Diagnostic Accuracy of β-d-Glucan (Fungitell) Testing among Patients with Hematologic Malignancies or Solid Organ Tumors

Abstract

Objectives: To determine the accuracy of Fungitell, a β-dglucan (BDG) test, for the diagnosis of invasive fungal infection (IFI) among cancer patients. Methods: For this meta-analysis, MEDLINE and EMBASE were searched for references related to BDG testing. Study quality was evaluated using QUADAS-2. Statistical analysis was performed using Stata 14. Results: We screened 12,426 references and identifed 189 studies for full-text review. Nineteen studies were included in the fnal meta-analysis. There was moderate heterogeneity between studies. Nine studies had a high risk of bias, which signifcantly elevated the overall specifcity estimate. Restricting to only low-bias studies, the sensitivity and specifcity were 80% and 63%, respectively. Conclusions: The overall sensitivity and specifcity of Fungitell as a diagnostic test for IFI is moderate, and there is substantial heterogeneity between studies. Limiting studies to only low-bias risk reduced heterogeneity but also lowered the overall specifcity estimate.