A systematic review including 21 studies with a total of 17,737 samples was abstracted in DARE. There were 572 culture-positive female samples and 901 culture-positive male samples, and 92 other or total culture-positive samples. In detecting gonococcal infections of the endocervix the sensitivity of nucleic acid hybridisation was 92.1% and specificity was 99.1%. For LCR the sensitivity was 96.7% and the specificity 99.1%). In detecting gonococcal infection of the male urethra, the sensitivity of nucleic acid hybridisation was 96.4% and specificity was 98.8%. For LCR the sensitivity was 98.6% and the specificity was 99.97%. For detecting gonococcal infection in a urine specimen, the sensitivity of LCR for women was 96.2% and the specificity was 100.0%. For men, the sensitivity was 98.3% and the specificity was 100.0%.
Comment: The quality of evidence is upgraded by large magnitude of effect (high accuracy of the test) and consistent results, but downgraded by indirectness (as studies were limited to North America, due to the differences in the nature of the disease in other areas, the results will have limited generalisability).