Evidence map›Paper›PMID 36104292›Full record

ArticleThe European respiratory journal2022

A biomarker assay to risk-stratify patients with symptoms of respiratory tract infection.

Shahid Husain, Andrew T Sage, Lorenzo Del Sorbo, Marcelo Cypel, Tereza Martinu, Stephen C Juvet, Andrea Mariscal, Julie Wright, Bonnie T Chao, Alaa A Shamandy and 22 more

Open access · hybridAbstract readMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Article in The European respiratory journal, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.2field-weighted citation impact, top 20% of its field
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

6 citing papers in PubMed, 8 citations in OpenAlex.

  1. Multi-site cytokine levels are predictive of primary graft dysfunction following lung transplantation.Transplant international : official journal of the European Society for Organ Transplantation · 2026
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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

32 authors at 5 institutions in 3 countries.

Shahid HusainDivision of Infectious Diseases, Toronto General Hospital, University Health Network, University of Toronto, Toronto, ON, Canada.
Andrew T SageToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Lorenzo Del SorboToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Marcelo CypelToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Tereza MartinuToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Stephen C JuvetToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0002-7243-556X
Andrea MariscalToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Julie WrightTropical Disease Unit, Department of Medicine, University of Toronto, Sandra Rotman Centre for Global Health, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Bonnie T ChaoToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Alaa A ShamandyDepartment of Computer Science, University of Toronto, Toronto, ON, Canada.ORCID https://orcid.org/0000-0001-7074-437X
S Hossein MousaviToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Jin MaBiostatistics Research Unit, University Health Network, Toronto, ON, Canada.
Bo WangDepartment of Computer Science, University of Toronto, Toronto, ON, Canada.
Jerome ValeroToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Mingyao LiuToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Megan LandesDepartment of Emergency Medicine, University Health Network, Toronto, ON, Canada.
Sharaniyaa BalachandranToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Kimberley HudsonToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada.
Michelle NgaiTropical Disease Unit, Department of Medicine, University of Toronto, Sandra Rotman Centre for Global Health, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Marialessia CapuanoDivision of Emergency Medicine and High Dependency Unit, Cittá della Salute e della Scienza di Torino Hospital-Molinette Site, Department of Medical Sciences, University of Turin, Turin, Italy.
Maria GelardiDivision of Emergency Medicine and High Dependency Unit, Cittá della Salute e della Scienza di Torino Hospital-Molinette Site, Department of Medical Sciences, University of Turin, Turin, Italy.
Enrico LupiaDivision of Emergency Medicine and High Dependency Unit, Cittá della Salute e della Scienza di Torino Hospital-Molinette Site, Department of Medical Sciences, University of Turin, Turin, Italy.
Daniel R MarinowicSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Frederico O FriedrichSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Carine R R SchmitzBiochemistry, Federal University of Rio Grande do Sul, Porto Alegre, Brazil.
Leticya S M Dos SantosSchool of Health, Sciences and Life, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Florencia M Barbe-TuanaSchool of Health, Sciences and Life, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Marcus H JonesSchool of Medicine, Pontifical Catholic University of Rio Grande do Sul, Porto Alegre, Brazil.
Kevin C KainTropical Disease Unit, Department of Medicine, University of Toronto, Sandra Rotman Centre for Global Health, University Health Network, Toronto General Hospital, Toronto, ON, Canada.
Tony MazzulliDepartment of Microbiology, Mount Sinai Hospital, Toronto, ON, Canada.
Sam SabbahDepartment of Emergency Medicine, University Health Network, Toronto, ON, Canada.
Shaf KeshavjeeToronto Lung Transplant Program and Latner Thoracic Research Laboratories, Toronto General Hospital Research Institute, University Health Network, University of Toronto, Toronto, ON, Canada shaf.keshavjee@uhn.ca.ORCID https://orcid.org/0000-0003-4547-8094
University Health Network · CAPontifícia Universidade Católica do Rio Grande do Sul · BRUniversity of Turin · ITMount Sinai Hospital · CAUniversidade Federal do Rio Grande do Sul · BR

Funding

CIHR FRN 440205
6 · The paper itself

Abstract

backgroundPatients who present to an emergency department (ED) with respiratory symptoms are often conservatively triaged in favour of hospitalisation. We sought to determine if an inflammatory biomarker panel that identifies the host response better predicts hospitalisation in order to improve the precision of clinical decision making in the ED.

methodsFrom April 2020 to March 2021, plasma samples of 641 patients with symptoms of respiratory illness were collected from EDs in an international multicentre study: Canada (n=310), Italy (n=131) and Brazil (n=200). Patients were followed prospectively for 28 days. Subgroup analysis was conducted on confirmed coronavirus disease 2019 (COVID-19) patients (n=245). An inflammatory profile was determined using a rapid, 50-min, biomarker panel (RALI-Dx (Rapid Acute Lung Injury Diagnostic)), which measures interleukin (IL)-6, IL-8, IL-10, soluble tumour necrosis factor receptor 1 (sTNFR1) and soluble triggering receptor expressed on myeloid cells 1 (sTREM1).

resultsRALI-Dx biomarkers were significantly elevated in patients who required hospitalisation across all three sites. A machine learning algorithm that was applied to predict hospitalisation using RALI-Dx biomarkers had a mean±sd area under the receiver operating characteristic curve of 76±6% (Canada), 84±4% (Italy) and 86±3% (Brazil). Model performance was 82±3% for COVID-19 patients and 87±7% for patients with a confirmed pneumonia diagnosis.

conclusionsThe rapid diagnostic biomarker panel accurately identified the need for inpatient care in patients presenting with respiratory symptoms, including COVID-19. The RALI-Dx test is broadly and easily applicable across many jurisdictions, and represents an important diagnostic adjunct to advance ED decision-making protocols.

Indexed as

COVID-19Respiratory Tract InfectionsBiomarkersEmergency Service, HospitalHumansInterleukin-6ROC CurveBiomarkersInterleukin-6

Identifiers

PMID36104292
PMCPMC9753477
OpenAlexW4295792345

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

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.