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Clinical utility of PCR compared to conventional culture and sensitivity testing for the management of complicated urinary tract infections in adults: Part I. Assessment of clinical outcomes, investigator satisfaction scores, and turnaround times

2024· article· en· W4404130731 on OpenAlexaff
Frank L Spangler, Cheau Williams, Michael Aberger, Khaled Ajib, Shahram S. Gholami, H. Goodwin, Lauren Park, Moustafa Kardjadj, DeAndre Derrick, Thomas K. Huard

Bibliographic record

VenueDiagnostic Microbiology and Infectious Disease · 2024
Typearticle
Languageen
FieldMedicine
TopicUrinary Tract Infections Management
Canadian institutionsCanadian Association for Co-operative Education
Fundersnot available
KeywordsUrinary systemTurnaround timeMedicineIntensive care medicineInternal medicineOperations management

Abstract

fetched live from OpenAlex

PURPOSE: Managing complicated urinary tract infections (cUTIs) poses significant challenges, often resulting in the overprescription of empiric antibiotics. This approach exposes patients to multiple antimicrobials and raises the risk of inadequate treatment efficacy. The purpose of this study is to assess and compare the clinical utility of molecular testing (PCR) versus conventional culture and sensitivity (C&S) in managing cUTI, to identify optimal management strategies for cUTI patients. MATERIALS AND METHODS: 773 symptomatic adult patients with suspected cUTI diagnosis were randomized (1:1) into either the PCR-guided treatment group or the control group (C&S-guided) and followed up for 28 days. The primary outcome measure was the number (and percentage) of patients in each study arm with favorable clinical outcomes at the end of the study visit. RESULTS: Overall, 468 patients completed all study procedures, and of those, data from 362 patients were analyzed (193 PCR arm, 169 C&S arm) for this Part 1 of the primary study analysis. Treatments guided by PCR results provided significantly better clinical outcomes compared to treatments guided by conventional C&S results (88.08 % vs. 78.11, p = 0.011), with a significantly shorter mean turnaround time (49.68 h vs. 104.4 h, p < 0.001), and a significant higher investigator satisfaction total score (23.95 ± 1.96 vs. 20.64 ± 4.12, p < 0.001). CONCLUSIONS: This data demonstrated the clinical utility of PCR in improving therapeutic clinical outcomes and facilitating expedited, patient-specific management of cUTI for optimal patient care. Furthermore, this study showed a clear preference among investigators for PCR over C&S when making clinical decisions and managing patients with cUTI.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.001
metaresearch head score (Gemma)0.002
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.005
Threshold uncertainty score0.526

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0010.002
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0010.000
Bibliometrics0.0000.000
Science and technology studies0.0000.001
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.047
GPT teacher head0.374
Teacher spread0.327 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

Quick stats

Citations6
Published2024
Admission routes1
Has abstractyes

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