EFEMP1 and Pleural effusion: Initial studies reported high diagnostic accuracy, with an area under the receiver operating characteristic curve (AUCROC) of 0.93 and optimal sensitivity and specificity thresholds between 346 ng/mL and 378 ng/mL.15 However, subsequent investigations have yielded conflicting results, with some reporting comparable fibulin-3 levels in pleural effusions from MPM and other pleural diseases.16 A meta-analysis by Schillebeeckx et al. estimated an overall AUCROC of 0.68 (95% CI: 0.50–0.87).17