Evaluation of FilmArray ME panel for the rapid diagnosis of meningitis–encephalitis in emergency departments

Biofire FilmArray Meningitis/Encephalitis panel for the aetiological diagnosis of central nervous system infections: A systematic review and diagnostic test accuracy meta-analysis

“…In the meta-analysis of “all bacteria” with reference test 1 (16 studies/6183 patients), 10 , 17 , 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 we obtained combined sensitivity and specificity of 89·5% (95%CI 81·1–94·4), and 97·4% (95%CI 94–98·9), respectively. With reference test 2 (15 studies/5524 patients), 10 , 17 , 29 , 30 , 31 , 32 , 33 , 18 , 19 , 20 , 21 , 22 , 24 , 26 , 27 we obtained combined sensitivity and specificity of 92.1% (95%CI 86.8–95.3), and 99.2(95%CI 98.3–99.6), respectively. Table 3 and Figure 2 , Figure 3 , Figure 4 , Figure 5 present all the combined DTA measures and the forest plots and SROC, respectively, for both reference tests.…”

“…In the meta-analysis of "all bacteria" with reference test 1 (16 studies/6183 patients), 10,17−22,24−27,29−33 we obtained combined sensitivity and specificity of 89¢5% (95%CI 81¢1−94¢4), and 97¢4% (95%CI 94−98¢9), respectively. With reference test 2 (15 studies/5524 patients), 10,17,[29][30][31][32][33][18][19][20][21][22]24,26,27 z Reference standard item for reference test 1 for bacterial detection was considered as low risk only when it was clear that the cultures samples were taken before the antimicrobial treatment.…”

“…The 19 studies included 11,351 patients. 10 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 Four studies enrolled only children , 18 , 19 , 27 , 28 two included only adults, and the rest included both. Six studies 10 , 17 , 18 , 26 , 29 , 32 used a laboratory method to resolve the disagreements between FA/ME and reference test 1, and the rest used clinical information or CSF cytochemical parameters to resolve disagreements.…”

“…Patients (Ref. studies) Sensitivity (95%CI).X 2 ; p value ¥ Specificity (95%CI)X 2 ; p value ¥ LR+ (95%CI) LR- (95%CI) All bacteria 16/6183 10 , 17 , 22 , 24 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 89.5 (81.1–94.4) 6.00; 0.98 97.4 (94–98.9) 251.9; <0.0001 34 (2.68–137) 0.11 (0.07–3.64) 15/5545 (10,17,29–33,18–22,24,26,27) 93.5 (87.8–96.6) 2.17; 0.99 99.1 (97.8–99.6) 60.2; <0.0001 104 (7.60–3.98) 0.07 (0.07–3.58) S. pneumoniae 16/7090 10 , 17 , 18 , 19 , 20 , 21 , 22 , 24 , 25 , 26 , 30 34 87.5 (77–94) 3.71; 0.999 98.5 (97–99.3) 144.7; <0.0001 58 (4.63–238) 0.13 (0.07–3.60) 10/5287 (10,17,30,32,33,34, 18,21,22,24) 93 (83.3–97.2) 2.64; 0.91 99.4 (98.2–99.8) 51.2; <0.0001 155 (11–600) 0.07 (0.07–3.58) H. influenzae 10/4959 10 , 17 , …”

“…x Chi2-test and corresponding p-value to assess presence of statistical heterogeneity. y Defined by the authors as >10 CSF cells in one study (21) and with no definition in the other study (24). z We defined it as studies with more than 70% of patients with previous antimicrobial therapy.…”