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Updated: Aug 2, 2025
The MODS method for diagnosis of tuberculosis and multidrug resistant tuberculosis
Published on: August 11, 2008
Diagnostic accuracy of clinical diagnostic scoring systems for childhood tuberculosis: a systematic review and
Michael Kakinda1,2, Ronald Olum3, Joseph Baruch Baluku4,5
1Clinical Directorate, Joint Clinical Research Center, Wakiso, Uganda michaelkakinda@gmail.com.
Insights
This systematic review evaluates diagnostic scoring systems for childhood tuberculosis (TB). It synthesizes evidence to improve the accuracy of diagnosing TB in children, addressing a critical gap in pediatric healthcare.
Area of Science:
- Pediatric Infectious Diseases
- Diagnostic Test Accuracy
- Systematic Review and Meta-analysis
Background:
- Diagnosing childhood tuberculosis (TB) presents significant challenges.
- Existing diagnostic methods include clinical signs, radiological studies, laboratory tests, scoring systems, and algorithms.
- There is a need for more data on the diagnostic accuracy of scoring systems for pediatric TB.
Purpose of the Study:
- To systematically review and meta-analyze the diagnostic accuracy of scoring systems used for diagnosing childhood tuberculosis.
- To synthesize available evidence to improve diagnostic yields in pediatric TB cases.
Main Methods:
- A systematic literature search will be conducted across multiple databases (PubMed, CINAHL, Embase, Scopus, Cochrane).
- Studies will be selected based on predefined criteria for participants, index test (TB scoring/diagnostic systems), comparator, and target condition.
- Quality assessment using QUADAS-2 Tool and diagnostic accuracy measures (sensitivity, specificity, PPV, NPV) will be pooled using appropriate meta-analysis models.
Main Results:
- This section is to be populated upon completion of the systematic review and meta-analysis.
- Results will include pooled diagnostic accuracy measures for various childhood TB scoring systems.
Conclusions:
- This systematic review protocol outlines a rigorous approach to evaluate the diagnostic accuracy of childhood TB scoring systems.
- The findings will provide crucial evidence to guide the clinical application of these tools, potentially improving TB diagnosis in children.
- Dissemination will occur through peer-reviewed publications and scientific conferences.
Introduction:
Diagnosis of childhood tuberculosis (TB) poses several challenges. Therefore, clinical signs and symptoms, radiological studies, laboratory examinations, point-based scoring systems or diagnostic algorithms have been developed to improve diagnostic yields in this population. However, there are limited data on the diagnostic test accuracy of paediatric TB scoring systems. Therefore, this systematic review and meta-analysis aims to synthesise the available evidence on the diagnostic accuracy of childhood TB diagnostic scoring systems.
Methods And Analysis:
This protocol describes a systematic review, developed in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analyses of Diagnostic Test Accuracy. We will conduct a comprehensive literature search for relevant articles in the following databases: PubMed, CINAHL, Embase, Scopus and Cochrane Databases. The eligibility criteria for studies will be formulated based on the Participants (Population), Index Test, Comparator Test and Target Condition criteria for the review question. The index test will be defined as any attempt to diagnose childhood TB using either a scoring system or a diagnostic algorithm, whereas a composite reference standard will be used as a reference standard. This will include any attempt to confirm diagnosis of TB. Where bacteriological confirmation is not obtained and there are at least two of the following features: chest radiograph consistent with TB, immunological evidence of Mycobacterium tuberculosis infection and/or positive response to TB treatment will also be considered. The QUADAS-2 Tool will be used to assess the quality of the studies. The diagnostic accuracy measures (ie, sensitivity, specificity, negative predictive and positive predictive values) will be pooled with the random-effects or fixed-effects models, as appropriate. All statistical analyses will be performed using the Review Manager V.5.4.
Ethics And Dissemination:
This research is exempt from ethics approval given that this is a protocol for a systematic review, which uses published data. The findings from this review will be disseminated through peer-reviewed publications and scientific conferences.
Prospero Registration Number:
CRD42022367049.
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