Reviewed disease state subgroups and associated gold standards
| Disease state | Gold standard |
| Secondary pleural malignancy | Malignant fluid cytology or pleural biopsy, or malignant pleural nodules/thickening on imaging and confirmed extrapleural primary cancer. |
| Tuberculous pleural effusion (TPE) | Clinical composite, including definite TPE (AAFB in pleural tissue or fluid culture, or sputum AAFB plus effusion) and probable TB (granulomatous histology or lymphocytic fluid, effusion resolved after TB therapy and other causes excluded). |
| Heart failure | Clinical composite including reduced LVEF on echo±MRI. |
| Complex parapneumonic effusion or empyema | Clinical composite including evidence of infection plus purulent fluid, positive culture or Gram’s stain, fluid pH <7.2. |
| Autoimmune pleuritis | Clinical compositive based on all available data. |
AAFB, acid alcohol fast bacilli; LVEF, left ventricular ejection fraction.