especially to explore whether the LDH/ADA ratio provides added diagnostic value to ADA.
Methods: The diagnostic accuracy of PF LDH/ADA ratio and ADA for TPE was evaluated in two cohorts, named the BUFF (Biomarkers for patients with Undiagnosed pleural eFFusion) cohort (62 with TPE and 194 with non-TPE) and the SIMPLE (a Study Investigating Markers in PLeural Effusion) cohort (33 with TPE and 177 with non-TPE). Receiver operating characteristic (ROC) curve and decision curve were used to measure the diagnostic accuracy of the PF LDH/ADA ratio. The added diagnostic value of the LDH/ADA ratio to ADA was evaluated with net reclassification improvement (NRI) and integrated discrimination improvement (IDI).
Results: The area under the ROC curves (AUCs) of PF ADA and LDH/ADA ratio in the BUFF cohort were 0.76 and 0.74, respectively. In the SIMPLE cohort, the AUCs of PF ADA and LDH/ADA ratio were 0.80 and 0.85, respectively. The decision curves of PF LDH/ADA and ADA were close in both the BUFF and SIMPLE cohorts. The NRI and IDI analyses did not reveal any added diagnostic value of LDH/ADA to ADA.
Conclusions: PF LDH/ADA ratio has moderate diagnostic accuracy for TPE. It does not provide added diagnostic value beyond ADA. The current evidence does not support LDH/ADA ratio for diagnosing TPE.
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Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC9675061 | PMC |
| http://dx.doi.org/10.1186/s12890-022-02247-w | DOI Listing |
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