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- Title
Diagnostic accuracy of pleural fluid lactate dehydrogenase to adenosine deaminase ratio for tuberculous pleural effusion: an analysis of two cohorts.
- Authors
Yan, Zhi; Wen, Jian-Xun; Wang, Hua; Jiang, Ting-Wang; Huang, Jin-Hong; Chen, Hong; Yan, Li; Hu, Zhi-De; Zheng, Wen-Qi
- Abstract
<bold>Background: </bold>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.<bold>Methods: </bold>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).<bold>Results: </bold>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.<bold>Conclusions: </bold>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.
- Subjects
ADENOSINE deaminase; PLEURAL effusions; LACTATE dehydrogenase; RECEIVER operating characteristic curves; COHORT analysis
- Publication
BMC Pulmonary Medicine, 2022, Vol 22, Issue 1, p1
- ISSN
1471-2466
- Publication type
journal article
- DOI
10.1186/s12890-022-02247-w