Diagnostic Accuracy of β-d-Glucan (Fungitell) Testing Among Patients With Hematologic Malignancies or Solid Organ Tumors: A Systematic Review and Meta-Analysis.

Sandra K White, Brandon S Walker, Kimberley E Hanson, Robert L Schmidt

Journal: American journal of clinical pathology 2020;151(3):275-285

PMID: 30307463

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Abstract

OBJECTIVES

To determine the accuracy of Fungitell, a β-d-glucan (BDG) test, for the diagnosis of invasive fungal infection (IFI) among cancer patients.

METHODS

For this meta-analysis, MEDLINE and EMBASE were searched for references related to BDG testing. Study quality was evaluated using QUADAS-2. Statistical analysis was performed using Stata 14.

RESULTS

We screened 12,426 references and identified 189 studies for full-text review. Nineteen studies were included in the final meta-analysis. There was moderate heterogeneity between studies. Nine studies had a high risk of bias, which significantly elevated the overall specificity estimate. Restricting to only low-bias studies, the sensitivity and specificity were 80% and 63%, respectively.

CONCLUSIONS

The overall sensitivity and specificity of Fungitell as a diagnostic test for IFI is moderate, and there is substantial heterogeneity between studies. Limiting studies to only low-bias risk reduced heterogeneity but also lowered the overall specificity estimate.

Address: Department of Pathology, Division of Infectious Disease, Health Sciences Center, University of Utah, Salt Lake City.; Associated Regional and University Pathologists Laboratories, Salt Lake City, UT.; Department of Medicine, Division of Infectious Disease, Health Sciences Center, University of Utah, Salt Lake City.

DOI: 10.1093/ajcp/aqy135

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MeSH Terms: Diagnostic Tests, Routine, Glucans, Hematologic Neoplasms, Humans, Immunocompromised Host, Invasive Fungal Infections, Sensitivity and Specificity