| Study characteristics |
| Patient sampling |
A prospective cohort study was performed at the Asan Medical Center, a 2700‐bed tertiary hospital in Seoul, South Korea, between May 2008 and January 2009. They included all adult patients (16 years of age) who underwent bronchoscopy with BAL to evaluate new pulmonary infiltrates and for whom GM assays from BAL were submitted were included. Informed consent was obtained from each patient. The study protocol was approved by the Institutional Review Board of the hospital. |
| Patient characteristics and setting |
Unclear; patients requiring BAL or undergoing BAL may be less severely ill than patients who can undergo serum GM |
| Index tests |
Transplant recipients and neutropenic cancer patients were measured weekly by ELISA (Platelia Aspergillus, Bio‐Rad, Hercules, CA). Serum GM was not regularly measured in other patients, although the assay was performed whenever IPA was suspected. An optical density (OD) cut‐off value of 0.5 or greater was considered positive for GM in serum or BAL samples, as previously recommended |
| Target condition and reference standard(s) |
Patients were categorised with proven, probable or possible IPA according to revised consensus definitions of the EORTC/MSG (De Pauw 2008); Platelia was part of that |
| Flow and timing |
Time between index test and diagnosis not reported; all patients were classified by the same reference standard; they provide a clear flow chart of patient flow |
| Comparative |
|
| No patients per category |
1 proven, 17 probable, 4 possible, 337 no IA |
| Notes |
No financial disclosure reported |
| Methodological quality |
| Item |
Authors' judgement |
Risk of bias |
Applicability concerns |
| DOMAIN 1: Patient Selection |
| Was a consecutive or random sample of patients enrolled? |
Yes |
|
|
| Was a case‐control design avoided? |
Yes |
|
|
| Did the study avoid inappropriate exclusions? |
Yes |
|
|
| |
|
Low |
Unclear |
| DOMAIN 2: Index Test All tests |
| Were the index test results interpreted without knowledge of the results of the reference standard? |
Unclear |
|
|
| If a threshold was used, was it pre‐specified? |
Yes |
|
|
| |
|
Low |
Low |
| DOMAIN 3: Reference Standard |
| Is the reference standards likely to correctly classify the target condition? |
Yes |
|
|
| Were the reference standard results interpreted without knowledge of the results of the index tests? |
No |
|
|
| |
|
High |
Low |
| DOMAIN 4: Flow and Timing |
| Was there an appropriate interval between index test and reference standard? |
Unclear |
|
|
| Did all patients receive the same reference standard? |
Yes |
|
|
| Were all patients included in the analysis? |
Yes |
|
|
| |
|
Low |
|
