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The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies.

Hou TY, Wang SH, Liang SX, Jiang WX, Luo DD, Huang DH - PLoS ONE (2015)

Bottom Line: A total of 1068 patients in 11 studies were analyzed.Deeks' funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055).The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively.

View Article: PubMed Central - PubMed

Affiliation: Medical Department of HAI Control, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, 510080, China.

ABSTRACT
The serum 1,3-beta-D-glucan (BG) assay aids in the early diagnosis of invasive fungal diseases (IFDs) and has been approved for their diagnosis. However, reports on the screening performance of BG are scarce. We performed a meta-analysis of data extracted from only prospective cohort studies to evaluate the screening performance of the BG assay in the diagnosis of IFDs. We specifically searched 4 databases (the PubMed, Web of Science, Elsevier, and Cochrane Collaboration databases) according to EORTC-MSG criteria. A total of 1068 patients in 11 studies were analyzed. Deeks' funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively. The findings of this meta-analysis suggest that the BG assay is a useful screening tool with high sensitivity and specificity for discriminating between patients with and without IFDs. In clinical practice, BG assay results should be evaluated together with clinical and microbiological findings.

No MeSH data available.


Related in: MedlinePlus

Flow chart showing the study selection process.
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pone.0131602.g001: Flow chart showing the study selection process.

Mentions: There were 1292 potentially relevant articles, of which 91 full-length articles were selected for a detailed analysis based on their title or abstract. The selection process for study inclusion is shown in Fig 1, and 11 prospective cohort studies met the inclusion criteria [6,7,9,10,12,28–34]. The characteristics of the 11 studies are summarized in Table 1. Among the 11 studies, 5 included patients with hematological malignancy (HM) or other serious tumors [6,12,28,29], 1 included patients who were liver transplant recipients[30], and the remaining 5 studies assessed hospitalized patients who might be at high risk for IFDs. The characteristics of the control groups varied. A screening strategy was used to measure the BG levels in blood samples in 9 studies. The 11 studies included 5 assays: 6 used Fungitell (cutoff value: 80 or 120 pg/ml), 2 used the Fungitec G test (cutoff value: 20 pg/ml), 2 used the Wako BG test (cutoff value: 7 or 11 pg/ml), and 1 used the GKT-25M set (cutoff value: 10 pg/ml). All of the studies, which comprised 1068 patients, employed the EORTC/MSG criteria as the reference standard for IFDs, as shown in Table 2.


The Screening Performance of Serum 1,3-Beta-D-Glucan in Patients with Invasive Fungal Diseases: A Meta-Analysis of Prospective Cohort Studies.

Hou TY, Wang SH, Liang SX, Jiang WX, Luo DD, Huang DH - PLoS ONE (2015)

Flow chart showing the study selection process.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4493111&req=5

pone.0131602.g001: Flow chart showing the study selection process.
Mentions: There were 1292 potentially relevant articles, of which 91 full-length articles were selected for a detailed analysis based on their title or abstract. The selection process for study inclusion is shown in Fig 1, and 11 prospective cohort studies met the inclusion criteria [6,7,9,10,12,28–34]. The characteristics of the 11 studies are summarized in Table 1. Among the 11 studies, 5 included patients with hematological malignancy (HM) or other serious tumors [6,12,28,29], 1 included patients who were liver transplant recipients[30], and the remaining 5 studies assessed hospitalized patients who might be at high risk for IFDs. The characteristics of the control groups varied. A screening strategy was used to measure the BG levels in blood samples in 9 studies. The 11 studies included 5 assays: 6 used Fungitell (cutoff value: 80 or 120 pg/ml), 2 used the Fungitec G test (cutoff value: 20 pg/ml), 2 used the Wako BG test (cutoff value: 7 or 11 pg/ml), and 1 used the GKT-25M set (cutoff value: 10 pg/ml). All of the studies, which comprised 1068 patients, employed the EORTC/MSG criteria as the reference standard for IFDs, as shown in Table 2.

Bottom Line: A total of 1068 patients in 11 studies were analyzed.Deeks' funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055).The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively.

View Article: PubMed Central - PubMed

Affiliation: Medical Department of HAI Control, Guangdong General Hospital, Guangdong Academy of Medical Sciences, Guangzhou, Guangdong province, 510080, China.

ABSTRACT
The serum 1,3-beta-D-glucan (BG) assay aids in the early diagnosis of invasive fungal diseases (IFDs) and has been approved for their diagnosis. However, reports on the screening performance of BG are scarce. We performed a meta-analysis of data extracted from only prospective cohort studies to evaluate the screening performance of the BG assay in the diagnosis of IFDs. We specifically searched 4 databases (the PubMed, Web of Science, Elsevier, and Cochrane Collaboration databases) according to EORTC-MSG criteria. A total of 1068 patients in 11 studies were analyzed. Deeks' funnel plot asymmetry test suggested a low likelihood of publication bias for the included studies (p = 0.055). The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the summary receiver operating characteristic curve, with 95% confidence intervals, were 0.75(0.63,0.84), 0.87(0.81,0.92), 5.85(3.96,8.63), 0.30(0.20,0.45), 19.53(11.16,34.18), and 0.89(0.86,0.91), respectively. The findings of this meta-analysis suggest that the BG assay is a useful screening tool with high sensitivity and specificity for discriminating between patients with and without IFDs. In clinical practice, BG assay results should be evaluated together with clinical and microbiological findings.

No MeSH data available.


Related in: MedlinePlus