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Diagnostic Stewardship: Appropriate Testing and Judicious Treatments.
Yasaman Fatemi1, Paul A Bergl2
1Division of Infectious Diseases, Children's Hospital of Philadelphia, 3401 Civic Center Boulevard, Philadelphia, PA 19104, USA.
Critical Care Clinics
|November 19, 2021
Summary
Diagnostic stewardship in the intensive care unit (ICU) optimizes testing for better patient care. This approach promotes appropriate diagnostic tests, improving outcomes and clinician decision-making.
Area of Science:
- Critical Care Medicine
- Clinical Diagnostics
- Healthcare Management
Background:
- Diagnostic stewardship evolved from antimicrobial stewardship principles.
- It addresses the diagnosis-to-treatment pathway in intensive care units (ICUs).
- Focuses on timely and appropriate diagnostic testing linked to management decisions.
Purpose of the Study:
- To define and advocate for diagnostic stewardship in the ICU setting.
- To highlight the importance of judicious diagnostic testing.
- To prepare for the integration of advanced diagnostic strategies.
Main Methods:
- Review of existing literature on diagnostic stewardship in ICUs.
- Analysis of retrospective data on stewardship initiatives.
- Conceptual framework for implementing stewardship principles.
Main Results:
- Current evidence suggests diagnostic stewardship initiatives are safe and feasible.
- These initiatives are associated with comparable patient outcomes.
- Discourages excessive testing in low-probability cases to avoid false positives.
Conclusions:
- Diagnostic stewardship is a valuable framework for optimizing patient care in the ICU.
- A stewardship mindset is crucial for clinicians navigating complex diagnostic technologies.
- Further research is needed to solidify the evidence base for ICU diagnostic stewardship.
Keywords:
Clinical decision supportDiagnostic errorDiagnostic stewardshipMedical-decision makingOverdiagnosisMore Related Videos
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