ArticleInfection control and hospital epidemiology2023
Healthcare providers consistently overestimate the diagnostic probability of ventilator-associated pneumonia.
Article in Infection control and hospital epidemiology, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.
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Who cites it
6 citing papers in PubMed.
- Reductions in ventilator-associated events following implementation of a ventilator-associated pneumonia diagnostic stewardship intervention: A difference-in-difference study.Infection control and hospital epidemiology · 2026Article
- Respiratory multiplex PCR and antimicrobial treatment modification in hospitalized patients with community-acquired pneumonia.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Ventilator-Associated Pneumonia, Ventilator-Associated Events, and Nosocomial Respiratory Viral Infections on the Leeside of the Pandemic.Respiratory care · 2024Review
- Improvement in Diagnosis and Management of Nosocomial Pneumonias in a Cardiovascular Surgery Intensive Care Unit: A Multidisciplinary Approach.Antibiotics (Basel, Switzerland) · 2024Article
- Breaking Boundaries in Pneumonia Diagnostics: Transitioning from Tradition to Molecular Frontiers with Multiplex PCR.Diagnostics (Basel, Switzerland) · 2024Review
- A quasi-experimental study of a bundled diagnostic stewardship intervention for ventilator-associated pneumonia.Clinical microbiology and infection : the official publication of the European Society of Clinical Microbiology and Infectious Diseases · 2024Article
Corrections and comments
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Authors and funding
2 authors.
Funding
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Abstract
objectiveTo assess the accuracy of provider estimates of ventilator-associated pneumonia (VAP) diagnostic probability in various clinical scenarios.
designWe conducted a clinical vignette-based survey of intensive care unit (ICU) physicians to evaluate provider estimates of VAP diagnostic probability before and after isolated cardinal VAP clinical changes and VAP diagnostic test results. Responses were used to calculate imputed diagnostic likelihood ratios (LRs), which were compared to evidence-based LRs.
settingMichigan Medicine University Hospital, a tertiary-care center.
participantsThis study included 133 ICU clinical faculty and house staff.
resultsProvider estimates of VAP diagnostic probability were consistently higher than evidence-based diagnostic probabilities. Similarly, imputed LRs from provider-estimated diagnostic probabilities were consistently higher than evidence-based LRs. These differences were most notable for positive bronchoalveolar lavage culture (provider-estimated LR 5.7 vs evidence-based LR 1.4;
conclusionsPhysicians routinely overestimated the diagnostic probability of VAP as well as the positive LRs of isolated cardinal VAP clinical changes and VAP diagnostic test results. Diagnostic stewardship initiatives, including educational outreach and clinical decision support systems, may be useful adjuncts in minimizing VAP overdiagnosis and ICU antibiotic overuse.
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