School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China.
Department of Pharmacy, Guizhou Provincial People's Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China.
Int J Clin Pharm. 2024 Aug;46(4):780-794. doi: 10.1007/s11096-024-01704-2. Epub 2024 Apr 3.
An increasing number of systematic reviews (SRs) have evaluated the diagnostic values of next-generation sequencing (NGS) in infectious diseases (IDs).
This umbrella analysis aimed to assess the potential risk of bias in existing SRs and to summarize the published diagnostic values of NGS in different IDs.
We searched PubMed, Embase, and the Cochrane Library until September 2023 for SRs assessing the diagnostic validity of NGS for IDs. Two investigators independently determined review eligibility, extracted data, and evaluated reporting quality, risk of bias, methodological quality, and evidence certainty in the included SRs.
Eleven SRs were analyzed. Most SRs exhibited a moderate level of reporting quality, while a serious risk of bias was observed in all SRs. The diagnostic performance of NGS in detecting pneumocystis pneumonia and periprosthetic/prosthetic joint infection was notably robust, showing excellent sensitivity (pneumocystis pneumonia: 0.96, 95% CI 0.90-0.99, very low certainty; periprosthetic/prosthetic joint infection: 0.93, 95% CI 0.83-0.97, very low certainty) and specificity (pneumocystis pneumonia: 0.96, 95% CI 0.92-0.98, very low certainty; periprosthetic/prosthetic joint infection: 0.95, 95% CI 0.92-0.97, very low certainty). NGS exhibited high specificity for central nervous system infection, bacterial meningoencephalitis, and tuberculous meningitis. The sensitivity to these infectious diseases was moderate. NGS demonstrated moderate sensitivity and specificity for multiple infections and pulmonary infections.
This umbrella analysis indicates that NGS is a promising technique for diagnosing pneumocystis pneumonia and periprosthetic/prosthetic joint infection with excellent sensitivity and specificity. More high-quality original research and SRs are needed to verify the current findings.
越来越多的系统评价（SR）评估了下一代测序（NGS）在传染病（IDs）中的诊断价值。
本伞式分析旨在评估现有 SR 中潜在的偏倚风险，并总结 NGS 在不同 IDs 中的已发表诊断价值。
我们检索了 PubMed、Embase 和 Cochrane 图书馆，以获取评估 NGS 对 IDs 诊断准确性的 SR，直到 2023 年 9 月。两名调查员独立确定了审查资格，提取数据，并评估了纳入的 SR 中的报告质量、偏倚风险、方法学质量和证据确定性。
分析了 11 项 SR。大多数 SR 的报告质量处于中等水平，而所有 SR 均存在严重的偏倚风险。NGS 在检测肺囊虫肺炎和假体周围/假体关节感染方面的诊断性能非常可靠，显示出极好的敏感性（肺囊虫肺炎：0.96，95%CI 0.90-0.99，极低确定性；假体周围/假体关节感染：0.93，95%CI 0.83-0.97，极低确定性）和特异性（肺囊虫肺炎：0.96，95%CI 0.92-0.98，极低确定性；假体周围/假体关节感染：0.95，95%CI 0.92-0.97，极低确定性）。NGS 对中枢神经系统感染、细菌性脑膜脑炎和结核性脑膜炎具有高特异性。对这些传染病的敏感性为中度。NGS 对多种感染和肺部感染具有中等敏感性和特异性。
本伞式分析表明，NGS 是诊断肺囊虫肺炎和假体周围/假体关节感染的有前途的技术，具有极好的敏感性和特异性。需要更多高质量的原始研究和 SR 来验证当前的发现。
