PMID- 35198914
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20220502
IS  - 2589-5370 (Electronic)
IS  - 2589-5370 (Linking)
VI  - 44
DP  - 2022 Feb
TI  - Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of 
      central nervous system infections: A systematic review and diagnostic test 
      accuracy meta-analysis.
PG  - 101275
LID - 10.1016/j.eclinm.2022.101275 [doi]
LID - 101275
AB  - BACKGROUND: The FilmArray Meningitis/Encephalitis(FA/ME) panel brings benefits in 
      clinical practice, but its diagnostic test accuracy (DTA) remains unclear. We 
      aimed to determine the DTA of FA/ME for the aetiological diagnostic in patients 
      with suspected central nervous system(CNS) infection. METHODS: We performed a 
      systematic review with DTA meta-analysis (PROSPERO: CRD42020139285). We searched 
      Embase, Medline (Ovid), and Web of Science from inception until September 1st, 
      2021. We assessed the study-level risk of bias with the QUADAS-2 tool and applied 
      the GRADE approach to assess the certainty of the synthesised evidence. We 
      included studies that simultaneously measured the reference test (CSF/blood 
      culture for bacteria, and specific polymerase chain reaction for viruses) and the 
      FA/ME in patients with suspected CNS infection. We performed random-effects 
      bivariate meta-analysis models of combined sensitivity and specificity using 
      CSF/blood cultures(reference test 1) and a final diagnosis adjudication based on 
      clinical/laboratory criteria (reference test 2). FINDINGS: We included 19 studies 
      (11,351 participants). For all bacteria with reference test 1 (16 studies/6183 
      patients) sensitivity was estimated at 89.5% (95%CI 81.1-94.4), and specificity 
      at 97.4% (95%CI 94-98.9). With reference test 2 (15 studies/5,524 patients), 
      sensitivity was estimated at 92.1%(95%CI 86.8-95.3) and specificity at 99.2(95%CI 
      98.3-99.6) For herpes simplex virus-2(HSV-2), enteroviruses, and Varicella-Zoster 
      virus (VZV), we obtained sensitivities between 75.5 and 93.8%, and specificities 
      above 99% (reference test 1). Certainty of the evidence was low. INTERPRETATION: 
      FA/ME may have acceptable-to-high sensitivities and high specificities for 
      identifying bacteria, especially for S.pneumoniae, and viruses, especially for 
      HSV-2, and enteroviruses. Sensitivities for L.monocytogenes, H.influenzae, 
      E.coli, and HSV-1 were suboptimal. FUNDING: None.
CI  - (c) 2022 Published by Elsevier Ltd.
FAU - Trujillo-Gomez, Juliana
AU  - Trujillo-Gomez J
AD  - Department of Paediatrics, Universidad de Antioquia, Calle 67 No. 53-108, 
      Medellin, Antioquia 050001, Colombia.
AD  - Hospital San Vicente Fundacion, Calle 64 # 51D - 154, Medellin 050010, Colombia.
AD  - Hospital General de Medellin, Carrera 48 # 32-102, Medellin 0500515, Colombia.
FAU - Tsokani, Sofia
AU  - Tsokani S
AD  - Department of Primary Education, School of Education, University of Ioannina, PO 
      Box: 1186, Ioannina 45110, Greece.
FAU - Arango-Ferreira, Catalina
AU  - Arango-Ferreira C
AD  - Department of Paediatrics, Universidad de Antioquia, Calle 67 No. 53-108, 
      Medellin, Antioquia 050001, Colombia.
AD  - Hospital San Vicente Fundacion, Calle 64 # 51D - 154, Medellin 050010, Colombia.
FAU - Atehortua-Munoz, Santiago
AU  - Atehortua-Munoz S
AD  - Hospital Pablo Tobon Uribe, Cl. 78b #69-240, Medellin 11001, Colombia.
AD  - Hospital Pablo Tobon Uribe, Cl. 78b #69-240, Medellin 11001, Colombia.
FAU - Jimenez-Villegas, Maria Jose
AU  - Jimenez-Villegas MJ
AD  - Department of Paediatrics, Universidad de Antioquia, Calle 67 No. 53-108, 
      Medellin, Antioquia 050001, Colombia.
AD  - Hospital San Vicente Fundacion, Calle 64 # 51D - 154, Medellin 050010, Colombia.
FAU - Serrano-Tabares, Carolina
AU  - Serrano-Tabares C
AD  - Department of Paediatrics, Universidad de Antioquia, Calle 67 No. 53-108, 
      Medellin, Antioquia 050001, Colombia.
AD  - Clinica Universitaria Bolivariana, Carrera 72A # 78b -50, Medellin 050015, 
      Colombia.
FAU - Veroniki, Areti-Angeliki
AU  - Veroniki AA
AD  - St. Michael's Hospital, Li Ka Shing Knowledge Institute, 8 Shuter St, Toronto, ON 
      M5B 1A6, Canada.
FAU - Florez, Ivan D
AU  - Florez ID
AD  - Department of Paediatrics, Universidad de Antioquia, Calle 67 No. 53-108, 
      Medellin, Antioquia 050001, Colombia.
AD  - School of Rehabilitation Science, McMaster University, 1400 Main St. W. Hamilton, 
      Hamilton, ON L8S 1C7, Canada.
AD  - Paediatric Intensive Care Unit, Clinica Las Americas AUNA, Dg. 75B ##2A-80/140, 
      Medellin, Colombia.
LA  - eng
PT  - Journal Article
DEP - 20220214
PL  - England
TA  - EClinicalMedicine
JT  - EClinicalMedicine
JID - 101733727
PMC - PMC8851290
OTO - NOTNLM
OT  - CNS infection
OT  - Diagnostic accuracy
OT  - Encephalitis
OT  - Film array
OT  - Meningitis
OT  - Meta-analysis
OT  - Multiplex PCR
COIS- Authors declare no competing interests.
EDAT- 2022/02/25 06:00
MHDA- 2022/02/25 06:01
PMCR- 2022/02/14
CRDT- 2022/02/24 05:45
PHST- 2021/07/14 00:00 [received]
PHST- 2021/12/30 00:00 [revised]
PHST- 2022/01/07 00:00 [accepted]
PHST- 2022/02/24 05:45 [entrez]
PHST- 2022/02/25 06:00 [pubmed]
PHST- 2022/02/25 06:01 [medline]
PHST- 2022/02/14 00:00 [pmc-release]
AID - S2589-5370(22)00005-0 [pii]
AID - 101275 [pii]
AID - 10.1016/j.eclinm.2022.101275 [doi]
PST - epublish
SO  - EClinicalMedicine. 2022 Feb 14;44:101275. doi: 10.1016/j.eclinm.2022.101275. 
      eCollection 2022 Feb.