Dried blood spots PCR assays to screen congenital cytomegalovirus infection: a meta-analysis

Abstract

The performance of dried blood spots (DBS) polymerase chain reaction (PCR) assays in screening for congenital cytomegalovirus (cCMV) infection varies between different studies. To determine whether the DBS PCR assay has sufficient accuracy to be used as a screening test for cCMV infection, we performed a meta-analysis of 15 studies (n = 26007 neonates) that evaluated the performance of DBS PCR tests in screening for cCMV infection and that met our inclusion criteria. The pooled sensitivity and specificity were 0.844 (95% CI = 0.812-0.872) and 0.999 (95% CI = 0.998-0.999), respectively, and the diagnostic odds ratio was 1362.10 (95%CI = 566.91-3272.60). As sensitivity analysis showed that the results were robust. In conclusion, the performance of DBS PCR assays for testing cCMV was more suitable for retrospective diagnosis than screening.

Figure 1

Flow chart showing the process of study selection. 14 articles were included in this meta-analysis.

Figure 2

Summary of diagnostic performance estimates using random effect model. a. Pooled sensitivity of DBS PCR assays; The pooled sensitivity is 0.84. b. Pooled specificity of DBS PCR assays; The pooled specificity is 1.00. c. DOR for DBS PCR assays; The DOR is 1362.09. d SROC curve for cCMV diagnosis by DBS PCR assays. The AUC is 0.9953.