TY - JOUR
T1 - The diagnostic accuracy of pooled testing from multiple individuals for the detection of Chlamydia trachomatis and Neisseria gonorrhoeae
T2 - a systematic review
AU - Xu, Yangqi
AU - Aboud, Lily
AU - Chow, Eric P.F.
AU - Mello, Maeve B.
AU - Wi, Teodora
AU - Baggaley, Rachel
AU - Fairley, Christopher K.
AU - Peeling, Rosanna
AU - Ong, Jason J.
N1 - Funding Information:
All authors declare they do not have any conflicts of interest. This study is funded by World Health Organization through a grant from the Bill and Melinda Gates Foundation. JJO and EPFC are supported by the Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (GNT1193955, GNT1172873). CKF is supported by an Australian NHMRC Leadership Investigator Grant (GNT1172900). JJO, EPFC, TW, and MBM designed the research study. LA and YX conducted the screening and data extraction. LA, YX, JJO, and EPFC analysed the data and wrote the first draft of the manuscript. All authors have read and approved the final manuscript. No ethical approvals were needed for this study as it was a review of literature without the direct involvement of patients.
Funding Information:
This study is funded by World Health Organization through a grant from the Bill and Melinda Gates Foundation. JJO and EPFC are supported by the Australian National Health and Medical Research Council (NHMRC) Emerging Leadership Investigator Grant (GNT1193955, GNT1172873). CKF is supported by an Australian NHMRC Leadership Investigator Grant (GNT1172900).
Publisher Copyright:
© 2022 The Author(s)
PY - 2022/5/1
Y1 - 2022/5/1
N2 - Objectives: Molecular testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is costly. Therefore, we appraised the evidence regarding pooling samples from multiple individuals to test for CT/NG. Methods: In this systematic review, we searched 5 databases (2000-2021). Studies were included if they contained primary data describing pooled testing. We calculated the pooled sensitivities and specificities for CT and NG using a bivariate mixed-effects logistic regression model. Results: We included 22 studies: most were conducted in high-income countries (81.8%, 18 of 22), among women (73.3%, 17 of 22), and pooled urine samples (63.6%, 14 of 22). Eighteen studies provided 25 estimates for the meta-analysis of diagnostic accuracy, with data from 6,913 pooled specimens. The pooled sensitivity for CT was 98.4% (95% confidence intervals [CI]: 96.8-99.2%, I2=77.5, p<0.001), and pooled specificity was 99.9% (95% CI: 99.6-100.0%, I2=62.6, p<0.001). Only 2 studies reported pooled testing for NG, and both reported similarly high sensitivity and specificity as for CT. Sixteen studies provided data on the cost of pooling, reporting cost-savings ranging from 39%-90%. Conclusions: Pooled testing from multiple individuals for CT is highly sensitive and specific compared with individual testing. This approach has the potential to reduce the cost of screening in populations for which single anatomic site screening is recommended.
AB - Objectives: Molecular testing for Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (NG) is costly. Therefore, we appraised the evidence regarding pooling samples from multiple individuals to test for CT/NG. Methods: In this systematic review, we searched 5 databases (2000-2021). Studies were included if they contained primary data describing pooled testing. We calculated the pooled sensitivities and specificities for CT and NG using a bivariate mixed-effects logistic regression model. Results: We included 22 studies: most were conducted in high-income countries (81.8%, 18 of 22), among women (73.3%, 17 of 22), and pooled urine samples (63.6%, 14 of 22). Eighteen studies provided 25 estimates for the meta-analysis of diagnostic accuracy, with data from 6,913 pooled specimens. The pooled sensitivity for CT was 98.4% (95% confidence intervals [CI]: 96.8-99.2%, I2=77.5, p<0.001), and pooled specificity was 99.9% (95% CI: 99.6-100.0%, I2=62.6, p<0.001). Only 2 studies reported pooled testing for NG, and both reported similarly high sensitivity and specificity as for CT. Sixteen studies provided data on the cost of pooling, reporting cost-savings ranging from 39%-90%. Conclusions: Pooled testing from multiple individuals for CT is highly sensitive and specific compared with individual testing. This approach has the potential to reduce the cost of screening in populations for which single anatomic site screening is recommended.
UR - http://www.scopus.com/inward/record.url?scp=85127005266&partnerID=8YFLogxK
U2 - 10.1016/j.ijid.2022.03.009
DO - 10.1016/j.ijid.2022.03.009
M3 - Review Article
C2 - 35283298
AN - SCOPUS:85127005266
VL - 118
SP - 183
EP - 193
JO - International Journal of Infectious Diseases
JF - International Journal of Infectious Diseases
SN - 1201-9712
ER -