ArticleInfection control and hospital epidemiology2009
Identification of a pseudo-outbreak of Clostridium difficile infection (CDI) and the effect of repeated testing, sensitivity, and specificity on perceived prevalence of CDI.
Article in Infection control and hospital epidemiology, 2009. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
11 citing papers in PubMed, 41 citations in OpenAlex.
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- Strategies to preventInfection control and hospital epidemiology · 2023Article
- Dietary fat promotes antibiotic-induced Clostridioides difficile mortality in mice.NPJ biofilms and microbiomes · 2022Article
- When is an outbreak an outbreak? Using literature and discharge data to define Clostridioides difficile incidence changes referred to as outbreaks.The Journal of hospital infection · 2020Article
- The Role of Diagnostic Stewardship inCurrent infectious disease reports · 2020Article
- Impact of an electronic hard-stop clinical decision support tool to limit repeatInfection control and hospital epidemiology · 2019Article
- The impact of ICD-9-CM code rank order on the estimated prevalence of Clostridium difficile infections.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2011Article
- Epidemiological model for Clostridium difficile transmission in healthcare settings.Infection control and hospital epidemiology · 2011Article
- Early Economic Modeling to Inform a Target Product Profile: A Case Study of a Novel Rapid Test forMDM policy & practiceArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
10 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo describe a pseudo-outbreak of Clostridium difficile infection (CDI) caused by a faulty toxin assay lot and to determine the effect of sensitivity, specificity, and repeated testing for C. difficile on perceived CDI burden, positive predictive value, and false-positive results.
designOutbreak investigation and criterion standard. PATIENTS: Patients hospitalized at a tertiary care hospital who had at least 1 toxin assay for detection of C. difficile performed during the period from July 1, 2004, through June 30, 2006.
methodsThe run control chart method and the chi(2) test were used to compare CDI rates and the proportion of positive test results before, during, and after the pseudo-outbreak. The effect of repeated testing was evaluated by using 3 hypothetical models with a sample of 10,000 patients and various assay sensitivity and specificity estimates.
resultsIn November of 2005, the CDI rate at the hospital increased from 1.5 to 2.6 cases per 1,000 patient-days (P < .01), and the proportion of positive test results increased from 13.6% to 22.1% (P < .01). An investigation revealed a pseudo-outbreak caused by a faulty toxin assay lot. A decrease of only 1.2% in the specificity of the toxin assay would result in a 32% increase in perceived incidence of CDI at this institution. When calculated by use of the manufacturer's stated specificity and sensitivity and this institution's testing practices, the positive predictive value of the test decreased from 80.6% to 4.1% for patients who received 3 tests.
conclusionSpecificity is as important as sensitivity when testing for CDI. False-positive CDI cases can drain hospital resources and adversely affect patients. Repeated testing for C. difficile should be performed with caution.
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What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.