TY - JOUR
T1 - Desirability of outcome ranking (DOOR) for comparing diagnostic tools and early therapeutic choices in patients with suspected candidemia
AU - Giacobbe, Daniele Roberto
AU - Signori, Alessio
AU - Tumbarello, Mario
AU - Ungaro, Riccardo
AU - Sarteschi, Giovanni
AU - Furfaro, Elisa
AU - Mikulska, Malgorzata
AU - Sanguinetti, Maurizio
AU - Posteraro, Brunella
AU - Losito, Angela Raffaella
AU - De Pascale, Gennaro
AU - Del Bono, Valerio
AU - Viscoli, Claudio
PY - 2018
Y1 - 2018
N2 - Desirability of outcome ranking (DOOR) has been developed for assessing desirability of outcome in interventional studies. However, its possible use in observational studies of the diagnosis and early treatment of infectious diseases has not been explored so far, and it might introduce interesting features in specific scenarios. This was a post hoc analysis of a prospective observational study in intensive care unit patients with sepsis and at risk of candidemia. The probabilities that a randomly selected patient would have a more, less, and equally cost-effective early therapeutic choice following a BDG-based diagnostic strategy rather than the empirical administration of antifungals to all patients were calculated using DOOR methods. The probability of a more cost-effective therapeutic choice following the BDG-based rather than the empirical strategy was 67.81% (95% CI 67.32–68.30), whereas the probabilities of a less and equally cost-effective early therapeutic choice were 19.68% (95% CI 19.27–20.10) and 12.50% (95% CI 12.16–12.85), respectively. The application of DOOR methods to observational studies focused on diagnosis and early treatment is a novel field that could merit further investigation.
AB - Desirability of outcome ranking (DOOR) has been developed for assessing desirability of outcome in interventional studies. However, its possible use in observational studies of the diagnosis and early treatment of infectious diseases has not been explored so far, and it might introduce interesting features in specific scenarios. This was a post hoc analysis of a prospective observational study in intensive care unit patients with sepsis and at risk of candidemia. The probabilities that a randomly selected patient would have a more, less, and equally cost-effective early therapeutic choice following a BDG-based diagnostic strategy rather than the empirical administration of antifungals to all patients were calculated using DOOR methods. The probability of a more cost-effective therapeutic choice following the BDG-based rather than the empirical strategy was 67.81% (95% CI 67.32–68.30), whereas the probabilities of a less and equally cost-effective early therapeutic choice were 19.68% (95% CI 19.27–20.10) and 12.50% (95% CI 12.16–12.85), respectively. The application of DOOR methods to observational studies focused on diagnosis and early treatment is a novel field that could merit further investigation.
KW - Biomarker
KW - Candidemia
KW - DOOR
KW - Diagnosis
KW - Glucan
KW - Infectious Diseases
KW - Microbiology (medical)
KW - Biomarker
KW - Candidemia
KW - DOOR
KW - Diagnosis
KW - Glucan
KW - Infectious Diseases
KW - Microbiology (medical)
UR - https://publicatt.unicatt.it/handle/10807/129556
UR - https://www.scopus.com/inward/citedby.uri?partnerID=HzOxMe3b&scp=85057780513&origin=inward
UR - https://www.scopus.com/inward/record.uri?partnerID=HzOxMe3b&scp=85057780513&origin=inward
U2 - 10.1007/s10096-018-3441-1
DO - 10.1007/s10096-018-3441-1
M3 - Article
SN - 0934-9723
VL - 38
SP - 413
EP - 417
JO - European Journal of Clinical Microbiology and Infectious Diseases
JF - European Journal of Clinical Microbiology and Infectious Diseases
IS - 2
ER -