Informing estimates of probability of Clostridioides difficile infection for testing and treatment: expert consensus from a modified-Delphi procedure Article Swipe
Jonathan Baghdadi
,
M A Wessel
,
Erik R. Dubberke
,
Alison D. Lydecker
,
Kimberly C. Claeys
,
Carolyn D. Alonso
,
K.C. Coffey
,
Michael J. Durkin
,
Anne J Gonzales-Luna
,
Alice Guh
,
Jennie H. Kwon
,
Elise Martin
,
Preeti Mehrotra
,
Christopher R. Polage
,
Michael S. Pulia
,
Clare Rock
,
Andrew M Skinner
,
Valerie M. Vaughn
,
Tara Vijayan
,
Michael E Yarrington
,
Daniel J. Morgan
·
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1017/ash.2024.387
YOU?
·
· 2024
· Open Access
·
· DOI: https://doi.org/10.1017/ash.2024.387
Background: Clostridioides difficile infection (CDI) may be misdiagnosed if testing is performed in the absence of signs or symptoms of disease. This study sought to support appropriate testing by estimating the impact of signs, symptoms, and healthcare exposures on pre-test likelihood of CDI. Methods: A panel of fifteen experts in infectious diseases participated in a modified UCLA/RAND Delphi study to estimate likelihood of CDI. Consensus, defined as agreement by >70% of panelists, was assessed via a REDCap survey. Items without consensus were discussed in a virtual meeting followed by a second survey. Results: All fifteen panelists completed both surveys (100% response rate). In the initial survey, consensus was present on 6 of 15 (40%) items related to risk of CDI. After panel discussion and clarification of questions, consensus (>70% agreement) was reached on all remaining items in the second survey. Antibiotics were identified as the primary risk factor for CDI and grouped into three categories: high-risk (likelihood ratio [LR] 7, 93% agreement among panelists in first survey), low-risk (LR 3, 87% agreement in first survey), and minimal-risk (LR 1, 71% agreement in first survey). Other major factors included new or unexplained severe diarrhea (e.g., ≥ 10 liquid bowel movements per day; LR 5, 100% agreement in second survey) and severe immunosuppression (LR 5, 87% agreement in second survey). Conclusion: Infectious disease experts concurred on the importance of signs, symptoms, and healthcare exposures for diagnosing CDI. The resulting risk estimates can be used by clinicians to optimize CDI testing and treatment.
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Metadata
- Type
- article
- Language
- en
- Landing Page
- https://doi.org/10.1017/ash.2024.387
- OA Status
- gold
- Cited By
- 1
- References
- 34
- Related Works
- 10
- OpenAlex ID
- https://openalex.org/W4403218172
All OpenAlex metadata
Raw OpenAlex JSON
- OpenAlex ID
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https://openalex.org/W4403218172Canonical identifier for this work in OpenAlex
- DOI
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https://doi.org/10.1017/ash.2024.387Digital Object Identifier
- Title
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Informing estimates of probability of Clostridioides difficile infection for testing and treatment: expert consensus from a modified-Delphi procedureWork title
- Type
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articleOpenAlex work type
- Language
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enPrimary language
- Publication year
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2024Year of publication
- Publication date
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2024-01-01Full publication date if available
- Authors
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Jonathan Baghdadi, M A Wessel, Erik R. Dubberke, Alison D. Lydecker, Kimberly C. Claeys, Carolyn D. Alonso, K.C. Coffey, Michael J. Durkin, Anne J Gonzales-Luna, Alice Guh, Jennie H. Kwon, Elise Martin, Preeti Mehrotra, Christopher R. Polage, Michael S. Pulia, Clare Rock, Andrew M Skinner, Valerie M. Vaughn, Tara Vijayan, Michael E Yarrington, Daniel J. MorganList of authors in order
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https://doi.org/10.1017/ash.2024.387Publisher landing page
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YesWhether a free full text is available
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goldOpen access status per OpenAlex
- OA URL
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https://doi.org/10.1017/ash.2024.387Direct OA link when available
- Concepts
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Clostridioides, Medicine, Delphi method, Clostridium difficile, Family medicine, Internal medicine, Statistics, Antibiotics, Mathematics, Microbiology, BiologyTop concepts (fields/topics) attached by OpenAlex
- Cited by
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1Total citation count in OpenAlex
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2025: 1Per-year citation counts (last 5 years)
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10Other works algorithmically related by OpenAlex
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| primary_location.raw_source_name | Antimicrobial Stewardship & Healthcare Epidemiology |
| primary_location.landing_page_url | https://doi.org/10.1017/ash.2024.387 |
| publication_date | 2024-01-01 |
| publication_year | 2024 |
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