Comparative accuracy of 1,3 beta-D glucan and galactomannan for diagnosis of invasive fungal infections in pediatric patients: a systematic review with meta-analysis

2020 ◽  
Author(s):  
Shreya Singh ◽  
Manvi Singh ◽  
Nipun Verma ◽  
Minakshi Sharma ◽  
Pranita Pradhan ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pediatric Patients ◽  
Fungal Infections ◽  
Meta Analysis ◽  
Invasive Fungal Infections ◽  
Cochrane Library ◽  
Operating Characteristics ◽  
Oncology Patients ◽  
Specificity And Sensitivity ◽  
Sensitivity Specificity

Abstract Invasive fungal infections (IFI) cause considerable morbidity and mortality in pediatric patients. Serum biomarkers such as 1,3-beta-D glucan (BDG) and galactomannan (GM) have been evaluated for the IFI diagnosis. However, most evidence regarding their utility is derived from studies in adult oncology patients. This systematic review aimed to compare the diagnostic accuracy of BDG and GM individually or in combination for diagnosing IFI in pediatric patients. PubMed, CINAHL, Embase, and Cochrane Library were searched until March 2019 for diagnostic studies evaluating both serum GM and BDG for diagnosing pediatric IFI. The pooled diagnostic odds ratio (DOR), specificity and sensitivity were computed. Receiver operating characteristics (ROC) curve and area under the curve (AUC) were used for summarizing overall assay performance. Six studies were included in the meta-analysis. The summary estimates of sensitivity, specificity, pooled DOR, AUC of the GM assay for proven or probable IFI were 0.74, 0.76, 13.25, and 0.845. The summary estimates of sensitivity, specificity, pooled DOR, AUC of the BDG assay were 0.70, 0.69, 4.3, and 0.722. The combined predictive ability of both tests was reported in two studies (sensitivity: 0.67, specificity: 0.877). Four studies were performed in hematology-oncology patients, while two were retrospective studies from pediatric intensive care units (ICUs). In the subgroup of hematology-oncology patients, DOR of BDG remained similar at 4.25 but increased to 40.28 for GM. We conclude that GM and BDG have a modest performance for identifying IFI in pediatric patients. GM has a better accuracy over BDG. Combining both improves the specificity at the cost of sensitivity.

scholarly journals Can liquid-based preparation substitute for conventional smear in thyroid fine-needle aspiration? A systematic review based on meta-analysis

2017 ◽  
Vol 6 (8) ◽  
pp. 817-829 ◽  
Author(s):  
Yosep Chong ◽  
Soon-Jin Ji ◽  
Chang Suk Kang ◽  
Eun Jung Lee
Keyword(s):  
Systematic Review ◽  
Fine Needle Aspiration ◽  
Meta Analysis ◽  
Needle Aspiration ◽  
Cochrane Library ◽  
Fine Needle ◽  
Specificity And Sensitivity ◽  
Full Text Review ◽  
Thyroid Fine Needle Aspiration ◽  
Similar Accuracy

Objective Conventional smear (CS) using fine-needle aspiration cytology (FNAC) has been established as the test of choice for diagnosing thyroid lesions, despite low sample adequacy and inter-individual variations. Although a liquid-based preparation (LBP) technique has been recently applied to overcome these limitations, its clinical utility and its accuracy over CS are controversial. This study aimed to determine the true sensitivity and specificity of LBP in thyroid FNAC by meta-analysis. Design Systematic review with meta-analysis. Methods We searched major electronic databases (MEDLINE, EMBASE, Cochrane library, Google Scholar) with queries of ‘thyroid’, ‘LBP’ and ‘liquid-based cytology’. Original articles including cytohistologic correlation data comparing the accuracy of any LBP technique, such as ThinPrep, SurePath and Liqui-Prep, with CS were included for qualitative meta-analysis and preparation of synthesized reporter-operating curves (sROC). Results A total of 372 studies were screened and 51 original articles were eligible for full-text review; finally, 24 studies were chosen for the meta-analysis. Average sample inadequacy was significantly lower in two mainstream LBP methods (ThinPrep and SurePath) than CS. Specificity and sensitivity by sROC were similar or slightly superior for LBP vs CS. Various cytomorphologic changes by each method have been reported. Conclusions Although a learning curve is essential for adapting to the cytomorphologic features of the LBP technique, our results support the use of two mainstream LBPs alone in thyroid FNAC that LBP will increase the sample adequacy and reduce the workload with similar accuracy. More data and further evaluation are needed for the other LBP methods.

Risk factors of invasive fungal infections in liver transplant recipients: a systematic review and meta‐analysis

2021 ◽  
Author(s):  
Pakpoom Phoompoung ◽  
Sabina Herrera ◽  
Armelle Pérez Cortés Villalobos ◽  
Farid Foroutan ◽  
Ani Orchanian‐Cheff ◽  
...  
Keyword(s):  
Risk Factors ◽  
Systematic Review ◽  
Liver Transplant ◽  
Fungal Infections ◽  
Meta Analysis ◽  
Invasive Fungal Infections ◽  
Transplant Recipients ◽  
Liver Transplant Recipients

scholarly journals Reliability of synovial fluid alpha-defensin and leukocyte esterase in diagnosing periprosthetic joint infection (PJI): a systematic review and meta-analysis

2019 ◽  
Vol 14 (1) ◽  
Author(s):  
Yisheng Chen ◽  
Xueran Kang ◽  
Jie Tao ◽  
Yunpeng Zhang ◽  
Chenting Ying ◽  
...  
Keyword(s):  
Systematic Review ◽  
Synovial Fluid ◽  
Periprosthetic Joint Infection ◽  
Meta Analysis ◽  
Joint Infection ◽  
High Specificity ◽  
Diagnostic Efficiency ◽  
Operating Characteristics ◽  
Musculoskeletal Infection ◽  
Sensitivity Specificity

Abstract Background Synovial fluid proteins had been applied as diagnostic biomarkers for periprosthetic joint infection (PJI) in recent research papers. Thus, this meta-analysis aimed to estimate the diagnostic efficiency of synovial fluid α-defensin and leukocyte esterase (LE) for PJI. Methods We conducted our systematic review by searching the keywords in online databases such as PubMed, Embase, Cochrane, Elsevier, Springer, and Web of Science from the time of database inception to October 2018. Inclusion criteria were as follows: patients who have undergone knee, hip, or shoulder joint replacements; α-defensin or leukocyte esterase (LE strip) of synovial fluid was detected as the biomarker for PJI diagnosis; and Musculoskeletal Infection Society (MSIS) or utilizing a combination of clinical data was considered as the gold standard. Diagnostic parameters including sensitivity, specificity, diagnostic odds ratio (DOR), and area under the summary of receiver operating characteristics curve (AUSROC) were calculated for the included studies to evaluate the synovial fluid α-defensin and LE for PJI diagnosis. Results After full-text review, 28 studies were qualified for this systematic review, 16 studies used α-defensin and the other 12 were conducted using LE strip. The pooled sensitivity, specificity, and DOR of LE strip were 87% (95% CI 84–90%), 96% (95% CI 95–97%), and 170.09 (95% CI 97.63–296.32), respectively, while the pooled sensitivity, specificity, and DOR of α-defensin were 87% (95% CI 83–90%), 97% (95% CI 96–98%), and 158.18 (95% CI 74.26–336.91), respectively. The AUSROC for LE strip and α-defensin were 0.9818 and 0.9685, respectively. Conclusion Both LE strip and α-defensin of synovial fluid provide rapid and convenient diagnosis for PJI. Sensitivity of α-defensin and LE strip are the same, while both these two methods have high specificity in clinical practice.

scholarly journals Diagnostic accuracy of non-contact infrared thermometers and thermal scanners: a systematic review and meta-analysis

2020 ◽  
Vol 27 (8) ◽  
Author(s):  
Nishant Aggarwal ◽  
Mohil Garg ◽  
Vignesh Dwarakanathan ◽  
Nitesh Gautam ◽  
Swasthi S Kumar ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Predictive Value ◽  
Meta Analysis ◽  
World Health ◽  
Cochrane Library ◽  
Research Database ◽  
Index Test ◽  
Reference Standard ◽  
Operating Characteristics

Abstract Infrared thermal screening, via the use of handheld non-contact infrared thermometers (NCITs) and thermal scanners, has been widely implemented all over the world. We performed a systematic review and meta-analysis to investigate its diagnostic accuracy for the detection of fever. We searched PubMed, Embase, the Cochrane Library, medRxiv, bioRxiv, ClinicalTrials.gov, COVID-19 Open Research Dataset, COVID-19 research database, Epistemonikos, EPPI-Centre, World Health Organization International Clinical Trials Registry Platform, Scopus and Web of Science databases for studies where a non-contact infrared device was used to detect fever against a reference standard of conventional thermometers. Forest plots and Hierarchical Summary Receiver Operating Characteristics curves were used to describe the pooled summary estimates of sensitivity, specificity and diagnostic odds ratio. From a total of 1063 results, 30 studies were included in the qualitative synthesis, of which 19 were included in the meta-analysis. The pooled sensitivity and specificity were 0.808 (95%CI 0.656–0.903) and 0.920 (95%CI 0.769–0.975), respectively, for the NCITs (using forehead as the site of measurement), and 0.818 (95%CI 0.758–0.866) and 0.923 (95%CI 0.823–0.969), respectively, for thermal scanners. The sensitivity of NCITs increased on use of rectal temperature as the reference. The sensitivity of thermal scanners decreased in a disease outbreak/pandemic setting. Changes approaching statistical significance were also observed on the exclusion of neonates from the analysis. Thermal screening had a low positive predictive value, especially at the initial stage of an outbreak, whereas the negative predictive value (NPV) continued to be high even at later stages. Thermal screening has reasonable diagnostic accuracy in the detection of fever, although it may vary with changes in subject characteristics, setting, index test and the reference standard used. Thermal screening has a good NPV even during a pandemic. The policymakers must take into consideration the factors surrounding the screening strategy while forming ad-hoc guidelines.

scholarly journals Is neutrophil CD11b a special marker for the early diagnosis of sepsis in neonates? A systematic review and meta-analysis

BMJ Open ◽  
2019 ◽  
Vol 9 (4) ◽  
pp. e025222 ◽  
Author(s):  
Xia Qiu ◽  
Jinhui Li ◽  
Xiaoyan Yang ◽  
Jun Tang ◽  
Jing Shi ◽  
...  
Keyword(s):  
Systematic Review ◽  
Early Diagnosis ◽  
Likelihood Ratio ◽  
Neonatal Sepsis ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Cochrane Library ◽  
Post Test ◽  
Sensitivity Specificity

ObjectivesOur study aimed to synthesise and analyse the early diagnostic value of neutrophil CD11b (nCD11b) for neonatal sepsis.DesignSystematic review and meta-analysis.MethodsPubmed, Embase, the Cochrane Library and Web of Science Databases were searched up to June 2018. We used Stata software (V.14.0) to conduct the pooled sensitivity, specificity, positive likelihood ratio (PLR), negative likelihood ratio (NLR), diagnostic OR (DOR), pretest probability, post-test probability and summary receiver operating characteristic (SROC) curve for diagnostic efficiency of n CD11b.ResultsNine studies, accounting for 843 neonates, were included. The overall pooled sensitivity, specificity, PLR, NLR, DOR, post-test positive probability and post-test negative probability and the area under the SROC curve were 0.82 (95% CI 0.71 to 0.90), 0.93 (95% CI 0.62 to 0.99), 11.51 (95% CI 1.55 to 85.62), 0.19 (95% CI 0.10 to 0.36), 59.50 (95% CI 4.65 to 761.58), 74%, 5% and 0.90, which had accuracy in diagnosing neonatal sepsis.ConclusionThe present evidence indicated that nCD11b is a promising biomarker for the early diagnosis of neonatal sepsis.

Diffuse excessive high signal intensity on term equivalent MRI does not predict disability: a systematic review and meta-analysis

2020 ◽  
Vol 106 (1) ◽  
pp. 9-16 ◽  
Author(s):  
Chandra Prakash Rath ◽  
Saumil Desai ◽  
Shripada C Rao ◽  
Sanjay Patole
Keyword(s):  
Systematic Review ◽  
Preterm Infants ◽  
Roc Curve ◽  
Signal Intensity ◽  
Meta Analysis ◽  
High Signal Intensity ◽  
Cochrane Library ◽  
Mental Disability ◽  
High Signal ◽  
Operating Characteristics

ObjectiveTo evaluate whether diffuse excessive high signal intensity (DEHSI) on term equivalent age MRI (TEA-MRI) predicts disability in preterm infants.DesignThis is a systematic review and meta-analysis. Medline, EMBASE, Cochrane Library, EMCARE, Google Scholar and MedNar databases were searched in July 2019. Studies comparing developmental outcomes of isolated DEHSI on TEA-MRI versus normal TEA-MRI were included. Two reviewers independently extracted data and assessed the risk of bias. Meta-analysis was undertaken where data were available in a format suitable for pooling.Main outcome measuresNeurodevelopmental outcomes ≥1 year of corrected age based on validated tools.ResultsA total of 15 studies (n=1832) were included, of which data from 9 studies were available for meta-analysis. The pooled estimate (n=7) for sensitivity of DEHSI in predicting cognitive/mental disability was 0.58 (95% CI 0.34 to 0.79) and for specificity was 0.46 (95% CI 0.20 to 0.74). The summary area under the receiver operating characteristics (ROC) curve was low at 0.54 (CI 0.50 to 0.58). A pooled diagnostic OR (DOR) of 1 indicated that DEHSI does not discriminate preterm infants with and without mental disability. The pooled estimate (n=8) for sensitivity of DEHSI in predicting cerebral palsy (CP) was 0.57 (95% CI 0.37 to 0.75) and for specificity was 0.41 (95% CI 0.24 to 0.62). The summary area under the ROC curve was low at 0.51 (CI 0.46 to 0.55). A pooled DOR of 1 indicated that DEHSI does not discriminate between preterm infants with and without CP.ConclusionsDEHSI on TEA-MRI did not predict future development of cognitive/mental disabilities or CP.PROSPERO registration numberCRD42019130576.

scholarly journals The diagnostic accuracy of B-mode ultrasound in detecting meniscal tears: a systematic review and pooled meta-analysis

2018 ◽  
Vol 20 (2) ◽  
pp. 164 ◽  
Author(s):  
Fajin Dong ◽  
Lei Zhang ◽  
Shuxia Wang ◽  
Duo Dong ◽  
Jinfeng Xu ◽  
...  
Keyword(s):  
Systematic Review ◽  
Diagnostic Accuracy ◽  
Likelihood Ratio ◽  
Odds Ratio ◽  
Meta Analysis ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Meniscal Tears ◽  
Linear Probe ◽  
Sensitivity Specificity

Aim: To evaluate the diagnostic accuracy of meniscal tears using B-mode ultrasound and high-frequency linear probe by conducting a systematic review and pooled meta-analysis. Material and methods: The Cochrane library, Embase, and Pubmed were searched for relevant studies up to 29 July 2017. The arthroscopy was used as the reference standard. The results were estimated by pooled sensitivity, specificity, diagnostic odds ratio, likelihood ratio, and the area under the summary receiver operating characteristic (SROC). Results: Seven prospective studies met the selection criteria, comprising 321meniscal tears from 472 patients. The pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, diagnostic odds ratio, and area under the SROC curve were 88.80% (95%CI: 82.83-92.87), 84.66% (95%CI: 75.89-90.64), 5.79(95%CI: 3.66-9.15), 0.13 (95%CI: 0.09-0.20), and 43.74 (95%CI: 24.01-79.68), respectively. The area under the SROC curve was 93% (95%CI: 91-95). Conclusions: This meta-analysis indicates that 2-dimensional ultrasound is useful, and could be routinely used for estimating meniscal injuries in the human knee joint

scholarly journals Clinical value of thoracic ultrasonography in the diagnosis of pulmonary embolism: a systematic review and meta-analysis

2021 ◽  
Author(s):  
Wu Chen ◽  
Kun Xu ◽  
Yiying Li ◽  
Meifang Hao ◽  
Yongsheng Yang ◽  
...  
Keyword(s):  
Systematic Review ◽  
Pulmonary Embolism ◽  
Likelihood Ratio ◽  
Meta Analysis ◽  
Positive Likelihood Ratio ◽  
Negative Likelihood Ratio ◽  
Diagnostic Odds Ratio ◽  
Cochrane Library ◽  
Clinical Value ◽  
Sensitivity Specificity

Aims: The present study investigated and evaluated the accuracy of thoracic ultrasonography (TUS) in the diagnosis of pulmonary embolism (PE) by conducting a systematic review and meta-analysis. Material and methods: The PubMed, Em-base and the Cochrane library databases were searched till March 2019 to retrieve relevant articles and the overall diagnostic accuracy of TUS in PE diagnosis was evaluated by meta-analysis. Results: Overall, 16 studies including 1,916 patients were enrolled in this meta-analysis. Of these, 762 (39.8%) had confirmed PE. The overall sensitivity, specificity, and area under the ROC curve (AUC) of TUS for PE were 82% (95% confidence interval (CI), 72%–88%), 89% (95% CI, 79%–95%), and 0.91 (95% CI, 0.88–0.93), respectively. Other efficacy parameters assessed demonstrated a positive likelihood ratio (PLR) of (7.6; 95% CI, 4.0–14.5), negative likelihood ratio of (NLR) (0.21; 95% CI, 0.14–0.30), and diagnostic odds’ ratio (DOR) of (36.86; 95% CI, 21.41–63.48). Conclusions: The current study suggested that although TUS cannot safely rule out PE, it is likely to be used as an aid or guidance to establish procedures and help to improve the diagnostic deficits in patients with PE.

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