Reliability of clinical research on invasive fungal infections: a systematic review of the literature

The aim of this study was to assess the comparability and reliability of cl inical research on invasive fungal infections (IFIs) which is accumulating in the medical literature. A Medline search strategy was developed covering the years 1985-1997, The 7086 articles identified this way were further li mited to 173 by reading the abstracts to studies involving immunocompromise d patients and deep tissue infections. Diagnostic criteria used for definit ions of IFIs were evaluated according to the level of confidence in diagnos is. For analysing the reliability, we used the sample of 397 patients from the European Organization for Research and Treatment of Cancer (EORTC) data base. Each patient in the database was evaluated according to the definitio ns employed in each article. The level of overall agreement among the artic les was very low (Kappa = 0.253). The results of this analysis show the dis crepancy in the medical literature in diagnosing IFIs and the necessity for the standardization of definitions.