Diagnostic value of galactomannan detection for invasive aspergillosis infections in pediatric patients with Meta-analysis

Abstract

Objective To evaluate the diagnostic value of galactomannan (GM) detection for invasive aspergillosis infections in pediatric patients , a Meta-analysis was performed. Methods According to selection criteria, studies indexed by PubMed,EMBASE,Medline,CNKI and Wanfang Data on GM testing in pediatric aspergillosis were included from January 2001 to November 2012 . The methodological quality was assessed by QUADAS, sources of heterogeneity investigated, pooled effect quantities evaluated, and summary receiver operative curves (ROC) and subgroup analysis performed. Stata12.0 was used to analyze diagnostic parameters, such as, sensitivity, specificity, positive likelihood ratio, negative likelihood ratio and area under the curve (AUC). Results Thirteen articles with 16 sets of data were included. The weighted sensitivity and specificity with 95% confidence interval were 0.71(0.60-0.79) and 0.94(0.89-0.96), respectively. Under different cut-off values , sensitivities of GM assay in diagnosis of pediatric aspergillosis were 0.71（0.54-0.84） for 0.5, 0.77（0.64-0.87） for 0.8 ,0.72（0.58-0.84） for 1.0 and 0.59（0.39-0.76） for 1.5, and its responding specificities were 0.94（0.89-0.97）, 0.89（0.82-0.93）, 0.89（0.81-0.94） and 0.91（0.88-0.94）. Conclusion Under the cut-off value of 0.8, the GM assay is a useful method in the detection of pediatric invasive aspergillosis.（Chin J Lab Med，2014,37：772-775） Key words: Aspergillosis; Mannans; Meta-analysis; Child