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开发一个参考标准,以分配细菌与病毒感染病因学,使用全面的方法来比较新型诊断工具的性能

Coburn Allen¹, J Kate Deanehan², Yaniv Dotan³

¹Department of Pediatrics, University of Texas at Austin Dell Medical School, Austin, Texas, USA.

Clinical infectious diseases : an official publication of the Infectious Diseases Society of America

|January 3, 2025

概括

对急性感染的新参考标准方法提高了诊断准确度. 这种方法,使用不受限制的裁决,确保可靠比较生物标记器工具,如MeMed BV (MMBV) 和prokalcitonin,即使在复杂的情况下.

科学领域:

临床诊断临床诊断临床诊断
传染病研究传染病研究.
生物标志物评估评估

背景情况:

准确的诊断测试评估需要一个强大的参考标准.
这项研究引入了一种新的方法,通过不受限制的裁决来创建急性感染的参考标准.
该方法用于比较生物标记器工具的性能.

研究的目的:

开发和验证急性感染的综合参考标准.
根据本标准,评估生物标记器工具的性能,包括MeMed BV (MMBV) 和prokalcitonin.
评估参考标准的选择如何影响工具性能比较.

主要方法:

怀疑患有急性感染的成人和儿童被纳入前性研究.
鉴定人员对生物标志物结果视而不见,将病例分类为细菌,病毒,非传染性或不确定的.
为了建立参考标准,采用多个判断层和队列定义 (微生物学确认,一致,疑似,全面),以适应难以诊断的病例.

主要成果:

MeMed BV (MMBV) 试验在所有定义的参考标准队列中表现出高的诊断性能,ROC曲线下的面积从0.90到0.98.9不等.
甲素的表现因队列而异,ROC曲线下的面积在0.69到0.77.之间.
无论使用哪个基准标准队列,MMBV和prokalcitonin之间始终存在显著的性能差异.

结论:

建立一个包含诊断不确定性的参考标准对于评估急性感染至关重要.
诊断工具的性能取决于所使用的参考标准.
为了在诊断工具之间进行有效的比较,必须一致地应用相同的参考标准.

关键词:

基于裁决的参考标准.诊断性表现的诊断性表现是什么诊断工具诊断工具诊断工具难以诊断的病例很难诊断.感染病因学感染病因学

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