PRISMA flow chart of literature retrieval.

In total, 104, 31, 429, 171, and 231 articles were found in PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database, respectively. NAAT: nucleic acid amplification test.</p

Subgroup analysis for different parameters with sufficient data compared with a composite reference standard.

Subgroup analysis for different parameters with sufficient data compared with a composite reference standard.</p

Characteristics of the included studies.

BackgroundAbdominal tuberculosis (TB) is a severe extrapulmonary TB, which can lead to serious complications. Early diagnosis and treatment are very important for the prognosis and the diagnosis of abdominal TB is still difficult.MethodsWe searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database for studies evaluating the diagnostic accuracy of NAATs for abdominal TB until August 2020. Any types of study design with full text were sought and included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Subgroup analysis, meta-regression analysis and sensitivity analysis were used to explore the sources of heterogeneity. Stata version 15.0 with the midas command packages was used to carry out meta-analyses.ResultsWe included a total of 78 independent studies from 53 articles; 64 with CRS as the reference standard, and 14 with culture as the reference standard. The pooled sensitivity, specificity, and the areas under summary receiver operating characteristic (SROC) curves (AUC) were 58% (51%–64%; I2 = 87%), 99% (97%–99%; I2 = 81%), and 0.92 (0.89–0.94) compared with CRS, respectively. The pooled sensitivity, specificity, and the AUC values of the SROC were 80% (66%–90%; I2 = 56%), 96% (92%–98%; I2 = 84%), and 0.97 (0.95–0.98) compared with culture, respectively. The heterogeneity of sensitivity and specificity was significant.ConclusionsNAATs had excellent efficacy in the diagnosis of abdominal TB regardless of the reference standard and regardless of the subtype of abdominal TB. Multiplex PCR with multiple target genes may improve diagnostic sensitivity, and stool specimens may also be used for the diagnosis of abdominal TB in addition to tissue and ascites.</div

Search strategies.

BackgroundAbdominal tuberculosis (TB) is a severe extrapulmonary TB, which can lead to serious complications. Early diagnosis and treatment are very important for the prognosis and the diagnosis of abdominal TB is still difficult.MethodsWe searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database for studies evaluating the diagnostic accuracy of NAATs for abdominal TB until August 2020. Any types of study design with full text were sought and included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Subgroup analysis, meta-regression analysis and sensitivity analysis were used to explore the sources of heterogeneity. Stata version 15.0 with the midas command packages was used to carry out meta-analyses.ResultsWe included a total of 78 independent studies from 53 articles; 64 with CRS as the reference standard, and 14 with culture as the reference standard. The pooled sensitivity, specificity, and the areas under summary receiver operating characteristic (SROC) curves (AUC) were 58% (51%–64%; I2 = 87%), 99% (97%–99%; I2 = 81%), and 0.92 (0.89–0.94) compared with CRS, respectively. The pooled sensitivity, specificity, and the AUC values of the SROC were 80% (66%–90%; I2 = 56%), 96% (92%–98%; I2 = 84%), and 0.97 (0.95–0.98) compared with culture, respectively. The heterogeneity of sensitivity and specificity was significant.ConclusionsNAATs had excellent efficacy in the diagnosis of abdominal TB regardless of the reference standard and regardless of the subtype of abdominal TB. Multiplex PCR with multiple target genes may improve diagnostic sensitivity, and stool specimens may also be used for the diagnosis of abdominal TB in addition to tissue and ascites.</div

Methodological quality graphs (risk of bias and applicability concerns) across the included studies.

a) composite reference standard as gold standard. b) culture as gold standard.</p

Forest plot for the sensitivity and specificity of NAATs for the diagnosis of abdominal TB compared with culture.

Forest plot for the sensitivity and specificity of NAATs for the diagnosis of abdominal TB compared with culture.</p

Methodological quality summary.

a) composite reference standard as gold standard. b) culture as gold standard. (TIF)</p

Forest plot for the sensitivity and specificity of NAATs for the diagnosis of abdominal TB compared with a composite reference standard.

Forest plot for the sensitivity and specificity of NAATs for the diagnosis of abdominal TB compared with a composite reference standard.</p

Subgroup analysis for different parameters with sufficient data compared with culture.

Subgroup analysis for different parameters with sufficient data compared with culture.</p

Excluded articles.

BackgroundAbdominal tuberculosis (TB) is a severe extrapulmonary TB, which can lead to serious complications. Early diagnosis and treatment are very important for the prognosis and the diagnosis of abdominal TB is still difficult.MethodsWe searched PubMed, the Cochrane Library, Embase, China National Knowledge Infrastructure, and the Wanfang database for studies evaluating the diagnostic accuracy of NAATs for abdominal TB until August 2020. Any types of study design with full text were sought and included. The risk of bias was assessed using the Quality Assessment of Diagnostic Accuracy Studies tool. Subgroup analysis, meta-regression analysis and sensitivity analysis were used to explore the sources of heterogeneity. Stata version 15.0 with the midas command packages was used to carry out meta-analyses.ResultsWe included a total of 78 independent studies from 53 articles; 64 with CRS as the reference standard, and 14 with culture as the reference standard. The pooled sensitivity, specificity, and the areas under summary receiver operating characteristic (SROC) curves (AUC) were 58% (51%–64%; I2 = 87%), 99% (97%–99%; I2 = 81%), and 0.92 (0.89–0.94) compared with CRS, respectively. The pooled sensitivity, specificity, and the AUC values of the SROC were 80% (66%–90%; I2 = 56%), 96% (92%–98%; I2 = 84%), and 0.97 (0.95–0.98) compared with culture, respectively. The heterogeneity of sensitivity and specificity was significant.ConclusionsNAATs had excellent efficacy in the diagnosis of abdominal TB regardless of the reference standard and regardless of the subtype of abdominal TB. Multiplex PCR with multiple target genes may improve diagnostic sensitivity, and stool specimens may also be used for the diagnosis of abdominal TB in addition to tissue and ascites.</div