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Chlamydia antibody testing and diagnosing tubal pathology in subfertile women: an individual patient data meta-analysis
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2011 (English)In: Human Reproduction Update, ISSN 1355-4786, E-ISSN 1460-2369, Vol. 17, no 3, 301-310 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND The Chlamydia IgG antibody test (CAT) shows considerable variations in reported estimates of test accuracy, partly because of the use of different assays and cut-off values. The aim of this study was to reassess the accuracy of CAT in diagnosing tubal pathology by individual patient data (IPD) meta-analysis for three different CAT assays.

METHODS We approached authors of primary studies that used micro-immunofluorescence tests (MIF), immunofluorescence tests (IF) or enzyme-linked immunosorbent assay tests (ELISA). Using the obtained IPD, we performed pooled receiver operator characteristics analysis and logistic regression analysis with a random effects model to compare the three assays. Tubal pathology was defined as either any tubal obstruction or bilateral tubal obstruction.

RESULTS We acquired data of 14 primary studies containing data of 6191 women, of which data of 3453 women were available for analysis. The areas under the curve for ELISA, IF and MIF were 0.64, 0.65 and 0.75, respectively (P-value < 0.001) for any tubal pathology and 0.66, 0.66 and 0.77, respectively (P-value = 0.01) for bilateral tubal pathology.

CONCLUSIONS In Chlamydia antibody testing, MIF is superior in the assessment of tubal pathology. In the initial screen for tubal pathology MIF should therefore be the test of first choice.

Place, publisher, year, edition, pages
2011. Vol. 17, no 3, 301-310 p.
Keyword [en]
systematic review, individual patient data meta-analysis, chlamydia antibody test, tubal pathology
National Category
Obstetrics, Gynecology and Reproductive Medicine
URN: urn:nbn:se:umu:diva-41609DOI: 10.1093/humupd/dmq060PubMedID: 21227996OAI: diva2:407307
Available from: 2011-03-30 Created: 2011-03-30 Last updated: 2012-04-02Bibliographically approved

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Idahl, Annika
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