An assessment of nucleic acid amplification testing for active mycobacterial infection

Population
Patients with tissue biopsy consistent with NTM infection
Intervention	Culture plus NAAT for the detection of non TB-mycobacteria (e.g. Mycobacterium avium, M. kansasii, M. gordonae, or M. intracellulare)
Comparators	Culture plus other tests, e.g. lung biopsy or skin biopsy if possible
Outcomes	Safety—adverse events from testing procedures and subsequent treatments Direct effectiveness—time to symptom resolution, quality of life
Study design	Randomised trials, cohort studies, case series or systematic reviews of these study designs
Search period	1990 – May 2014 or inception of the database if later than 1990
Language	Studies in languages other than English will only be translated if they represent a higher level of evidence than that available in the English language evidence-base

Note: The patient population was expanded to include all patients suspected of having an NTM infection.

Due to the paucity of evidence, variations from the PICO were necessary. The patient population for eligible studies was expanded to include any patients suspected of having an NTM infection. Although the protocol for this review stated that the reference standard should be AFB microscopy and culture, as so little evidence was found, studies with clinical reference standards (i.e. various combinations of clinical assessment and pathology results, but also response to treatment) were also included. Twelve studies conducted between 1997 and 2005 were identified that reported on the diagnostic accuracy of NAAT for the detection of NTM infections. The study profiles and the quality appraisal are summarised in Table (Appendix ) and the extracted 2x2 data are presented in Table and Table (Appendix C). An overall summary of the body of evidence is presented in Table .

Table Body of evidence matrix for studies reporting on the accuracy of NAAT in diagnosing NTM infections