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. 2024 Jul 14;10(14):e34569.
doi: 10.1016/j.heliyon.2024.e34569. eCollection 2024 Jul 30.

Diagnostic accuracy of galactomannan and lateral flow assay in invasive aspergillosis: A diagnostic meta-analysis

Xiaohong Zhang  1 , Xue Shang  2 , Yinghua Zhang  1 , Xiuxia Li  3 , Kehu Yang  4 , Yan Wang  1 , Kangle Guo  1
Affiliations

Diagnostic accuracy of galactomannan and lateral flow assay in invasive aspergillosis: A diagnostic meta-analysis

Xiaohong Zhang et al. Heliyon. .

Abstract

Background: Efficient diagnosis of patients at high risk for invasive aspergillosis (IA) improves the outcome of the disease. Lateral flow assay (LFA) is a novel technology and assessing its diagnostic accuracy is of great significance in the clinical management of IA.

Methods: A meta-analysis using case-control studies was performed to assess the diagnostic performance of LFA alone or galactomannan (GM) combined with LFA (GM-LFA) as screening tests for IA. The sensitivity, specificity, and summary receiver operating characteristic curves were constructed.

Results: Nineteen studies with 2838 patients were included. The pooled effect sizes for different indicators included: sensitivity (77 % for LFA and 75 % for GM-LFA), specificity (88 % for LFA and 87 % for GM-LFA), positive likelihood ratio (6.65 for LFA and 12.02 for GM-LFA), negative likelihood ratio (0.26 for LFA and 0.27 for GM-LFA), and the diagnostic odds ratio (25.81 for LFA and 44.87 for GM-LFA). The area under the curve was 0.91 for LFA and 0.94 for GM-LFA with a cut-off value ≥ 0.5.

Conclusion: The present meta-analysis suggested that LFA or GM-LFA at an optical density index (ODI) cutoff of ≥0.5 was a useful diagnostic tool for IA in patients. The results showed no significant differences in the accuracy of LFA alone and GM-LFA in diagnosing IA. In the clinical diagnosis and treatment of IA, LFA can be recommended if timely results are needed.

Keywords: Diagnostic meta-analysis; Galactomannan; Invasive aspergillosis; Lateral flow assay.

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Conflict of interest statement

The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Fig. 1
Fig. 1
PRISMA diagram of literature screening process.
Fig. 2
Fig. 2
Overall quality assessment of all 19 included studies.
Fig. 3
Fig. 3
Forest plot of sensitivities and specificities of LFA or GM-LFA test accuracy in the diagnosis of proven or probable IA.
Fig. 4
Fig. 4
Forest plot of PLR and NLR of LFA or GM-LFA test accuracy in the diagnosis of proven or probable IA.
Fig. 5
Fig. 5
Forest plot of DOR of LFA or GM-LFA test accuracy in the diagnosis of proven or probable IA.
Fig. 6
Fig. 6
Summary SROC plots of SEN and SPE.
See this image and copyright information in PMC

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