Table 2.

Meta-analyses of biomarker performance to detect sepsis^a

Setting and study design (reference)	Biomarker	Specificity (%)	Sensitivity (%)	Cutoff	AUC	Clinical relevance	Verification of infection (diagnostic reference standard)
MA of 12 studies of hospitalized patients (46 neonates, 638 children, and 702 adults) on the accuracy of PCT and CRP to diagnose bacterial infection (255)	PCT	83	85	0.5–6.1 ng/ml	Graph provided	Diagnostic accuracy of PCT markers was higher than that of CRP markers	Microbiologically proven infection
	CRP	60	78	6–100 mg/liter
MA of 17 studies with 2,008 patients in the emergency department on the accuracy of PCT to diagnose bacteremia (124)	PCT	70	76	0.4–0.5 ng/ml	0.84	Diagnostic performance of the PCT test for identifying bacteremia in emergency department patients is judged as moderate	Positive blood culture
MA of 33 studies with 3,943 critically ill adults or patients after trauma or surgery on the accuracy of PCT alone or compared with that with CRP to diagnose sepsis, severe sepsis, or septic shock (280)	PCT	48–100	42–100	0.6–5 ng/ml	Graph provided	Procalcitonin represents a good biological diagnostic marker and is superior to C-reactive protein	Clinical and/or microbiological criteria defined by those authors
	CRP	18–85	35–100	39–180 mg/liter
MA of 18 studies with 2,097 critically ill patients from ICU, emergency department, and hospital wards on the accuracy of PCT to diagnose sepsis (267)	PCT	Mean joint values of both sensitivity and specificity of 71 (95% CI, 67–76)		0.2–20 ng/ml	0.78	Diagnostic performance of PCT was upwardly biased in smaller studies but moving toward a null effect in larger studies	Microbiologically proven infection
MA of 24 studies on the value of PCT as a marker of development of severe acute pancreatitis and infected pancreatic necrosis (183)	PCT	0.86 (severe acute pancreatitis), 0.91 (infected pancreatic necrosis)	0.72 (severe acute pancreatitis), 0.80 (infected pancreatic necrosis)	No significant heterogeneity in studies using a cutoff of >0.5 ng/ml	0.87 (severe acute pancreatitis), 0.91 (infected pancreatic necrosis)	PCT may be valuable in predicting the severity of acute pancreatitis and the risk of developing infected pancreatic necrosis	Confirmed diagnosis of acute pancreatitis
MA of 13 studies with 980 patients on the accuracy of the sTREM-1 as a diagnostic test for bacterial infection (122)	sTREM-1	0.86	0.82	5–374 pg/ml	0.91	sTREM-1 represents a reliable biological marker of bacterial infection	Bacterial infection
MA of 16 studies with 1,959 neonates on the accuracy of PCT to diagnose sepsis in comparison with other conditions (292)	PCT	79	81		0.87	PCT has very good diagnostic accuracy for the diagnosis of neonatal sepsis	Culture-proven or clinically diagnosed sepsis

^aMA, meta-analysis; CI, confidence interval.