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Figure 1.

Flow diagram of the process of selecting included studies.

This flow-diagram shows 398 references identified, after screening all of the titles and abstracts, 71 articles were selected for full-text review. Ultimately, 16 studies that were included in the meta-analysis, 55 studies were excluded for various reasons.

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Table 1.

Characteristics of the included studies.

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Table 2.

Technical details methods of the PCR in the included studies.

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Figure 2.

Summary of the methodological quality assessment of the included studies according to QUADAS-2 criteria.

Data was carried out using a bar graph showing the percentages of the 16 studies that met the criteria (Yes), did not meet the criteria (No), and did not provide adequate relevant data (Unclear).

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Figure 3.

Forest plots of the sensitivity and specificity of BALF-PCR for the diagnosis of PJP.

The circles in squares and the horizontal lines represent the point estimate and 95% confidence interval for each included study and the diamond represents the pooled estimate.

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Figure 4.

SROC curve shows summary operating sensitivity and specificity with confidence and prediction contours.

SROC curve with confidence and prediction regions around mean operating sensitivity and specificity point analyses of PCR assays in BALF for the diagnosis of PJP. Abbreviations: AUC, area under curve; SENS, sensitivity; SPEC, specificity; SROC curve, summary receiver operating (SROC) curve.

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Table 3.

Subgroup analyses of PCR in BAL fluid for the diagnosis of PJP.

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Figure 5.

Fagan’s nomogram for calculating post-test probabilities (PTPs).

Lines were drawn from the prior probability on the left through the likelihood ratios in the center and extended to the posterior probabilities on the right, which demonstrates that BALF-PCR is very informative raising probability of PJP to over 3-fold when positive from 20% and lowering the probability of disease to as low as 0.5% when negative.

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