Evidence map›Paper›PMID 27170017›Full record

ArticleJournal of clinical microbiology2016

Proposal for a New Score-Based Approach To Improve Efficiency of Diagnostic Laboratory Workflow for Acute Bacterial Meningitis in Adults.

Filippo Lagi, Filippo Bartalesi, Patrizia Pecile, Tiziana Biagioli, Anna Lucia Caldini, Alessandra Fanelli, Giuseppe Giannazzo, Stefano Grifoni, Luca Massacesi, Alessandro Bartoloni and 1 more

Abstract readEvaluation Study
In one paragraph

Article in Journal of clinical microbiology, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Clinical impact of cerebrospinal fluid Gram stain and culture testing: A retrospective cohort study.Journal of the Association of Medical Microbiology and Infectious Disease Canada = Journal officiel de l'Association pour la microbiologie medicale et l'infectiologie Canada · 2019
    Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors.

Filippo LagiDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Filippo BartalesiInfectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy.
Patrizia PecileClinical Microbiology and Virology Unit, Careggi University Hospital, Florence, Italy.
Tiziana BiagioliGeneral Laboratory, Careggi University Hospital, Florence, Italy.
Anna Lucia CaldiniGeneral Laboratory, Careggi University Hospital, Florence, Italy.
Alessandra FanelliGeneral Laboratory, Careggi University Hospital, Florence, Italy.
Giuseppe GiannazzoDepartment of Emergency Medicine, Careggi University Hospital, Florence, Italy.
Stefano GrifoniDepartment of Emergency Medicine, Careggi University Hospital, Florence, Italy.
Luca MassacesiDivision Neurology 2, Careggi University Hospital, Florence, Italy.
Alessandro BartoloniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Gian Maria RossoliniDepartment of Experimental and Clinical Medicine, University of Florence, Florence, Italy gianmaria.rossolini@unifi.it.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Microbiological tests on cerebrospinal fluid (CSF) utilize a common urgent-care procedure that does not take into account the chemical and cytological characteristics of the CSF, resulting sometimes in an unnecessary use of human and diagnostic resources. The aim of this study was to retrospectively validate a simple scoring system (bacterial meningitis-Careggi score [BM-CASCO]) based on blood and CSF sample chemical/cytological parameters for evaluating the probability of acute bacterial meningitis (ABM) in adults. BM-CASCO (range, 0 to 6) was defined by the following parameters: CSF cell count, CSF protein levels, CSF lactate levels, CSF glucose-to-serum glucose ratio, and peripheral neutrophil count. BM-CASCO was retrospectively calculated for 784 cases of suspected ABM in adult subjects observed during a four-and-a-half-year-period (2010 to 2014) at the emergency department (ED) of a large tertiary-care teaching hospital in Italy. Among the 28 confirmed ABM cases (3.5%), Streptococcus pneumoniae was the most frequent cause (16 cases). All ABM cases showed a BM-CASCO value of ≥3. Most negative cases (591/756) exhibited a BM-CASCO value of ≤1, which was adopted in our laboratory as a cutoff to not proceed with urgent microbiological analysis of CSF in cases of suspected ABM in adults. During a subsequent 1-year follow-up, the introduction of the BM-CASCO in the diagnostic workflow of ABM in adults resulted in a significant decrease in unnecessary microbiological analysis, with no false negatives. In conclusion, BM-CASCO appears to be an accurate and simple scoring system for optimization of the microbiological diagnostic workflow of ABM in adults.

Indexed as

Decision Support TechniquesWorkflowAdultAgedAged, 80 and overBlood CellsCerebrospinal FluidClinical Laboratory TechniquesDiagnostic Tests, RoutineFemaleHumansItalyLeukocyte CountMaleMeningitis, BacterialMiddle Aged

Identifiers

PMID27170017
PMCPMC4922106

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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.