Galactomannan in the diagnosis of invasive aspergillosis in immunocompromized patients

At the cut-off value 0.5 ODI (Optical Density Index), galactomannan detection in serum by ELISA test for the diagnosis of invasive aspergillosis seems to have a sensitivity of 78% and a specificity of 81%. At the cut-off value 1.5, the specificity would rise to 95% at the cost of sensitivity (64%).

A Cochrane review included 54 studies (50 in the meta-analyses), containing 5660 patients, of whom 586 had proven or probable invasive aspergillosis. When using an optical density index (ODI) of 0.5 as a cut-off value, the sensitivity of the test was 82% (73% to 90%) and the specificity was 81% (72% to 90%). At a cut-off value of 1.0 ODI, the sensitivity was 72% (65% to 80%) and the specificity was 88% (84% to 92%). At a cut-off value of 1.5 ODI, the sensitivity was 61% (47% to 75%) and the specificity was 93% (89% to 97%). None of the potential sources of heterogeneity had a statistically significant effect on either sensitivity or specificity.

Comment: The quality of evidence is downgraded by inconsistency (variability in results across studies).

Ədəbiyyat

1. Leeflang MM, Debets-Ossenkopp YJ, Wang J et al. Galactomannan detection for invasive aspergillosis in immunocompromised patients. Cochrane Database Syst Rev 2015;(12):CD007394.