Abstract：
Systematic evaluation of the diagnostic value of next generation sequencing (NGS) in sepsis etiology.
We conducted a systematic search on four databases (Web of Science, Cochrane, PubMed, and Embase) and compiled diagnostic experiments using NGS to evaluate sepsis etiology. Two researchers conducted research and obtained data independently.
Nine documents were included comprising 747 patients, 988 blood samples, 175 bronchoalveolar lavage fluid (BALF) samples, 16 cerebrospinal fluid samples, and one urine sample. The combined sensitivity of each study was 0.89 (95% CI: 0.82-0.95). The combined specificity was 0.40 (95% CI: 0.25-0.55). The combined positive likelihood ratio was 1.51 (95% CI: 1.18-1.98). The combined negative likelihood ratio was 0.28 (95% CI: 0.11-0.48). The diagnostic odds ratio (DOR) was 6.38 (95% CI: 2.53-15.32) and the area under the curve (AUC) was 0.84, (95% CI: 0.62-0.94).
Based on the data we collected, we found that compared with the blood culture technology, NGS has the advantages of high sensitivity and wide detection range, but its specificity was low. Further study is needed to confirm the value of NGS in the etiological diagnosis of patients with sepsis.
We conducted a systematic search on four databases (Web of Science, Cochrane, PubMed, and Embase) and compiled diagnostic experiments using NGS to evaluate sepsis etiology. Two researchers conducted research and obtained data independently.
Nine documents were included comprising 747 patients, 988 blood samples, 175 bronchoalveolar lavage fluid (BALF) samples, 16 cerebrospinal fluid samples, and one urine sample. The combined sensitivity of each study was 0.89 (95% CI: 0.82-0.95). The combined specificity was 0.40 (95% CI: 0.25-0.55). The combined positive likelihood ratio was 1.51 (95% CI: 1.18-1.98). The combined negative likelihood ratio was 0.28 (95% CI: 0.11-0.48). The diagnostic odds ratio (DOR) was 6.38 (95% CI: 2.53-15.32) and the area under the curve (AUC) was 0.84, (95% CI: 0.62-0.94).
Based on the data we collected, we found that compared with the blood culture technology, NGS has the advantages of high sensitivity and wide detection range, but its specificity was low. Further study is needed to confirm the value of NGS in the etiological diagnosis of patients with sepsis.
摘要：
背景：对下一代测序（NGS）在脓毒症病因中的诊断价值进行系统评估。
方法：我们对四个数据库进行了系统搜索(WebofScience，科克伦,PubMed,和Embase），并使用NGS编制诊断实验来评估脓毒症病因。两名研究人员独立进行了研究并获得了数据。
结果：纳入9份文件，包括747名患者，988份血液样本,175个支气管肺泡灌洗液（BALF）样本，16个脑脊液样本,还有一份尿液样本.每个研究的联合敏感性为0.89（95％CI：0.82-0.95）。联合特异性为0.40(95%CI:0.25-0.55)。合并阳性似然比为1.51（95％CI：1.18-1.98）。合并阴性似然比为0.28（95％CI：0.11-0.48）。诊断比值比（DOR）为6.38（95％CI：2.53-15.32），曲线下面积（AUC）为0.84（95％CI：0.62-0.94）。
结论：根据我们收集的数据，我们发现与血液培养技术相比，NGS具有灵敏度高、检测范围广等优点,但其特异性较低。需要进一步的研究来证实NGS在脓毒症患者病因诊断中的价值。
方法：我们对四个数据库进行了系统搜索(WebofScience，科克伦,PubMed,和Embase），并使用NGS编制诊断实验来评估脓毒症病因。两名研究人员独立进行了研究并获得了数据。
结果：纳入9份文件，包括747名患者，988份血液样本,175个支气管肺泡灌洗液（BALF）样本，16个脑脊液样本,还有一份尿液样本.每个研究的联合敏感性为0.89（95％CI：0.82-0.95）。联合特异性为0.40(95%CI:0.25-0.55)。合并阳性似然比为1.51（95％CI：1.18-1.98）。合并阴性似然比为0.28（95％CI：0.11-0.48）。诊断比值比（DOR）为6.38（95％CI：2.53-15.32），曲线下面积（AUC）为0.84（95％CI：0.62-0.94）。
结论：根据我们收集的数据，我们发现与血液培养技术相比，NGS具有灵敏度高、检测范围广等优点,但其特异性较低。需要进一步的研究来证实NGS在脓毒症患者病因诊断中的价值。
