title: Diagnosis of invasive fungal disease using serum (1→3)-β-D-glucan: a bivariate meta-analysis.
abstract: BACKGROUND
  The (1→3)-β-D-Glucan (BG) assay has been approved for diagnosing invasive fungal disease (IFD). However, the test performance has been variable. We conducted a meta-analysis to determine the overall accuracy of BG assay for diagnosing IFD.
  
  
  METHODS
  The sensitivity, specificity, and positive and negative likelihood ratios (PLR and NLR, respectively) of BG for diagnosing IFD were pooled using a bivariate meta-analysis. We also performed subgroup analyses.
  
  
  RESULTS
  Twelve reports, including 15 studies, were included for the analysis (proven and probable IFD vs possible or no IFD). The sensitivity, specificity, PLR and NLR were 0.76 (95% CI, 0.67-0.83), 0.85 (95% CI, 0.73-0.92), 5.05 (95% CI, 2.71-9.43), and 0.28 (95% CI, 0.20-0.39), respectively. Subgroup analyses showed that the BG assay had higher specificities for patients with hematological disorders and a positive BG result with two consecutive samples. The combination of galactomannan and BG increased the specificity value to 0.98 (95% CI, 0.95-0.99) for diagnosing invasive aspergillosis.
  
  
  CONCLUSIONS
  Serum BG determination is clinically useful for diagnosing IFD in at-risk patients, especially for hematology patients. The combination of galactomannan and BG was sufficient for diagnosing invasive aspergillosis. Since the BG assay is not absolutely sensitive and specific for IFD, the BG results should be interpreted in parallel with clinical findings.
authors.affiliation: School of International Education, Guangxi Medical University, People's Republic of China.
authors.forename: Yuan
authors.initials: Y
authors.lastname: Lu
authors.forename: Yi-Qiang
authors.initials: YQ
authors.lastname: Chen
authors.forename: Ya-Ling
authors.initials: YL
authors.lastname: Guo
authors.forename: Shou-Ming
authors.initials: SM
authors.lastname: Qin
authors.forename: Cong
authors.initials: C
authors.lastname: Wu
authors.forename: Ke
authors.initials: K
authors.lastname: Wang
mesh_terms: D001228:Aspergillosis / Q000097:blood / Q000175:diagnosis; D015415:Biomarkers / Q000097:blood; D058365:Candidiasis, Invasive / Q000097:blood / Q000175:diagnosis; D005690:Galactose / Q000031:analogs & derivatives; D006801:Humans; D016013:Likelihood Functions; D016014:Linear Models; D008351:Mannans / Q000097:blood; D009181:Mycoses / Q000097:blood* / Q000175:diagnosis*; D011509:Proteoglycans; D012372:ROC Curve; D012680:Sensitivity and Specificity; D047071:beta-Glucans / Q000097:blood*
chemical_list: D015415:Biomarkers; D008351:Mannans; D011509:Proteoglycans; D047071:beta-Glucans; C012990:galactomannan; C010770:polysaccharide-K; D005690:Galactose