Reliability of clinical research on invasive fungal infections: a systematic review of the literature

Abstract

The aim of this study was to assess the comparability and reliability of clinical research on invasive fungal infections (IFIs) which is accumulating in the medical literature. A Medline search strategy was developed covering the years 1985-1997. The 7,086 articles identified this way were further limited to 173 by reading the abstracts to studies involving immunocompromised patients and deep tissue infections. Diagnostic criteria used for definitions of IFIs were evaluated according to the level of confidence in diagnosis. For analysing the reliability, we used the sample of 397 patients from the European Organization for Research and Treatment of Cancer (EORTC) database. Each patient in the database was evaluated according to the definitions employed in each article. The level of overall agreement among the articles was very low (Kappa = 0.253). The results of this analysis show the discrepancy in the medical literature in diagnosing IFIs and the necessity for the standardization of definitions.