Consensus Recommendations for Blood Culture Use in Critically Ill Children Using a Modified Delphi Approach* Article Swipe
Charlotte Woods-Hill
,
Danielle W. Koontz
,
Annie Voskertchian
,
Anping Xie
,
Judy A. Shea
,
Marlene R. Miller
,
James C. Fackler
,
Aaron M. Milstone
·
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/pcc.0000000000002749
YOU?
·
· 2021
· Open Access
·
· DOI: https://doi.org/10.1097/pcc.0000000000002749
Objectives: Blood cultures are fundamental in evaluating for sepsis, but excessive cultures can lead to false-positive results and unnecessary antibiotics. Our objective was to create consensus recommendations focusing on when to safely avoid blood cultures in PICU patients. Design: A panel of 29 multidisciplinary experts engaged in a two-part modified Delphi process. Round 1 consisted of a literature summary and an electronic survey sent to invited participants. In the survey, participants rated a series of recommendations about when to avoid blood cultures on five-point Likert scale. Consensus was achieved for the recommendation(s) if 75% of respondents chose a score of 4 or 5, and these were included in the final recommendations. Any recommendations that did not meet these a priori criteria for consensus were discussed during the in-person expert panel review (Round 2). Round 2 was facilitated by an independent expert in consensus methodology. After a review of the survey results, comments from round 1, and group discussion, the panelists voted on these recommendations in real-time. Setting: Experts’ institutions; in-person discussion in Baltimore, MD. Subjects: Experts in pediatric critical care, infectious diseases, nephrology, oncology, and laboratory medicine. Interventions: None. Measurements and Main Results: Of the 27 original recommendations, 18 met criteria for achieving consensus in Round 1; some were modified for clarity or condensed from multiple into single recommendations during Round 2. The remaining nine recommendations were discussed and modified until consensus was achieved during Round 2, which had 26 real-time voting participants. The final document contains 19 recommendations. Conclusions: Using a modified Delphi process, we created consensus recommendations on when to avoid blood cultures and prevent overuse in the PICU. These recommendations are a critical step in disseminating diagnostic stewardship on a wider scale in critically ill children.
Related Topics
Concepts
Medicine
Delphi method
Likert scale
CLARITY
Delphi
Voting
Blood culture
MEDLINE
Multidisciplinary approach
Family medicine
Medical education
Psychology
Political science
Politics
Biology
Social science
Antibiotics
Microbiology
Operating system
Developmental psychology
Chemistry
Sociology
Statistics
Biochemistry
Computer science
Mathematics
Law
Metadata
- Type
- review
- Language
- en
- Landing Page
- https://doi.org/10.1097/pcc.0000000000002749
- OA Status
- green
- Cited By
- 15
- References
- 39
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W3158638646
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W3158638646Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1097/pcc.0000000000002749Digital Object Identifier
- Title
-
Consensus Recommendations for Blood Culture Use in Critically Ill Children Using a Modified Delphi Approach*Work title
- Type
-
reviewOpenAlex work type
- Language
-
enPrimary language
- Publication year
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2021Year of publication
- Publication date
-
2021-04-26Full publication date if available
- Authors
-
Charlotte Woods-Hill, Danielle W. Koontz, Annie Voskertchian, Anping Xie, Judy A. Shea, Marlene R. Miller, James C. Fackler, Aaron M. MilstoneList of authors in order
- Landing page
-
https://doi.org/10.1097/pcc.0000000000002749Publisher landing page
- Open access
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YesWhether a free full text is available
- OA status
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greenOpen access status per OpenAlex
- OA URL
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https://www.ncbi.nlm.nih.gov/pmc/articles/8416691Direct OA link when available
- Concepts
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Medicine, Delphi method, Likert scale, CLARITY, Delphi, Voting, Blood culture, MEDLINE, Multidisciplinary approach, Family medicine, Medical education, Psychology, Political science, Politics, Biology, Social science, Antibiotics, Microbiology, Operating system, Developmental psychology, Chemistry, Sociology, Statistics, Biochemistry, Computer science, Mathematics, LawTop concepts (fields/topics) attached by OpenAlex
- Cited by
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15Total citation count in OpenAlex
- Citations by year (recent)
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2025: 3, 2024: 2, 2023: 4, 2022: 4, 2021: 2Per-year citation counts (last 5 years)
- References (count)
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39Number of works referenced by this work
- Related works (count)
-
10Other works algorithmically related by OpenAlex
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| abstract_inverted_index.consensus | 25, 122, 142, 203, 231, 257 |
| abstract_inverted_index.consisted | 54 |
| abstract_inverted_index.discussed | 124, 227 |
| abstract_inverted_index.diseases, | 181 |
| abstract_inverted_index.excessive | 10 |
| abstract_inverted_index.in-person | 127, 169 |
| abstract_inverted_index.medicine. | 186 |
| abstract_inverted_index.objective | 21 |
| abstract_inverted_index.oncology, | 183 |
| abstract_inverted_index.panelists | 159 |
| abstract_inverted_index.patients. | 37 |
| abstract_inverted_index.pediatric | 177 |
| abstract_inverted_index.real-time | 240 |
| abstract_inverted_index.remaining | 223 |
| abstract_inverted_index.Baltimore, | 172 |
| abstract_inverted_index.Experts’ | 167 |
| abstract_inverted_index.critically | 286 |
| abstract_inverted_index.diagnostic | 279 |
| abstract_inverted_index.discussion | 170 |
| abstract_inverted_index.electronic | 61 |
| abstract_inverted_index.evaluating | 6 |
| abstract_inverted_index.five-point | 83 |
| abstract_inverted_index.infectious | 180 |
| abstract_inverted_index.laboratory | 185 |
| abstract_inverted_index.literature | 57 |
| abstract_inverted_index.real-time. | 165 |
| abstract_inverted_index.Objectives: | 0 |
| abstract_inverted_index.discussion, | 157 |
| abstract_inverted_index.facilitated | 136 |
| abstract_inverted_index.fundamental | 4 |
| abstract_inverted_index.independent | 139 |
| abstract_inverted_index.nephrology, | 182 |
| abstract_inverted_index.respondents | 95 |
| abstract_inverted_index.stewardship | 280 |
| abstract_inverted_index.unnecessary | 18 |
| abstract_inverted_index.Conclusions: | 249 |
| abstract_inverted_index.Measurements | 189 |
| abstract_inverted_index.antibiotics. | 19 |
| abstract_inverted_index.methodology. | 143 |
| abstract_inverted_index.participants | 70 |
| abstract_inverted_index.disseminating | 278 |
| abstract_inverted_index.institutions; | 168 |
| abstract_inverted_index.participants. | 66, 242 |
| abstract_inverted_index.Interventions: | 187 |
| abstract_inverted_index.false-positive | 15 |
| abstract_inverted_index.recommendations | 26, 75, 112, 163, 218, 225, 258, 272 |
| abstract_inverted_index.recommendations, | 197 |
| abstract_inverted_index.recommendations. | 110, 248 |
| abstract_inverted_index.multidisciplinary | 43 |
| abstract_inverted_index.recommendation(s) | 91 |
| cited_by_percentile_year.max | 97 |
| cited_by_percentile_year.min | 93 |
| countries_distinct_count | 1 |
| institutions_distinct_count | 8 |
| citation_normalized_percentile.value | 0.85444324 |
| citation_normalized_percentile.is_in_top_1_percent | False |
| citation_normalized_percentile.is_in_top_10_percent | False |