Point-of-care multiplex-PCR enables germ identification in haemolytic uremic syndrome 94 h earlier than stool culture

López, Luis H. Llano; Melonari, Pablo; Gehring, Stephan; Schreiner, Daniel; Grucci, Sandra; Araujo, Sofía Pérez; Pauli, Lorena Di; Sochaczewski, Christina Oetzmann von; Schröder, Arne; Piovano, Laura

doi:10.1007/s10096-020-04060-x

Cited by 2 publications

(3 citation statements)

References 9 publications

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“…Posthoc-power was calculated using the power2 × 2-function from the exact2 × 2-package (version 1.6.5) [ 30 ]. Medians were compared using Mood’s test from the RVAideMemoire-package (version 0.9–75) [ 31 ]. P values were Shannon-transformed by calculating their negative base-2 logarithm [ 32 ].…”

Section: Methodsmentioning

confidence: 99%

Paediatric surgical trials, their fragility index, and why to avoid using it to evaluate results

2022

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Background The fragility index has been gaining ground in the evaluation of comparative clinical studies. Many scientists evaluated trials in their fields and deemed them to be fragile, although there is no consensus on the definition of fragility. We aimed to calculate the fragility index and its permutations for paediatric surgical trials. Methods We searched pubmed for prospectively conducted paediatric surgical trials with intervention and control group without limitations and calculated their (reverse) fragility indices and respective quotients along with posthoc-power. Relationships between variables were evaluated using Spearman’s ρ. We also calculated S values by negative log transformation base-2 of P values. Results Of 516 retrieved records, we included 87. The median fragility index was 1.5 (interquartile range: 0–4) and the median reverse fragility index was 3 (interquartile range: 2–4), although they were statistically not different (Mood’s test: χ2 = 0.557, df = 1, P = 0.4556). P values and fragility indices were strongly inversely correlated (ρ = − 0.71, 95% confidence interval: − 0.53 to − 0.85, P < 0.0001), while reverse fragility indices were moderately correlated to P values (ρ = 0.5, 95% confidence interval: 0.37–0.62, P < 0.0001). A fragility index of 1 resulted from P values between 0.039 and 0.003, which resulted in S values between 4 and 8. Conclusions Fragility indices, reverse fragility indices, and their respective fragility quotients of paediatric surgical trials are low. The fragility index can be viewed as no more than a transformed P value with even more substantial limitations. Its inherent penalisation of small studies irrespective of their clinical relevance is particularly harmful for paediatric surgery. Consequently, the fragility index should be avoided.

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Section: Methodsmentioning

confidence: 99%

Paediatric surgical trials, their fragility index, and why to avoid using it to evaluate results

2022

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“…This allows for quicker TAT (from 31–72 h for cultures to 2–8 h), increased sensitivity to identify some organisms, and decreased personnel technical expertise required for stool testing (e.g., parasite detection) 12 . Multiplex PCR stool testing may be useful in patients pretreated with bismuth or antibiotic therapy, both of which may cause falsely negative culture results, or in patients with suspected hemolytic uremic syndrome, where rapid identification of Shiga‐toxin producing infections is critical to avoid antibiotics, which may exacerbate illness 13,14 . PCR panels can improve infection control practices by reducing costs due to unnecessary use of isolation rooms and decreasing the time to appropriate isolation, which limits time windows for spread of pathogens.…”

Section: Gastrointestinal (Gi)mentioning

confidence: 99%

“…12 Multiplex PCR stool testing may be useful in patients pretreated with bismuth or antibiotic therapy, both of which may cause falsely negative culture results, or in patients with suspected hemolytic uremic syndrome, where rapid identification of Shiga-toxin producing infections is critical to avoid antibiotics, which may exacerbate illness. 13,14 PCR panels can improve infection control practices by reducing costs due to unnecessary use of isolation rooms and decreasing the time to appropriate isolation, which limits time windows for spread of pathogens. GI PCR panels also decreased rates of imaging and endoscopy in some studies.…”

Section: Gastrointestinal (Gi)mentioning

confidence: 99%

Clinical progress note: Multiplex panels for identifying infection in children

Nabower

Snowden

2023

Journal of Hospital Medicine

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Point-of-care multiplex-PCR enables germ identification in haemolytic uremic syndrome 94 h earlier than stool culture

Cited by 2 publications

References 9 publications

Paediatric surgical trials, their fragility index, and why to avoid using it to evaluate results

Paediatric surgical trials, their fragility index, and why to avoid using it to evaluate results

Clinical progress note: Multiplex panels for identifying infection in children

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