Table 5.
Diagnostic Test Evaluation of 96 FN Episodes With mNGS Results
| Test system | Infection present/Statistics | Infection not present/Value | Total/95% CI |
|---|---|---|---|
| mNGS positive | 26 | 5 | 31 |
| mNGS negative | 39 | 26 | 65 |
| BC positive | 12 | 1 | 13 |
| BC negative | 53 | 30 | 83 |
| mNGS | |||
| Sensitivity | 40.0% | 28.0% to 52.9% | |
| Specificity | 83.9% | 66.3% to 94.6% | |
| Positive Likelihood Ratio | 2.5 | 1.1 to 5.8 | |
| Negative Likelihood Ratio | 0.7 | 0.6 to 0.9 | |
| Disease prevalence | 67.7% | 57.4% to 76.9% | |
| Positive Predictive Value | 83.9% | 68.8% to 92.5% | |
| Negative Predictive Value | 40.0% | 34.1% to 46.2% | |
| Accuracy | 54.2% | 43.7% to 64.4% | |
| Blood culture | |||
| Sensitivity | 18.5% | 9.9% to 30.0% | |
| Specificity | 96.8% | 83.3% to 99.9% | |
| Positive Likelihood Ratio | 5.7 | 0.8 to 42.1 | |
| Negative Likelihood Ratio | 0.8 | 0.7 to 0.1 | |
| Disease prevalence | 67.7% | 57.4% to 76.9% | |
| Positive Predictive Value | 92.3% | 62.0% to 98.9% | |
| Negative Predictive Value | 36.1% | 33.2% to 39.3% | |
| Accuracy | 43.8% | 33.6% to 54.3% |
Abbreviations: BC, blood culture; CI, confidence interval; FN, febrile neutropenia; mNGS, metagenomic next-generation sequencing.
NOTE: Viruses were excluded in the assessment of mNGS. One FN episode with negative mNGS and BC could not be adjudicated by the Infectious Diseases review panel, and 1 FN episode with a polymicrobial BC finding could not be successfully analyzed by mNGS.