Ventilator-associated pneumonia diagnosis: a prioritization exercise based on multi-criteria decision analysis
Autor(a) principal: | |
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Data de Publicação: | 2019 |
Outros Autores: | , , , , , , , , , |
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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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 |
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Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) |
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Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação |
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