Monocyte distribution width and the fighting action to neutralize sepsis (FANS) score for sepsis prediction in emergency department

Ognibene, Agostino; Lorubbio, Maria; Montemerani, Sara; Tacconi, Danilo; Saracini, Alessandro; Fabbroni, Sara; Parisio, Eva Maria; Zanobetti, Maurizio; Mandò, Massimo; D’Urso, Antonio

doi:10.1016/j.cca.2022.07.007

Cited by 4 publications

(11 citation statements)

References 15 publications

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“…Quality assessments using the QUADAS-2 criteria are summarized in Figure 2 . In the patient selection domain, one study (5.6%) had an unclear risk of bias due to its insufficient description of enrollment design ( 16 ). In the index test domain, four studies (22.2%) had an unclear risk of bias because they calculated sensitivity and specificity using the optimal cutoff value other than the predefined value ( 4 , 16 , 24 , 27 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the patient selection domain, one study (5.6%) had an unclear risk of bias due to its insufficient description of enrollment design ( 16 ). In the index test domain, four studies (22.2%) had an unclear risk of bias because they calculated sensitivity and specificity using the optimal cutoff value other than the predefined value ( 4 , 16 , 24 , 27 ). In the reference standard domain, eight studies (44.4%) had an unclear risk of bias because whether their reference standard results were interpreted with the results of the index test was not explicitly stated ( 4 , 14 – 16 , 19 , 22 , 24 , 25 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the index test domain, four studies (22.2%) had an unclear risk of bias because they calculated sensitivity and specificity using the optimal cutoff value other than the predefined value ( 4 , 16 , 24 , 27 ). In the reference standard domain, eight studies (44.4%) had an unclear risk of bias because whether their reference standard results were interpreted with the results of the index test was not explicitly stated ( 4 , 14 – 16 , 19 , 22 , 24 , 25 ). For the flow and timing domain, the risk of bias was unclear in 11 studies (61.1%) since the interval between the index test and the reference standard was not clearly defined ( 4 , 14 – 16 , 18 , 20 – 22 , 24 – 26 ).…”

Section: Resultsmentioning

confidence: 99%

“…In the reference standard domain, eight studies (44.4%) had an unclear risk of bias because whether their reference standard results were interpreted with the results of the index test was not explicitly stated ( 4 , 14 – 16 , 19 , 22 , 24 , 25 ). For the flow and timing domain, the risk of bias was unclear in 11 studies (61.1%) since the interval between the index test and the reference standard was not clearly defined ( 4 , 14 – 16 , 18 , 20 – 22 , 24 – 26 ). As for the applicability, one study had an unclear applicability in the patient selection domain as it enrolled only patients with liver cirrhosis ( 27 ), whereas all other studies were at a low risk.…”

Section: Resultsmentioning

confidence: 99%

“…The potential disadvantage of using MDW as a biomarker lies in its specificity. Studies have shown that the combination of MDW and other biomarkers could improve the diagnostic performance in specificity under a similar sensitivity ( 16 , 17 , 22 , 23 , 28 , 29 ). More evidence is required to determine the optimal combination of biomarkers for sepsis diagnosis.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Diagnostic Accuracies of Monocyte Distribution Width, Procalcitonin, and C-Reactive Protein for Sepsis: A Systematic Review and Meta-Analysis

Huang

Shao

et al. 2023

Critical Care Medicine

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OBJECTIVES: We performed a systemic review and meta‐analysis to evaluate the diagnostic accuracy of monocyte distribution width (MDW) and to compare with procalcitonin and C‐reactive protein (CRP), in adult patients with sepsis. DATA SOURCES: A systematic literature search was performed in PubMed, Embase, and the Cochrane Library to identify all relevant diagnostic accuracy studies published before October 1, 2022. STUDY SELECTION: Original articles reporting the diagnostic accuracy of MDW for sepsis detection with the Sepsis-2 or Sepsis-3 criteria were included. DATA EXTRACTION: Study data were abstracted by two independent reviewers using a standardized data extraction form. DATA SYNTHESIS: Eighteen studies were included in the meta‐analysis. The pooled sensitivity and specificity of MDW were 84% (95% CI [79–88%]) and 68% (95% CI [60–75%]). The estimated diagnostic odds ratio and the area under the summary receiver operating characteristic curve (SROC) were 11.11 (95% CI [7.36–16.77]) and 0.85 (95% CI [0.81–0.89]). Significant heterogeneity was observed among the included studies. Eight studies compared the diagnostic accuracies of MDW and procalcitonin, and five studies compared the diagnostic accuracies of MDW and CRP. For MDW versus procalcitonin, the area under the SROC was similar (0.88, CI = 0.84–0.93 vs 0.82, CI = 0.76–0.88). For MDW versus CRP, the area under the SROC was similar (0.88, CI = 0.83–0.93 vs 0.86, CI = 0.78–0.95). CONCLUSIONS: The results of the meta-analysis indicate that MDW is a reliable diagnostic biomarker for sepsis as procalcitonin and CRP. Further studies investigating the combination of MDW and other biomarkers are advisable to increase the accuracy in sepsis detection.

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