Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage

Nardo, Pasquale De; Gentilotti, Elisa; Mazzaferri, Fulvia; Cremonini, Eleonora; Hansen, Paul; Goossens, Herman; Tacconelli, Evelina

doi:10.1016/j.ijid.2020.06.082

Cited by 64 publications

(67 citation statements)

References 21 publications

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“…Healthcare in the current COVID-19 pandemic must necessarily be based on the best use of available resources [ 24 , 47 ]. The number of patients, their different presentations and their condition over time make scoring systems a tool that should certainly be considered [ 48 , 49 ].…”

Section: Discussionmentioning

confidence: 99%

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Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Martin-Rodríguez

Conty

Sanz-García

et al. 2021

JPM

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Early warning scores (EWSs) help prevent and recognize and thereby act as the first signs of clinical and physiological deterioration. The objective of this study is to evaluate different EWSs (National Early Warning Score 2 (NEWS2), quick sequential organ failure assessment score (qSOFA), Modified Rapid Emergency Medicine Score (MREMS) and Rapid Acute Physiology Score (RAPS)) to predict mortality within the first 48 h in patients suspected to have Coronavirus disease 2019 (COVID-19). We conducted a retrospective observational study in patients over 18 years of age who were treated by the advanced life support units and transferred to the emergency departments between March and July of 2020. Each patient was followed for two days registering their final diagnosis and mortality data. A total of 663 patients were included in our study. Early mortality within the first 48 h affected 53 patients (8.3%). The scale with the best capacity to predict early mortality was the National Early Warning Score 2 (NEWS2), with an area under the curve of 0.825 (95% CI: 0.75–0.89). The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positive patients presented an area under the curve (AUC) of 0.804 (95% CI: 0.71–0.89), and the negative ones with an AUC of 0.863 (95% CI: 0.76–0.95). Among the EWSs, NEWS2 presented the best predictive power, even when it was separately applied to patients who tested positive and negative for SARS-CoV-2.

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Section: Discussionmentioning

confidence: 99%

“…For the COVID-19 pandemic, we hypothesized that EWSs can be an effective tool that will allow an initial triage of patients to be evacuated with high-priority by ambulances to EDs, helping in such complex decision-making situations [ 23 , 24 , 25 ].…”

Section: Introductionmentioning

confidence: 99%

Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Martin-Rodríguez

Conty

Sanz-García

et al. 2021

JPM

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“…By learning from a war-time situation, we can respond to a war-like emergency time (like the pandemic outbreak) with better management and prioritization plan [2]. This is recognized as a common practice in hospitals and surgeries [30] [31] [32] [33] as well as for communication and care planning [34]. There is no reason why the same cannot occur at the larger scale, where the managed and prioritization are significant in evaluating assets and facilities to combat the disease and contain it in an adequate timeframe.…”

Section: Early Asset Management and Prioritization Planmentioning

confidence: 99%

Reflection on Early Lessons for Urban Resilience and Public Health Enhancement during the COVID-19

Cheshmehzangi¹

2020

Health

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With growing impacts on public health systems and economies across the world, as a result of the COVID-19 pandemic outbreak, we need to reflect on some of the early lessons for urban resilience enhancement. In this paper, a brief discussion is made through several recommendations that could make our cities more prepared specially in the probable future waves of this current outbreak or potential spikes in infections or clustered cases. The experiences from global examples highlighted in this study address what has worked in the past few months at the spatial levels of communities and cities. The COVID-19 outbreak highlighted the deficiencies and shortfall across multiple sectors of the urban systems and enabled us to identify risks, challenges, and pathways to better city management. With regard to urban resilience enhancement, the negative impacts of the COVID-19 outbreak are assessed to suggest a checklist of what could be done through early preparedness. The findings are novel in ongoing research related to urban resilience and public health during the COVID-19 pandemic. The early lessons here reflect on the ongoing situation of this pandemic outbreak, but could effectually help to enhance the resilience of our cities and communities, and especially addressing the protection of public health and societal well-being. The findings contribute to major sectors of urban resilience, city management, and public health. The recommendations from this study could be utilised and adapted in any context, allowing for the consideration of all-inclusive decision-making and much-enhanced planning processes.

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“…Specialized MCDA software, 1000minds ( www.1000minds.com ), which implements the “Potentially All Pairwise RanKings of all possible Alternatives” (PAPRIKA) method to determine the weights ( 36 ), was used to support the group’s work. This software and method have been used since 2004 in a wide range of health applications, including for prioritizing patients for elective services ( 33 ), antibiotic-resistant diseases for research into new drugs ( 37 ), and noncritical COVID-19 patients for hospital admission ( 38 ) (at about the same time as the present project).…”

Section: Methodsmentioning

confidence: 99%

Rapid Development of a Tool for Prioritizing Patients with Coronavirus Disease 2019 for Intensive Care

Roy

Hansen

Sullivan

et al. 2021

Critical Care Explorations

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Multi-Criteria Decision Analysis to prioritize hospital admission of patients affected by COVID-19 in low-resource settings with hospital-bed shortage

Abstract: a , the members of the COVID-19MCDA Group 2

Cited by 64 publications

References 21 publications

Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Early Warning Scores in Patients with Suspected COVID-19 Infection in Emergency Departments

Reflection on Early Lessons for Urban Resilience and Public Health Enhancement during the COVID-19

Rapid Development of a Tool for Prioritizing Patients with Coronavirus Disease 2019 for Intensive Care

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