Improved diagnostics of infectious diseases in emergency departments: a protocol of a multifaceted multicentre diagnostic study
| Autor: | Helene Skjøt-Arkil, Stefan Posth, Claus Østergaard, Mathias Amdi Hertz, Eva Rabing Brix Petersen, Ole Graumann, Christian Backer Mogensen, Christian B. Laursen, Mariana Bichuette Cartuliares, Morten Hjarnø Lorentzen, Ming Chen, Flemming S Rosenvinge, Anne Heltborg, Thor Aage Skovsted |
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| Rok vydání: | 2021 |
| Předmět: |
Adult
musculoskeletal diseases medicine.medical_specialty Bacteriuria Point-of-care testing Acute infection Communicable Diseases accident & emergency medicine medicine diagnostic radiology Humans Multicenter Studies as Topic In patient Medical prescription Intensive care medicine Ultrasonography Protocol (science) ultrasound business.industry microbiology computed tomography General Medicine diagnostic microbiology medicine.disease Pneumonia Infectious Diseases Point-of-Care Testing Medicine Sputum medicine.symptom Emergency Service Hospital business human activities |
| Zdroj: | BMJ Open BMJ Open, Vol 11, Iss 9 (2021) Skjøt-Arkil, H, Heltborg, A, Lorentzen, M H, Cartuliares, M B, Hertz, M A, Graumann, O, Rosenvinge, F S, Petersen, E R B, Østergaard, C, Laursen, C B, Skovsted, T A, Posth, S, Chen, M & Mogensen, C B 2021, ' Improved diagnostics of infectious diseases in emergency departments : a protocol of a multifaceted multicentre diagnostic study ', BMJ Open, vol. 11, no. 9, e049606 . https://doi.org/10.1136/bmjopen-2021-049606 |
| ISSN: | 2044-6055 |
| Popis: | BackgroundThe major obstacle in prescribing an appropriate and targeted antibiotic treatment is insufficient knowledge concerning whether the patient has a bacterial infection, where the focus of infection is and which bacteria are the agents of the infection. A prerequisite for the appropriate use of antibiotics is timely access to accurate diagnostics such as point-of-care (POC) testing.The study aims to evaluate diagnostic tools and working methods that support a prompt and accurate diagnosis of hospitalised patients suspected of an acute infection. We will focus on the most common acute infections: community-acquired pneumonia (CAP) and acute pyelonephritis (APN). The objectives are to investigate (1) patient characteristics and treatment trajectory of the different acute infections, (2) diagnostic and prognostic accuracy of infection markers, (3) diagnostic accuracy of POC urine flow cytometry on diagnosing and excluding bacteriuria, (4) how effective the addition of POC analysis of sputum to the diagnostic set-up for CAP is on antibiotic prescriptions, (5) diagnostic accuracy of POC ultrasound and ultralow dose (ULD) computerized tomography (CT) on diagnosing CAP, (6) diagnostic accuracy of specialist ultrasound on diagnosing APN, (7) diagnostic accuracy of POC ultrasound in diagnosing hydronephrosis in patients suspected of APN.Methods and analysisIt is a multifaceted multicentre diagnostic study, including 1000 adults admitted with suspicion of an acute infection. Participants will, within the first 24 hours of admission, undergo additional diagnostic tests including infection markers, POC urine flow cytometry, POC analysis of sputum, POC and specialist ultrasound, and ULDCT. The primary reference standard is an assigned diagnosis determined by a panel of experts.Ethics, dissemination and registrationApproved by Regional Committees on Health Research Ethics for Southern Denmark, Danish Data Protection Agency and clinicaltrials.gov. Results will be presented in peer-reviewed journals, and positive, negative and inconclusive results will be published.Trial registration numbersNCT04661085, NCT04681963, NCT04667195, NCT04652167, NCT04686318, NCT04686292, NCT04651712, NCT04645030, NCT04651244. |
| Databáze: | OpenAIRE |
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