Table 5.

Diagnostic Test Evaluation of 96 FN Episodes With mNGS Results

Test systemInfection present/StatisticsInfection not present/ValueTotal/95% CI
mNGS positive26531
mNGS negative392665
BC positive12113
BC negative533083
mNGS
Sensitivity40.0%28.0% to 52.9%
Specificity83.9%66.3% to 94.6%
Positive Likelihood Ratio2.51.1 to 5.8
Negative Likelihood Ratio0.70.6 to 0.9
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value83.9%68.8% to 92.5%
Negative Predictive Value40.0%34.1% to 46.2%
Accuracy54.2%43.7% to 64.4%
Blood culture
Sensitivity18.5%9.9% to 30.0%
Specificity96.8%83.3% to 99.9%
Positive Likelihood Ratio5.70.8 to 42.1
Negative Likelihood Ratio0.80.7 to 0.1
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value92.3%62.0% to 98.9%
Negative Predictive Value36.1%33.2% to 39.3%
Accuracy43.8%33.6% to 54.3%
Test systemInfection present/StatisticsInfection not present/ValueTotal/95% CI
mNGS positive26531
mNGS negative392665
BC positive12113
BC negative533083
mNGS
Sensitivity40.0%28.0% to 52.9%
Specificity83.9%66.3% to 94.6%
Positive Likelihood Ratio2.51.1 to 5.8
Negative Likelihood Ratio0.70.6 to 0.9
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value83.9%68.8% to 92.5%
Negative Predictive Value40.0%34.1% to 46.2%
Accuracy54.2%43.7% to 64.4%
Blood culture
Sensitivity18.5%9.9% to 30.0%
Specificity96.8%83.3% to 99.9%
Positive Likelihood Ratio5.70.8 to 42.1
Negative Likelihood Ratio0.80.7 to 0.1
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value92.3%62.0% to 98.9%
Negative Predictive Value36.1%33.2% to 39.3%
Accuracy43.8%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.

Table 5.

Diagnostic Test Evaluation of 96 FN Episodes With mNGS Results

Test systemInfection present/StatisticsInfection not present/ValueTotal/95% CI
mNGS positive26531
mNGS negative392665
BC positive12113
BC negative533083
mNGS
Sensitivity40.0%28.0% to 52.9%
Specificity83.9%66.3% to 94.6%
Positive Likelihood Ratio2.51.1 to 5.8
Negative Likelihood Ratio0.70.6 to 0.9
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value83.9%68.8% to 92.5%
Negative Predictive Value40.0%34.1% to 46.2%
Accuracy54.2%43.7% to 64.4%
Blood culture
Sensitivity18.5%9.9% to 30.0%
Specificity96.8%83.3% to 99.9%
Positive Likelihood Ratio5.70.8 to 42.1
Negative Likelihood Ratio0.80.7 to 0.1
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value92.3%62.0% to 98.9%
Negative Predictive Value36.1%33.2% to 39.3%
Accuracy43.8%33.6% to 54.3%
Test systemInfection present/StatisticsInfection not present/ValueTotal/95% CI
mNGS positive26531
mNGS negative392665
BC positive12113
BC negative533083
mNGS
Sensitivity40.0%28.0% to 52.9%
Specificity83.9%66.3% to 94.6%
Positive Likelihood Ratio2.51.1 to 5.8
Negative Likelihood Ratio0.70.6 to 0.9
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value83.9%68.8% to 92.5%
Negative Predictive Value40.0%34.1% to 46.2%
Accuracy54.2%43.7% to 64.4%
Blood culture
Sensitivity18.5%9.9% to 30.0%
Specificity96.8%83.3% to 99.9%
Positive Likelihood Ratio5.70.8 to 42.1
Negative Likelihood Ratio0.80.7 to 0.1
Disease prevalence67.7%57.4% to 76.9%
Positive Predictive Value92.3%62.0% to 98.9%
Negative Predictive Value36.1%33.2% to 39.3%
Accuracy43.8%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.

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