The Diagnostic Accuracy of Serum Procalcitonin for Sepsis in Adult Patients in the Emergency Department
Bibliographic record
Abstract
<h3>Background</h3> Procalcitonin, a precursor hormone of calcitonin, represents a promising marker of bacterial infections. <h3>Research Question</h3> What is the accuracy of procalcitonin for the diagnosis of sepsis in adult patients in the emergency department (ED)? <h3>Study Design and Methods</h3> In this this systematic review and meta-analysis, we searched 5 databases (PubMed, Google Scholar, Science Direct, Wiley, and the Cochrane database) from the inception of the Third International Consensus Definitions for Sepsis and Septic Shock diagnostic criteria (January 1, 2016) through December 31, 2024. We included studies that assessed the accuracy of procalcitonin for sepsis in adult patients admitted in the ED. We performed a random-effects meta-analysis, evaluated individual study risk of bias using Quality Assessment of Diagnostic Accuracy Studies 2 criteria and certainty of evidence using Grading of Recommendations, Assessment, Development, and Evaluations methodology. <h3>Results</h3> We included 11 studies comprising 7,937 patients in the analysis. The pooled sensitivity of procalcitonin for sepsis in patients in the ED was 0.62 (95% CI, 0.60-0.64) and the pooled specificity was 0.80 (95% CI, 0.79-0.81); both were based on low certainty evidence. The pooled positive likelihood ratio was 2.80 (95% CI, 2.20-3.57), the negative likelihood ratio was 0.42 (95% CI, 0.32-0.55), and the pooled diagnostic OR was 6.83 (95% CI, 4.87-9.58). The area under the summary receiver operating characteristic curve for procalcitonin was 0.77 (95% CI, 0.7281-0.8309). <h3>Conclusions</h3> Based on pooled analysis, procalcitonin was shown to have reasonable specificity but poor sensitivity for diagnosis of sepsis in patients in the ED with suspected infection. Given that the results are based on low certainty of evidence, further high-quality data in this population are needed. <h3>Clinical Trial Registration</h3> International Prospective Register of Systematic Reviews; No.: CRD42024618786; URL: https://www.crd.york.ac.uk/prospero/
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot 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.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.018 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
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.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
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".