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An umbrella review of the diagnostic value of next-generation sequencing in infectious diseases

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Abstract

Background

An increasing number of systematic reviews (SRs) have evaluated the diagnostic values of next-generation sequencing (NGS) in infectious diseases (IDs).

Aim

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.

Method

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.

Results

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.

Conclusion

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.

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Acknowledgements

We thank Juniie Lan, Jiaxue Wang, Shuimei Sun, Songsong Tan, and Jinyong Cao at Guizhou Provincia People's Hospital for helping with English language and manuscript editing.

Funding

This research received support from the National Natural Science Foundation of China (No. 72064004), the Hospital Pharmaceutical Research Project funded by the China Pharmaceutical Association (CPA-Z05-ZC-2023-002), and the Health Commission Foundation of Guizhou Province (gzwkj2022-224).

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Author notes

  1. Hong Cao and Yan Chen have contributed equally to this work.

Authors and Affiliations

  1. School of Pharmaceutical Sciences, Guizhou University, 2708 South of Huaxi Avenue Road, Guiyang, Guizhou Province, China

    Hong Cao & Yan Chen

  2. Department of Pharmacy, Guizhou Provincial People’s Hospital, No.83 Zhongshandong Road, Guiyang, Guizhou Province, China

    Hong Cao, Yan Chen, Rui Zhang, Huaye Zhao, Linfang Hu & Jiaxing Zhang

  3. Evidence-Based Social Science Research Center, School of Public Health, Lanzhou University, Lanzhou, China

    Long Ge & Honghao Lai

  4. Key Laboratory of Evidence Based Medicine and Knowledge Translation of Gansu Province, No. 199, Donggang West Road, Chengguan District, Lanzhou City, Gansu Province, China

    Long Ge & Honghao Lai

  5. Global Health Nursing, Graduate School of Nursing Science, St. Luke’s International University, 10-1 Akashi-Cho, Chuo-Ku, Tokyo, 104-0044, Japan

    Joey Sum-wing Kwong

  6. Department of Laboratory, Guizhou Provincial People’s Hospital, No.83 Zhongshandong Road, Guiyang, 550002, Guizhou Province, China

    Fangfang Hu

  7. Experimental Cancer Medicine, Department of Laboratory Medicine, Karolinska Institute, Room 601, Novum PI 6, Hälsovägen 7, Huddinge, 14157, Stockholm, Sweden

    Rui He & Wenyi Zheng

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  1. Hong Cao
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Cao, H., Chen, Y., Ge, L. et al. An umbrella review of the diagnostic value of next-generation sequencing in infectious diseases. Int J Clin Pharm (2024). https://doi.org/10.1007/s11096-024-01704-2

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