Evidence map›Paper›PMID 25122854›Full record

SynthesisJournal of clinical microbiology2014

PCR in diagnosis of invasive aspergillosis: a meta-analysis of diagnostic performance.

Marios Arvanitis, Panayiotis D Ziakas, Ioannis M Zacharioudakis, Fainareti N Zervou, Angela M Caliendo, Eleftherios Mylonakis

Open access · bronzeAbstract readEvaluation StudyMeta-Analysis
In one paragraph

Synthesis in Journal of clinical microbiology, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 59 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
59citing papers in PubMed, 5 pooled it
8.3field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

59 citing papers in PubMed, 5 syntheses or guidelines pooled it, 142 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Practice Guidelines for the Diagnosis and Management of Aspergillosis: 2016 Update by the Infectious Diseases Society of America.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2016
    Guideline
  5. Aspergillus Polymerase Chain Reaction: Systematic Review of Evidence for Clinical Use in Comparison With Antigen Testing.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2015
    Pooled it
  6. Trial
  7. Review
  8. Article
  9. Review
  10. Article
  11. Review
  12. ISCCM Position Statement on the Management of Invasive Fungal Infections in the Intensive Care Unit.Indian journal of critical care medicine : peer-reviewed, official publication of Indian Society of Critical Care Medicine · 2024
    Article
  13. Clinical Implementation ofJournal of fungi (Basel, Switzerland) · 2023
    Article
  14. Review
  15. Performance of a Real-Time PCR Assay for the Detection of FiveJournal of fungi (Basel, Switzerland) · 2023
    Article
  16. Review
  17. Review
  18. Article
  19. Review
  20. InvasiveDiagnostics (Basel, Switzerland) · 2022
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 2 institutions in 1 country.

Marios ArvanitisInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Panayiotis D ZiakasInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Ioannis M ZacharioudakisInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Fainareti N ZervouInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Angela M CaliendoInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.
Eleftherios MylonakisInfectious Diseases Division, Rhode Island Hospital, Providence, Rhode Island, USA Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA emylonakis@lifespan.org.
Brown University · USRhode Island Hospital · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Invasive aspergillosis is a difficult-to-diagnose infection with a high mortality rate that affects high-risk groups such as patients with neutropenia and hematologic malignancies. We performed a bivariate meta-analysis of diagnostic data for an Aspergillus sp. PCR assay with blood specimens from high-risk hematology patients. We included all studies involving human subjects that assessed the performance of any PCR assay for invasive aspergillosis in whole blood or serum and that used the European Organization for the treatment of Cancer/Mycoses Study Group criteria as a reference standard. Three investigators independently searched the literature for eligible studies and extracted the data. Out of a total of 37 studies, 25 met strict quality criteria and were included in our evidence synthesis. Twenty-five studies with 2,595 patients were analyzed. The pooled diagnostic performance of whole-blood and serum PCR assays was moderate, with a sensitivity and specificity of 84% (95% confidence interval [CI], 75 to 91%) and 76% (95% CI, 65 to 84%), respectively, suggesting that a positive or negative result is unable, on its own, to confirm or exclude a suspected infection. The performance of a PCR assay of serum was not significantly different from that of whole blood. Notably, at least two positive PCR test results were found to have a specificity of 95% and a sensitivity of 64% for invasive infection, achieving a high positive likelihood ratio of 12.8. Importantly, the European Aspergillus PCR Initiative (EAPCRI) recommendations improved the performance of the PCR even further when at least two positive specimens were used to define PCR positivity. In conclusion, two positive PCR results should be considered highly indicative of an active Aspergillus sp. infection. Use of the EAPCRI recommendations by clinical laboratories can further enhance PCR performance.

Indexed as

AdultAspergillusBloodChildChild, PreschoolHematologic NeoplasmsHumansInvasive Pulmonary AspergillosisMolecular Diagnostic TechniquesPolymerase Chain ReactionSensitivity and Specificity

Identifiers

PMID25122854
PMCPMC4187770
OpenAlexW1964786295

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.