Annals of Emergency Medicine
Volume 52, Issue 6 , Pages 754-763 , December 2008

Risk Prediction With Procalcitonin and Clinical Rules in Community-Acquired Pneumonia: Answers to the July 2008 Journal Club Questions

  • Michael D. Menchine, MD, MPH

      Affiliations

    • University of California, Irvine, Irvine, CA
    • ,
  • David L. Schriger, MD, MPH (Section Editor)

      Affiliations

    • University of California, Los Angeles, Los Angeles, CA
    • ,
  • Tyler W. Barrett, MD (Section Editor)

      Affiliations

    • Vanderbilt University Medical Center, Nashville, TN

References 

  1. Huang DT, Weissfeld LA, Kellum JA, et al. Risk prediction with procalcitonin and clinical rules in community-acquired pneumonia. Ann Emerg Med. 2008;52:48–58
  2. Schriger DL. Suggestions for improving the reporting of clinical research: the role of narrative. Ann Emerg Med. 2005;45:437–443
  3. Christ-Crain M, Muller B. Procalcitonin in bacterial infections—hype, hope, more or less?. Swiss Med Wkly. 2005;135:451–460
  4. Luzzani A, Polati E, Dorizzi R, et al. Comparison of procalcitonin and C-reactive protein as markers of sepsis. Crit Care Med. 2003;31:1737–1741
  5. Casado-Flores J, Blanco-Quiros A, Asensio J, et al. Serum procalcitonin in children with suspected sepsis: a comparison with C-reactive protein and neutrophil count. Pediatr Crit Care Med. 2003;4:190–195
  6. Caterino JM, Scheatzle MD, Forbes ML, et al. Bacteremic elder emergency department patients: procalcitonin and white count. Acad Emerg Med. 2004;11:393–396
  7. Uzzan B, Cohen R, Nicolas P, et al. Procalcitonin as a diagnostic test for sepsis in critically ill adults and after surgery or trauma: a systematic review and meta-analysis. Crit Care Med. 2006;34:1996–2003
  8. Christ-Crain M, Stolz D, Bingisser R, et al. Procalcitonin-guidance of antibiotic therapy in community-acquired pneumonia: a randomized trial. Am J Respir Crit Care Med. 2006;174:84–93
  9. Stolz D, Christ-Crain M, Bingisser R, et al. Antibiotic treatment of exacerbations of COPD: a randomized, controlled trial comparing procalcitonin-guidance with standard therapy. Chest. 2007;131:9–19
  10. Christ-Crain M, Jaccard-Stolz D, Bingisser R, et al. Effect of procalcitonin-guided treatment on antibiotic use and outcome in lower respiratory tract infections: cluster-randomised, single-blinded intervention trial. Lancet. 2004;363:600–607
  11. Tang BM, Eslick GD, Craig JC, et al. Accuracy of procalcitonin for sepsis diagnosis in critically ill patients: systematic review and meta-analysis. Lancet Infect Dis. 2007;7:210–217
  12. Jones AE, Fiechtl JF, Brown MD, et al. Procalcitonin test in the diagnosis of bacteremia: a meta-analysis. Ann Emerg Med. 2007;50:34–41
  13. Masia M, Gutierrez F, Shum C, et al. Usefulness of procalcitonin levels in community-acquired pneumonia according to the Patients Outcome Research Team Pneumonia Severity Index. Chest. 2005;128:2223–2229
  14. Beovic B, Kreft S, Osredkar J, et al. Serum procalcitonin levels in patients with mild community-acquired pneumonia. Clin Microbiol Infect. 2005;11:1050–1051
  15. Greenland S, Pearl J, Robins JM. Causal diagrams for epidemiologic research. Epidemiology. 1999;10:37–48
  16. Lagakos SW. The challenge of subgroup analyses—reporting without distorting. N Engl J Med. 2006;354:1667–1669
  17. Assmann SF, Pocock SJ, Enos LE, et al. Subgroup analysis and other (mis)uses of baseline data in clinical trials. Lancet. 2000;355:1064–1069
  18. Yealy DM, Auble TE, Stone RA, et al. The Emergency Department Community-Acquired Pneumonia Trial: methodology of a quality improvement intervention. Ann Emerg Med. 2004;43:770–782
  19. Barrett TW, Schriger DL. Practical considerations in HIV testing in the emergency department, characteristics of diagnostic tests, and the role of sensitivity analysis in observational studies: answers to March 2008 Journal Club questions. Ann Emerg Med. 2008;52:170–181
  20. Fagan TJ. Letter: nomogram for Bayes theorem. N Engl J Med. 1975;293:257
  21. Singer JD, Willett JB. Applied Longitudinal Data Analysis. Oxford, England: Oxford University Press; 2003;
  22. Rabe-Hesketh S, Skrondal A. Multilevel and Longitudinal Modeling Using Stata. 2nd ed.. College Station, TX: StataCorp; 2008;

 Editor's Note: You are reading answers to the fourth installment of Annals of Emergency Medicine Journal Club. The questions and the article they are about (Huang et al. Ann Emerg Med. 2008;52:48-58) were published in the July 2008 issue.1 We thank Dr. Huang and his colleagues for sharing additional data with us, which we used in answering question 4.Information about journal club can be found at http://www.annemergmed.com/content/journalclub.Readers should recognize that these are suggested answers. We hope they are accurate; we know that they are not comprehensive. There are many other points that could be made about these questions or about the article in general. Questions are rated “novice,” () “intermediate,” () and “advanced” () so that individuals planning a journal club can assign the right question to the right student. The “novice” rating does not imply that a novice should be able to spontaneously answer the question. “Novice” means we expect that someone with little background should be able to do a bit of reading, formulate an answer, and teach the material to others. Intermediate and advanced questions also will likely require some reading and research, and that reading will be sufficiently difficult that some background in clinical epidemiology will be helpful in understanding the reading and concepts.We are interested in receiving feedback about this feature. Please e-mail journalclub@acep.org with your comments.

PII: S0196-0644(08)01487-X

doi: 10.1016/j.annemergmed.2008.07.010

Annals of Emergency Medicine
Volume 52, Issue 6 , Pages 754-763 , December 2008

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