PubMed Health⌕ Search

Biomedical subjects

Jianwei Chen

Publications and source records attributed to Jianwei Chen.

3 recordsLinked to original sources
PubMed2026

Metagenomic next-generation sequencing for tuberculosis diagnosis: enhanced performance and cost-effectiveness.

UNLABELLED: Metagenomic next-generation sequencing (mNGS) is a promising tool for diagnosing challenging infections like tuberculosis (TB). However, previous studies largely focused on case-specific application of mNGS in TB diagnosis. Thus, we conducted a retrospective observational study to first systematically evaluate the diagnostic performance and cost-effectiveness of mNGS for TB diagnosis. We retrieved a total of 16,776 results of the seven TB diagnostic assays, including mNGS, tuberculosis IgG antibody, TB interferon-γ release assay (TB-IGRA), TB-DNA, Xpert MTB/RIF (Xpert), culture, and acid-fast bacilli staining (AFS) from 3,757 participants with suspected TB infection at Sichuan Provincial People's Hospital from September 2021 to July 2024. Diagnostic metrics were compared against a composite reference standard. Microbial composition and a cost-utility analysis were performed. Among seven TB assays studied, the World Health Organization (WHO)-recommended assays AFS, culture, and Xpert, as well as TB-IGRA, were requested most frequently for TB diagnosis, whereas mNGS ranked last. mNGS demonstrated the highest specificity (100%), accuracy (72.3%), and area under the curve (AUC) (0.795). Its sensitivity in bronchoalveolar lavage fluid and tissue was 71.0% and 72.7%, respectively. Sequential use of mNGS after initial WHO-recommended tests (Xpert/Culture/AFS) significantly improved diagnostic performance (sensitivity, 70.4%; AUC, 0.823). Microbial analysis associated Candida albicans with TB. Cost-utility analysis showed sequential mNGS became cost-effective at higher willingness-to-pay thresholds (>200,000 RMB per correct diagnosis). mNGS offers superior specificity for TB diagnosis. A sequential strategy applying mNGS to conventional-test-negative cases provides enhanced diagnostic performance and is cost-effective at higher healthcare investment values, supporting its utility for diagnostically challenging TB. IMPORTANCE: This study systematically assesses the diagnostic performance and cost utility of metagenomic next-generation sequencing (mNGS) for tuberculosis (TB) in a large real-world cohort of 3,757 suspected patients, comparing it against six conventional assays (tuberculosis IgG antibody, TB interferon-γ release assay, TB-DNA, Xpert, culture, and acid-fast bacilli staining). mNGS demonstrated the highest specificity (100%), accuracy (72.3%), and area under the curve (AUC) (0.795), with sensitivities of 71.0% in bronchoalveolar lavage fluid and 72.7% in tissue. Notably, sequential use of mNGS after the World Health Organization-recommended tests significantly improved sensitivity to 70.4% and AUC to 0.823. Candida albicans showed significant differences among the three groups. The sequential mNGS strategy was cost-effective compared with no mNGS, and its cost-effectiveness increased with a rising willingness-to-pay threshold. Overall, these results highlight mNGS as a valuable supplementary tool for challenging TB cases, especially when conventional tests are inconclusive, and provide strong evidence for integrating it into diagnostic algorithms to optimize clinical decision-making and resource allocation.

Adult↗
PubMed2005

[Control effects of rice-duck farming and other weed management strategies on weed communities in paddy fields].

By the methods of community ecology, field studies were conducted to evaluate the control effects of three weed management strategies, i. e., rice-duck farming (RD), manual weeding (MW) and chemical weeding (CW), on the weed communities in paddy fields. The results showed that under rice-duck farming, the weed density in paddy fields decreased significantly, and the control effects on dominant weed species such as Monochoria vaginalis, Cyperus difformis, Sagittaria pygmaea were all above 95%, with an overall effect higher than CW and MW. Under RD, the species richness and Shannon-Wiener diversity indices decreased slightly, while Pielou community evenness indices increased markedly, indicating that the species composition of weed community was greatly improved, and the infestation of former dominant weed species was reduced. The structure of weed communities in paddy fields varied with different weed management strategies, e. g., under RD, Lindernia procumbens, Cyperus difformis and Fimbristylis miliacea constituted the major weed community, and the Whittaker index was significant higher than that of CW, MW and CK, which indicated that rice-duck farming had a greater effect on the structure of the weed communities. The same conclusion could be drawn from Sorensen's similarity indices and cluster analysis with Sorensen's index as the distance measurement.

Animals↗
PubMed2002

Random effects logistic regression analysis with auxiliary covariates.

We study a semiparametric estimation method for the random effects logistic regression when there is auxiliary covariate information about the main exposure variable. We extend the semiparametric estimator of Pepe and Fleming (1991, Journal of the American Statistical Association 86, 108-113) to the random effects model using the best linear unbiased prediction approach of Henderson (1975, Biometrics 31, 423-448). The method can be used to handle the missing covariate or mismeasured covariate data problems in a variety of real applications. Simulation study results show that the proposed method outperforms the existing methods. We analyzed a data set from the Collaborative Perinatal Project using the proposed method and found that the use of DDT increases the risk of preterm births among U.S. children.

Biometry↗