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Diagnostic Accuracy of Bronchoalveolar Lavage Fluid Galactomannan for Invasive Aspergillosis.
- Source :
-
BioMed research international [Biomed Res Int] 2020 Nov 30; Vol. 2020, pp. 5434589. Date of Electronic Publication: 2020 Nov 30 (Print Publication: 2020). - Publication Year :
- 2020
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Abstract
- Background: The pathogenesis of invasive aspergillosis (IA) is still unknown, but its progression is rapid and mortality rate remains high. Bronchoalveolar lavage fluid (BALF) galactomannan (GM) analysis has been used to diagnose IA. This study is aimed at making an accurate estimate of the whole accuracy of BALF-GM in diagnosing IA.<br />Methods: After a systematic review of the study, a bivariate meta-analysis was used to summarize the specificity (SPE), the sensitivity (SEN), the positive likelihood ratios (PLR), and the negative likelihood ratios (NLR) of BALF-GM in diagnosing IA. The overall test performance was summarized using a layered summary receiver operating characteristic (SROC) curve. Subgroup analysis was performed to explore the heterogeneity between studies.<br />Results: A total of 65 studies that are in line with the inclusion criteria were included. The summary estimates of BALF-GM analysis are divided into four categories. The first is the proven+probable vs. possible+no IA, with an SPE, 0.87 (95% CI, 0.85-0.98); SEN, 0.81 (95% CI, 0.76-0.84); PLR, 9.78 (5.78-16.56); and NLR, 0.20 (0.14-0.29). The AUC was 0.94. The BALF-GM test for proven+probable vs. no IA showed SPE, 0.88 (95% CI, 0.87-0.90); SEN, 0.82 (95% CI, 0.78-0.85); PLR, 6.56 (4.93-8.75); and NLR, 0.24 (0.17-0.33). The AUC was 0.93. The BALF-GM test for proven+probable+possible vs. no IA showed SPE, 0.82 (95% CI, 0.79-0.95); SEN, 0.59 (95% CI, 0.55-0.63); PLR, 3.60 (2.07-6.25); and NLR, 0.31 (0.15-0.61). The AUC was 0.86. The analyses for others showed SPE, 0.85 (95% CI, 0.83-0.87); SEN, 0.89 (95% CI, 0.86-0.91); PLR, 6.91 (4.67-10.22); and NLR, 0.18 (0.13-0.26). The AUC was 0.94.<br />Conclusions: The findings of this BALF-GM test resulted in some impact on the diagnosis of IA. The BALF-GM assay is considered a method for diagnosing IA with high SEN and SPE. However, the patients' underlying diseases may affect the accuracy of diagnosis. When the cutoff is greater than 1, the sensitivity will be higher.<br />Competing Interests: The authors declare that there are no competing interests associated with the manuscript.<br /> (Copyright © 2020 Xun-Jie Cao et al.)
- Subjects :
- Area Under Curve
False Negative Reactions
Galactose analogs & derivatives
Humans
Invasive Fungal Infections
Likelihood Functions
Probability
ROC Curve
Reproducibility of Results
Sensitivity and Specificity
Bronchoalveolar Lavage Fluid
Invasive Pulmonary Aspergillosis diagnosis
Invasive Pulmonary Aspergillosis metabolism
Mannans metabolism
Subjects
Details
- Language :
- English
- ISSN :
- 2314-6141
- Volume :
- 2020
- Database :
- MEDLINE
- Journal :
- BioMed research international
- Publication Type :
- Academic Journal
- Accession number :
- 33335924
- Full Text :
- https://doi.org/10.1155/2020/5434589