An Overview of Systematic Reviews of Polymerase Chain Reaction (PCR) for the Diagnosis of Invasive Aspergillosis in Immunocompromised People: A Report of the Fungal PCR Initiative (FPCRI)-An ISHAM Working Group

Warning

This publication doesn't include Faculty of Medicine. It includes Central European Institute of Technology. Official publication website can be found on muni.cz.

Authors	CRUCIANI Mario WHITE P Lewis BARNES Rosemary A LOEFFLER Juergen DONNELLY J Peter ROGERS Thomas R HEINZ Werner J WARRIS Adilia MORTON Charles Oliver LENGEROVÁ Martina KLINGSPOR Lena SENDID Boualem LOCKHART Deborah E A
Year of publication	2023
Type	Article in Periodical
Magazine / Source	Journal of Fungi
MU Faculty or unit	Central European Institute of Technology
Citation
Web	https://www.mdpi.com/2309-608X/9/10/967
Doi	http://dx.doi.org/10.3390/jof9100967
Keywords	systematic review; meta-analysis; umbrella review; Aspergillus fumigatus; invasive aspergillosis; diagnosis; polymerase chain reaction (PCR)
Description	This overview of reviews (i.e., an umbrella review) is designed to reappraise the validity of systematic reviews (SRs) and meta-analyses related to the performance of Aspergillus PCR tests for the diagnosis of invasive aspergillosis in immunocompromised patients. The methodological quality of the SRs was assessed using the AMSTAR-2 checklist; the quality of the evidence (QOE) within each SR was appraised following the GRADE approach. Eight out of 12 SRs were evaluated for qualitative and quantitative assessment. Five SRs evaluated Aspergillus PCR on bronchoalveolar lavage fluid (BAL) and three on blood specimens. The eight SRs included 167 overlapping reports (59 evaluating PCR in blood specimens, and 108 in BAL), based on 107 individual primary studies (98 trials with a cohort design, and 19 with a case-control design). In BAL specimens, the mean sensitivity and specificity ranged from 0.57 to 0.91, and from 0.92 to 0.97, respectively (QOE: very low to low). In blood specimens (whole blood or serum), the mean sensitivity ranged from 0.57 to 0.84, and the mean specificity from 0.58 to 0.95 (QOE: low to moderate). Across studies, only a low proportion of AMSTAR-2 critical domains were unmet (1.8%), demonstrating a high quality of methodological assessment. Conclusions. Based on the overall methodological assessment of the reviews included, on average we can have high confidence in the quality of results generated by the SRs.