ArticleEClinicalMedicine2020
Sensitivity of the Kaiser Permanente early-onset sepsis calculator: A systematic review and meta-analysis.
Article in EClinicalMedicine, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 34 papers.
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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.
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Who cites it
34 citing papers in PubMed.
- Antibiotic stewardship in the context of management of early onset neonatal sepsis-an evolving paradigm shift.World journal of clinical pediatrics · 2026Review
- Delineating the risk factors, sources of acquisition and clinical outcomes in neonates colonised with multidrug-resistant bacteria: the NeoCol study.Nature communications · 2026Article
- Aligning neonatal sepsis triage diagnostics with WHO target product profiles in low- and middle-income countries.BMJ global health · 2026Review
- Systems biology approaches to unravelling neonatal sepsis and potential for precision diagnostics and therapeutics.Frontiers in pharmacology · 2026Review
- Maternal and Perinatal Outcomes Associated with Intrapartum Antibiotic Regimens in Women with Prolonged Membrane Rupture and Unknown Group B Streptococcus Status: A Retrospective Comparative Study.Gynecologic and obstetric investigation · 2026Article
- Preterm meconium-stained amniotic fluid: A red flag for infection and adverse perinatal outcomes.International journal of gynaecology and obstetrics: the official organ of the International Federation of Gynaecology and Obstetrics · 2026Article
- Clinical Outcomes of the Adapted AAP 2019 Guidelines on Early Onset Sepsis in Thailand.Antibiotics (Basel, Switzerland) · 2025Article
- Safety and effectiveness of the early-onset sepsis calculator to reduce antibiotic exposure in at-risk newborns: a cluster-randomised controlled trial.EClinicalMedicine · 2025Article
- Negative Healthcare Impacts of Management of Presumed Early-Onset Sepsis in Moderate to Late Preterm Infants on Feeding, Jaundice, and Hospital Length of Stay.Healthcare (Basel, Switzerland) · 2025Article
- Safety and effectiveness of the Kaiser Permanente early-onset neonatal sepsis calculator in Qatar.Frontiers in pediatrics · 2025Article
- Implementation of an EOS calculator-based protocol decreased infant antibiotic exposure in chorioamnionitis without correlation with placental histopathology.Journal of perinatology : official journal of the California Perinatal Association · 2025Observational
- Predictive gene expression signature diagnoses neonatal sepsis before clinical presentation.EBioMedicine · 2024Article
- Clinical and economic impacts of a modified-observational screening approach to well-appearing infants born to mothers with chorioamnionitis.Journal of perinatology : official journal of the California Perinatal Association · 2024Article
- Differences in maternal-newborn ABO blood groups and risk of serious infant infection.QJM : monthly journal of the Association of Physicians · 2024Article
- Evaluating a Modified Use of the Kaiser Permanente Early-onset Sepsis Risk Calculator to Reduce Antibiotic Exposure: a Retrospective Study.BMJ paediatrics open · 2024Article
- Antimicrobial stewardship and targeted therapies in the changing landscape of maternal sepsis.Journal of intensive medicine · 2024Review
- Neonatal Sepsis: Aetiology, Pathophysiology, Diagnostic Advances and Management Strategies.Clinical medicine insights. Pediatrics · 2024Review
- Barriers and Facilitators to the Implementation of the Early-Onset Sepsis Calculator: A Multicenter Survey Study.Children (Basel, Switzerland) · 2023Article
- Kaiser Permanente early-onset sepsis calculator as a safe tool for reducing antibiotic use among chorioamnionitis-exposed term neonates: Qatar experience.BMJ open quality · 2023Article
- Article
Corrections and comments
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Authors and funding
4 authors.
Funding
Abstract
backgroundDetermining which babies should receive antibiotics for potential early onset sepsis (EOS) is challenging. We performed a meta-analysis quantifying how many EOS cases might be 'missed' using the Kaiser Permanente electronic calculator, compared with National Institute for Health and Care Excellence (NICE) guidelines.
methodsA systematic literature search was carried out for studies citing the article in which the calculator was publicised. Studies were eligible if they presented data evaluating the calculator, either by retrospective case review or prospective cohort study. The primary outcome measure was numbers of culture positive EOS cases where the calculator did not recommend empirical antibiotics, but NICE guidelines would have. Data were pooled using a random effect meta-analysis. A subgroup analysis was performed using data from studies of babies exposed to chorioamnionitis.
findingsEleven studies were included. There were a total of 75 EOS cases across the studies and a minimum of 14 (best case scenario), and a maximum of 22 (worst case scenario) cases where use of the calculator would have resulted in delayed or missed treatment, compared to if NICE guidelines had been followed. The probability of missed/delayed treatment for an EOS case were best case 0.19 [95% confidence intervals 0.11 - 0.29], worst case 0.31 [95% CI 0.17 - 0.49]. The probability of missing cases was significantly more in babies exposed to chorioamnionitis.
interpretationA large proportion of EOS cases were 'missed' by the calculator. Further evaluation of the calculator is recommended before it is introduced into UK clinical practice.
fundingNone.
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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.