Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis
Objectives The primary aim is to provide a summary of evidence for the diagnostic accuracies of multiplex PCR gastrointestinal (GI) panels—BioFire FilmArray and Luminex xTAG on the detection of gastroenteritis pathogens. The secondary aim is to compare the performance of these GI panels head to head...
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BMJ Publishing Group
2021-10-01
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| Series: | BMJ Open Gastroenterology |
| Online Access: | https://bmjopengastro.bmj.com/content/8/1/e000553.full |
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| author | Chien-Chang Lee Bing Chen Li-Jun Chang Chun-Jen Hsiao Tzu-Yu Liu Julia Ding Wan-Ting Hsu Victor Su-Ortiz Szu-Ta Chen Ke-Ying Su Han-Ping Wu |
| author_facet | Chien-Chang Lee Bing Chen Li-Jun Chang Chun-Jen Hsiao Tzu-Yu Liu Julia Ding Wan-Ting Hsu Victor Su-Ortiz Szu-Ta Chen Ke-Ying Su Han-Ping Wu |
| author_sort | Chien-Chang Lee |
| collection | DOAJ |
| description | Objectives The primary aim is to provide a summary of evidence for the diagnostic accuracies of multiplex PCR gastrointestinal (GI) panels—BioFire FilmArray and Luminex xTAG on the detection of gastroenteritis pathogens. The secondary aim is to compare the performance of these GI panels head to head.Methods A comprehensive search up to 1 December 2019 was conducted on PubMed, Embase, Ovid Medline and Web of Science for studies that used FilmArray or Luminex xTAG Gastrointestinal Pathogen Panel (GPP) for diagnosis of acute gastroenteritis. A summary of diagnostic accuracies for the 16 pathogens were calculated by comparing the GI panels to the current gold standards (conventional standard microbiology techniques such as culture or PCR for bacteria, PCR or enzyme immunoassay (EIA) for viruses, microscopy or EIA for parasite). Hierarchical summary receiver operating characteristic (HSROC) curve analysis, pretest and post-test probabilities were used for estimating the pathogen detection performance.Results A total of 11 studies with 7085 stool samples were eligible for analysis. Multiplex PCRs demonstrated high diagnostic accuracy, with specificity ≧0.98 and area under the ROC curve (AUROC) ≧0.97 for all the pathogens except for Yersinia enterocolitica (AUROC 0.91). The FilmArray panel demonstrated a higher sensitivity than xTAG GPP for most of the pathogens with the exception of Rotavirus A (xTAG GPP and FilmArray were both 0.93).Conclusions This is the first meta-analysis that is a head-to-head comparison examining the performance of the novel multiplex PCR-based tests Luminex xTAG GPP and FilmArray GI panel in detecting each pathogen. Point estimates calculated from eligible studies showed that both GI panels are highly accurate and may provide important diagnostic information for early identification of gastroenteritis. In addition, although FilmArray has higher sensitivity and post-test probability than xTAG GPP for most of the pathogens, how this will translate to a clinical setting remains unclear. |
| format | Article |
| id | doaj-art-0fbb9a08afdf4cf79c58cfeb7cae8dfc |
| institution | Kabale University |
| issn | 2054-4774 |
| language | English |
| publishDate | 2021-10-01 |
| publisher | BMJ Publishing Group |
| record_format | Article |
| series | BMJ Open Gastroenterology |
| spelling | doaj-art-0fbb9a08afdf4cf79c58cfeb7cae8dfc2024-12-07T11:00:09ZengBMJ Publishing GroupBMJ Open Gastroenterology2054-47742021-10-018110.1136/bmjgast-2020-000553Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysisChien-Chang Lee0Bing Chen1Li-Jun Chang2Chun-Jen Hsiao3Tzu-Yu Liu4Julia Ding5Wan-Ting Hsu6Victor Su-Ortiz7Szu-Ta Chen8Ke-Ying Su9Han-Ping Wu10The Centre for Intelligent Healthcare, National Taiwan University Hospital, Taipei, TaiwanDepartment of Medicine, Mount Sinai Morningside Hospital, New York, New York, USADepartment of Medical Education, National Taiwan University Hospital, Taipei, TaiwanDepartment of Medical Education, National Taiwan University Hospital, Taipei, TaiwanDepartment of Medicine, Brown University Warren Alpert Medical School, Providence, Rhode Island, USAInternal Medicine, Brown University Division of Biology and Medicine, Providence, Rhode Island, USADepartment of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USADepartment of Medical Engineering, College of Engineering, Cornell University, Ithaca, New York, USADepartment of Epidemiology, Harvard University T H Chan School of Public Health, Boston, Massachusetts, USADepartment of Emergency Medicine, National Taiwan University Hospital, Taipei, TaiwanDepartment of Pediatric Emergency Medicine and Medical Research, China Medical University Children`s Hospital, Taichung, TaiwanObjectives The primary aim is to provide a summary of evidence for the diagnostic accuracies of multiplex PCR gastrointestinal (GI) panels—BioFire FilmArray and Luminex xTAG on the detection of gastroenteritis pathogens. The secondary aim is to compare the performance of these GI panels head to head.Methods A comprehensive search up to 1 December 2019 was conducted on PubMed, Embase, Ovid Medline and Web of Science for studies that used FilmArray or Luminex xTAG Gastrointestinal Pathogen Panel (GPP) for diagnosis of acute gastroenteritis. A summary of diagnostic accuracies for the 16 pathogens were calculated by comparing the GI panels to the current gold standards (conventional standard microbiology techniques such as culture or PCR for bacteria, PCR or enzyme immunoassay (EIA) for viruses, microscopy or EIA for parasite). Hierarchical summary receiver operating characteristic (HSROC) curve analysis, pretest and post-test probabilities were used for estimating the pathogen detection performance.Results A total of 11 studies with 7085 stool samples were eligible for analysis. Multiplex PCRs demonstrated high diagnostic accuracy, with specificity ≧0.98 and area under the ROC curve (AUROC) ≧0.97 for all the pathogens except for Yersinia enterocolitica (AUROC 0.91). The FilmArray panel demonstrated a higher sensitivity than xTAG GPP for most of the pathogens with the exception of Rotavirus A (xTAG GPP and FilmArray were both 0.93).Conclusions This is the first meta-analysis that is a head-to-head comparison examining the performance of the novel multiplex PCR-based tests Luminex xTAG GPP and FilmArray GI panel in detecting each pathogen. Point estimates calculated from eligible studies showed that both GI panels are highly accurate and may provide important diagnostic information for early identification of gastroenteritis. In addition, although FilmArray has higher sensitivity and post-test probability than xTAG GPP for most of the pathogens, how this will translate to a clinical setting remains unclear.https://bmjopengastro.bmj.com/content/8/1/e000553.full |
| spellingShingle | Chien-Chang Lee Bing Chen Li-Jun Chang Chun-Jen Hsiao Tzu-Yu Liu Julia Ding Wan-Ting Hsu Victor Su-Ortiz Szu-Ta Chen Ke-Ying Su Han-Ping Wu Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis BMJ Open Gastroenterology |
| title | Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis |
| title_full | Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis |
| title_fullStr | Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis |
| title_full_unstemmed | Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis |
| title_short | Accuracy and comparison of two rapid multiplex PCR tests for gastroenteritis pathogens: a systematic review and meta-analysis |
| title_sort | accuracy and comparison of two rapid multiplex pcr tests for gastroenteritis pathogens a systematic review and meta analysis |
| url | https://bmjopengastro.bmj.com/content/8/1/e000553.full |
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