Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis

Detalhes bibliográficos
Autor(a) principal: Ferreira-Coimbra, João
Data de Publicação: 2019
Outros Autores: Ardanuy, Carmen, Diaz, Emili, Leone, Marc, De Pascale, Gennaro, Póvoa, Pedro, Prat-Aymerich, Cristina, Serrano-Garcia, Ricardo, Solé-Violan, Jordi, Zaragoza, Rafael, Rello, Jordi
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10400.16/2605
Resumo: The aim was to provide global experts ranking on priorities in diagnostic tools for VAP in clinical practice. A multiple criteria decision analysis (MCDA) was performed to identify diagnosis tools for VAP diagnosis. Priority factors were identified after literature review. An international, multidisciplinary expert panel reviewed variables and ranked diagnostic tools. Experts from ten European hospitals participated. Regarding bedside clinical practices, seven required chest X-ray use in all patients, whereas six reported the use of blood cultures and endotracheal aspirate in all patients. Invasive techniques were routinely performed in seven sites. CRP, PCT, and Gram stains were performed in all patients by 5, 2, and 8, respectively. Impact on patient outcomes, safety, and impact on the decision to start antibiotic therapy were ranked as the top three relevant concerns (7.7/10, 7/10, and 6.9/10, respectively). Chest X-ray was ranked as the most important imaging technique to diagnose VAP (score 251.7). Apart from blood cultures, endotracheal aspirate culture was identified as the main collection method for the microbiological testing (scores of 274.8 and 246.8, respectively). Mini-BAL was the preferred invasive technique with a score of 208. Top three biomarkers were CRP (score 184.3), PCT (181.3), and WBC (166.4). Gram stain (192.5) was prioritized among laboratory diagnostic techniques. Using MCDA, it is recommended to perform a combination of diagnostic techniques including images (chest X-ray), culture of clinical specimens (blood cultures and endotracheal aspirate), and biomarkers (CRP or PCT) for VAP diagnosis at the bedside. Gram stain was ranked as the preferred laboratory technique.
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spelling Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysisBiomarkersDiagnosisImagingMCDAMicrobiology diagnosisMulticriteria decision analysisVAPVentilator-associated pneumoniaThe aim was to provide global experts ranking on priorities in diagnostic tools for VAP in clinical practice. A multiple criteria decision analysis (MCDA) was performed to identify diagnosis tools for VAP diagnosis. Priority factors were identified after literature review. An international, multidisciplinary expert panel reviewed variables and ranked diagnostic tools. Experts from ten European hospitals participated. Regarding bedside clinical practices, seven required chest X-ray use in all patients, whereas six reported the use of blood cultures and endotracheal aspirate in all patients. Invasive techniques were routinely performed in seven sites. CRP, PCT, and Gram stains were performed in all patients by 5, 2, and 8, respectively. Impact on patient outcomes, safety, and impact on the decision to start antibiotic therapy were ranked as the top three relevant concerns (7.7/10, 7/10, and 6.9/10, respectively). Chest X-ray was ranked as the most important imaging technique to diagnose VAP (score 251.7). Apart from blood cultures, endotracheal aspirate culture was identified as the main collection method for the microbiological testing (scores of 274.8 and 246.8, respectively). Mini-BAL was the preferred invasive technique with a score of 208. Top three biomarkers were CRP (score 184.3), PCT (181.3), and WBC (166.4). Gram stain (192.5) was prioritized among laboratory diagnostic techniques. Using MCDA, it is recommended to perform a combination of diagnostic techniques including images (chest X-ray), culture of clinical specimens (blood cultures and endotracheal aspirate), and biomarkers (CRP or PCT) for VAP diagnosis at the bedside. Gram stain was ranked as the preferred laboratory technique.SpringerRepositório Científico do Centro Hospitalar Universitário de Santo AntónioFerreira-Coimbra, JoãoArdanuy, CarmenDiaz, EmiliLeone, MarcDe Pascale, GennaroPóvoa, PedroPrat-Aymerich, CristinaSerrano-Garcia, RicardoSolé-Violan, JordiZaragoza, RafaelRello, Jordi2021-11-23T10:02:09Z20192019-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10400.16/2605engFerreira-Coimbra J, Ardanuy C, Diaz E, et al. Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis. Eur J Clin Microbiol Infect Dis. 2020;39(2):281-286. doi:10.1007/s10096-019-03720-x0934-972310.1007/s10096-019-03720-xinfo:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2023-10-20T11:01:16Zoai:repositorio.chporto.pt:10400.16/2605Portal AgregadorONGhttps://www.rcaap.pt/oai/openaireopendoar:71602024-03-19T20:38:48.585632Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
title Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
spellingShingle Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
Ferreira-Coimbra, João
Biomarkers
Diagnosis
Imaging
MCDA
Microbiology diagnosis
Multicriteria decision analysis
VAP
Ventilator-associated pneumonia
title_short Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
title_full Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
title_fullStr Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
title_full_unstemmed Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
title_sort Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
author Ferreira-Coimbra, João
author_facet Ferreira-Coimbra, João
Ardanuy, Carmen
Diaz, Emili
Leone, Marc
De Pascale, Gennaro
Póvoa, Pedro
Prat-Aymerich, Cristina
Serrano-Garcia, Ricardo
Solé-Violan, Jordi
Zaragoza, Rafael
Rello, Jordi
author_role author
author2 Ardanuy, Carmen
Diaz, Emili
Leone, Marc
De Pascale, Gennaro
Póvoa, Pedro
Prat-Aymerich, Cristina
Serrano-Garcia, Ricardo
Solé-Violan, Jordi
Zaragoza, Rafael
Rello, Jordi
author2_role author
author
author
author
author
author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório Científico do Centro Hospitalar Universitário de Santo António
dc.contributor.author.fl_str_mv Ferreira-Coimbra, João
Ardanuy, Carmen
Diaz, Emili
Leone, Marc
De Pascale, Gennaro
Póvoa, Pedro
Prat-Aymerich, Cristina
Serrano-Garcia, Ricardo
Solé-Violan, Jordi
Zaragoza, Rafael
Rello, Jordi
dc.subject.por.fl_str_mv Biomarkers
Diagnosis
Imaging
MCDA
Microbiology diagnosis
Multicriteria decision analysis
VAP
Ventilator-associated pneumonia
topic Biomarkers
Diagnosis
Imaging
MCDA
Microbiology diagnosis
Multicriteria decision analysis
VAP
Ventilator-associated pneumonia
description The aim was to provide global experts ranking on priorities in diagnostic tools for VAP in clinical practice. A multiple criteria decision analysis (MCDA) was performed to identify diagnosis tools for VAP diagnosis. Priority factors were identified after literature review. An international, multidisciplinary expert panel reviewed variables and ranked diagnostic tools. Experts from ten European hospitals participated. Regarding bedside clinical practices, seven required chest X-ray use in all patients, whereas six reported the use of blood cultures and endotracheal aspirate in all patients. Invasive techniques were routinely performed in seven sites. CRP, PCT, and Gram stains were performed in all patients by 5, 2, and 8, respectively. Impact on patient outcomes, safety, and impact on the decision to start antibiotic therapy were ranked as the top three relevant concerns (7.7/10, 7/10, and 6.9/10, respectively). Chest X-ray was ranked as the most important imaging technique to diagnose VAP (score 251.7). Apart from blood cultures, endotracheal aspirate culture was identified as the main collection method for the microbiological testing (scores of 274.8 and 246.8, respectively). Mini-BAL was the preferred invasive technique with a score of 208. Top three biomarkers were CRP (score 184.3), PCT (181.3), and WBC (166.4). Gram stain (192.5) was prioritized among laboratory diagnostic techniques. Using MCDA, it is recommended to perform a combination of diagnostic techniques including images (chest X-ray), culture of clinical specimens (blood cultures and endotracheal aspirate), and biomarkers (CRP or PCT) for VAP diagnosis at the bedside. Gram stain was ranked as the preferred laboratory technique.
publishDate 2019
dc.date.none.fl_str_mv 2019
2019-01-01T00:00:00Z
2021-11-23T10:02:09Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10400.16/2605
url http://hdl.handle.net/10400.16/2605
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv Ferreira-Coimbra J, Ardanuy C, Diaz E, et al. Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis. Eur J Clin Microbiol Infect Dis. 2020;39(2):281-286. doi:10.1007/s10096-019-03720-x
0934-9723
10.1007/s10096-019-03720-x
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv Springer
publisher.none.fl_str_mv Springer
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
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instacron_str RCAAP
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reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
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