Diagnostic value of metagenomic next-generation sequencing (mNGS) for infection in hematology patients: a systematic review and meta-analysis

Abstract Objectives Infection is one of the leading causes of death in hematology patients. Metagenomic next-generation sequencing (mNGS) has been applied to diagnose infection. This meta-analysis will focus on systematically assessing the diagnostic value of mNGS for infection in hematology patients. Methods We searched for studies that assessed the efficacy of mNGS for the diagnosis of infection in hematology patients published in Embase, PubMed, Cochrane Library, Web of Science, and China National Knowledge Infrastructure from inception to December 31, 2022. The pooled sensitivity and specificity were estimate and subgroup analysis was performed. Results The pooled sensitivity and specificity were 89.6% (95%CI: 88–91%) and 56% (95%CI: 44–69%), respectively. The pooled positive likelihood ratio and negative likelihood ratio were 2.10 (95%CI: 1.48–3.30) and 0.22 (95%CI: 0.15–0.32), respectively. And diagnostic odds ratio was 10.29 (95%CI: 4.61–19.72). The SROC (summary receiver operating characteristic) curve revealed an AUC (area under curve) of 0.88 (95%CI: 0.85–0.90). The method of sample selection and the research type/gold standard may be sources of heterogeneity in sensitivity and specificity, respectively. Conclusion mNGS has shown good diagnostic efficacy for infection in hematology patients, but it’s important to choose suitable samples for mNGS according to infection types.