ReviewClinical infectious diseases : an official publication of the Infectious Diseases Society of America2017
Addressing the Analytic Challenges of Cross-Sectional Pediatric Pneumonia Etiology Data.
Review in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers.
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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.
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Who cites it
24 citing papers in PubMed.
- A case-control study of the causes of acute respiratory infection among hospitalized patients in Northeastern Laos.Scientific reports · 2022Trial
- Aetiology of acute respiratory infection in Vientiane, Lao PDR, from a case-control study.Scientific reports · 2026Article
- Comparison of the effectiveness of penicillin and broad-spectrum β-lactam antibiotics in the treatment of community-acquired pneumonia in children.Archives of medical science : AMS · 2026Article
- Recent Advances in and Application of Fluorescent Microspheres for Multiple Nucleic Acid Detection.Biosensors · 2024Review
- Burden of respiratory syncytial virus diseases among under 5 children in Sub-Saharan Africa:Heliyon · 2023Article
- Viral etiologies of lower respiratory tract infections in children < 5 years of age in Addis Ababa, Ethiopia: a prospective case-control study.Virology journal · 2023Article
- Etiology of acute febrile illness in the peruvian amazon as determined by modular formatted quantitative PCR: a protocol for RIVERA, a health facility-based case-control study.BMC public health · 2023Article
- The global burden of hospitalisation due to pneumonia caused byEClinicalMedicine · 2022Article
- Viral loads in nasopharyngeal aspirates and tracheal aspirates among children hospitalized with invasive ventilation for human adenovirus pneumonia.Virology journal · 2021Article
- Aetiology of acute respiratory infection in preschool children requiring hospitalisation in Europe-results from the PED-MERMAIDS multicentre case-control study.BMJ open respiratory research · 2021Article
- Probabilistic cause-of-disease assignment using case-control diagnostic tests: A latent variable regression approach.Statistics in medicine · 2021Article
- The Predictive Performance of a Pneumonia Severity Score in Human Immunodeficiency Virus-negative Children Presenting to Hospital in 7 Low- and Middle-income Countries.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Challenges in the Diagnosis and Management of Bacterial Lung Infections in Solid Organ Recipients: A Narrative Review.International journal of molecular sciences · 2020Review
- Article
- The Usefulness of Lung Ultrasound for the Aetiological Diagnosis of Community-Acquired Pneumonia in Children.Scientific reports · 2019Article
- Causes of severe pneumonia requiring hospital admission in children without HIV infection from Africa and Asia: the PERCH multi-country case-control study.Lancet (London, England) · 2019Article
- Pneumococcal pneumonia prevalence among adults with severe acute respiratory illness in Thailand - comparison of Bayesian latent class modeling and conventional analysis.BMC infectious diseases · 2019Article
- Introducing a New Algorithm for Classification of Etiology in Studies on Pediatric Pneumonia: Protocol for the Trial of Respiratory Infections in Children for Enhanced Diagnostics Study.JMIR research protocols · 2019Article
- Bacteria and viruses in the nasopharynx immediately prior to onset of acute lower respiratory infections in Indigenous Australian children.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2018Article
- Investigating Pneumonia Etiology Among Refugees and the Lebanese population (PEARL): A study protocol.Gates open research · 2018Article
Corrections and comments
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Authors and funding
7 authors.
Funding
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Abstract
Despite tremendous advances in diagnostic laboratory technology, identifying the pathogen(s) causing pneumonia remains challenging because the infected lung tissue cannot usually be sampled for testing. Consequently, to obtain information about pneumonia etiology, clinicians and researchers test specimens distant to the site of infection. These tests may lack sensitivity (eg, blood culture, which is only positive in a small proportion of children with pneumonia) and/or specificity (eg, detection of pathogens in upper respiratory tract specimens, which may indicate asymptomatic carriage or a less severe syndrome, such as upper respiratory infection). While highly sensitive nucleic acid detection methods and testing of multiple specimens improve sensitivity, multiple pathogens are often detected and this adds complexity to the interpretation as the etiologic significance of results may be unclear (ie, the pneumonia may be caused by none, one, some, or all of the pathogens detected). Some of these challenges can be addressed by adjusting positivity rates to account for poor sensitivity or incorporating test results from controls without pneumonia to account for poor specificity. However, no classical analytic methods can account for measurement error (ie, sensitivity and specificity) for multiple specimen types and integrate the results of measurements for multiple pathogens to produce an accurate understanding of etiology. We describe the major analytic challenges in determining pneumonia etiology and review how the common analytical approaches (eg, descriptive, case-control, attributable fraction, latent class analysis) address some but not all challenges. We demonstrate how these limitations necessitate a new, integrated analytical approach to pneumonia etiology data.
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