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Table 2 Subgroup analysis of laboratory-based immunoassay and lateral flow test for PJI diagnosis

From: Synovial fluid α-defensin in the diagnosis of periprosthetic joint infection: the lateral flow test is an effective intraoperative detection method

Subgroup analyses No. of studies No. of patients Sensitivity (95%CI) Specificity (95%CI) AUC (95%CI) PLR (95%CI) NLR (95%CI) DOR (95%CI)
Laboratory-based immunoassay
 Overall studies 11 1110 0.96 (0.90–0.98) 0.97 (0.95–0.99) 0.99 (0.98–1.00) 35.0 (18.5–66.2) 0.04 (0.02–0.11) 811 (220–2990)
Excluded metallosis
 Yes 4 416 0.97 (0.88–0.99) 0.99 (0.96–1.00) 0.99 (0.98–1.00) 80.7 (26.0–251.1) 0.03 (0.01–0.13) 2447 (383–15,647)
 No and NA 7 694 0.94 (0.84–0.98) 0.96 (0.94–0.97) 0.98 (0.96–0.99) 23.1 (14.2–37.6) 0.06 (0.02–0.17) 382 (103–1414)
Study design
 Prospective 6 697 0.97 (0.92–0.99) 0.98 (0.96–0.99) 0.99 (0.98–1.00) 42.9 (22.9–80.4) 0.03 (0.01–0.09) 1480 (423–5172)
 Retrospective 5 413 0.91 (0.79–0.96) 0.95 (0.90–0.98) 0.98 (0.96–0.99) 19.9 (8.9–44.5) 0.10 (0.04–0.24) 207 (52–830)
Lateral flow test
 Overall studies 10 933 0.86 (0.81–0.91) 0.96 (0.93–0.98) 0.95 (0.93–0.97) 21.2 (11.7–38.5) 0.14 (0.10–0.21) 148 (64–343)
Excluded antibiotic therapy
 Yes 5 462 0.86 (0.77–0.92) 0.97 (0.91–0.99) 0.94 (0.92–0.96) 32.7 (9.3–114.6) 0.15 (0.08–0.25) 225 (46–1099)
 No and NA 5 471 0.87 (0.78–0.92) 0.95 (0.91–0.97) 0.97 (0.95–0.98) 17.3 (9.1–33.1) 0.14 (0.08–0.23) 124 (46–336)
Number of patients
 ≥ 50 7 826 0.89 (0.84–0.92) 0.97 (0.94–0.99) 0.95 (0.92–0.96) 30.9 (15.4–61.9) 0.12 (0.08–0.17) 263 (109–631)
  1. PLR positive likelihood ratio, NLR negative likelihood ratio, DOR diagnostic odds ratio, AUC area under the curve