ArticleOpen forum infectious diseases2023
An Adjudication Protocol for Severe Pneumonia.
Article in Open forum infectious diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 26 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
26 citing papers in PubMed, 30 citations in OpenAlex.
- Comparing clinical assessments of pneumonia to bronchoalveolar lavage results in critically ill patients with suspected pneumonia.Annals of the American Thoracic Society · 2026Observational
- Pathogen-specific host responses define distinct pneumonia endotypes in the human lung.bioRxiv : the preprint server for biology · 2026Article
- Development of a Pilot Machine Learning Model to Predict Successful Short-Term Treatment Success in Critically Ill Patients With Community-Acquired Pneumonia.CHEST critical care · 2026Article
- Developing and externally validating machine learning models to forecast short-term risk of ventilator-associated pneumonia.medRxiv : the preprint server for health sciences · 2026Article
- Targeted next-generation sequencing-based pathogens detection in children with severe pneumonia in the pediatric intensive care unit.Frontiers in pediatrics · 2026Article
- Adjudication instrument for infection in critically injured trauma patients.Trauma surgery & acute care open · 2026Article
- Clinical impact of a commercial multiplex pathogen panel for the detection of bacteria in sputum specimens from non-ICU patients with suspected lower respiratory tract infection.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2026Article
- Transitions in lung microbiota landscape associate with distinct patterns of pneumonia progression.Cell host & microbe · 2025Article
- Large language models accurately identify immunosuppression in intensive care unit patients.Journal of the American Medical Informatics Association : JAMIA · 2025Article
- Microbial cell-free DNA sequencing of bronchoalveolar lavage fluid improves diagnostic yield and may add clinical utility in immunocompromised patients with severe pneumonia.medRxiv : the preprint server for health sciences · 2025Article
- Performance evaluation of a commercial multiplex pathogen panel for detection of bacteria in sputum specimens from non-ICU patients with suspected lower respiratory tract infection.Microbiology spectrum · 2025Article
- Beyond Accuracy: Methodological Advances for Assessing the Clinical Impact of Infectious Disease Diagnostics.Open forum infectious diseases · 2025Article
- Ventilator-associated pneumonia biomarker evaluation (VIBE) study: protocol for a prospective, observational, case-cohort study.BMJ open · 2025Article
- Antibiotic de-escalation patterns and outcomes in critically ill patients with suspected pneumonia as informed by bronchoalveolar lavage results.European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology · 2025Article
- Developing and validating machine learning models to predict next-day extubation.Scientific reports · 2025Article
- Novel enzyme-based reduced representation method for DNA methylation profiling with low inputs.Nucleic acids research · 2025Article
- Article
- An Observational Cohort Study of Bronchoalveolar Lavage Fluid Galactomannan andOpen forum infectious diseases · 2025Article
- Large language models outperform traditional structured data-based approaches in identifying immunosuppressed patients.medRxiv : the preprint server for health sciences · 2025Article
- Neutrophil percentages in bronchoalveolar lavage fluid: Implications for diagnosing bacterial pneumonia in patients with immunocompromise and neutropenia.medRxiv : the preprint server for health sciences · 2024Article
Corrections and comments
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Authors and funding
12 authors at 1 institution in 1 country.
Funding
Abstract
Background: Clinical end points that constitute successful treatment in severe pneumonia are difficult to ascertain and vulnerable to bias. The utility of a protocolized adjudication procedure to determine meaningful end points in severe pneumonia has not been well described. Methods: This was a single-center prospective cohort study of patients with severe pneumonia admitted to the medical intensive care unit. The objective was to develop an adjudication protocol for severe bacterial and/or viral pneumonia. Each episode of pneumonia was independently reviewed by 2 pulmonary and critical care physicians. If a discrepancy occurred between the 2 adjudicators, a third adjudicator reviewed the case. If a discrepancy remained after all 3 adjudications, consensus was achieved through committee review. Results: Evaluation of 784 pneumonia episodes during 593 hospitalizations achieved only 48.1% interobserver agreement between the first 2 adjudicators and 78.8% when agreement was defined as concordance between 2 of 3 adjudicators. Multiple episodes of pneumonia and presence of bacterial/viral coinfection in the initial pneumonia episode were associated with lower interobserver agreement. For an initial episode of bacterial pneumonia, patients with an adjudicated day 7-8 clinical impression of cure (compared with alternative impressions) were more likely to be discharged alive (odds ratio, 6.3; 95% CI, 3.5-11.6). Conclusions: A comprehensive adjudication protocol to identify clinical end points in severe pneumonia resulted in only moderate interobserver agreement. An adjudicated end point of clinical cure by day 7-8 was associated with more favorable hospital discharge dispositions, suggesting that clinical cure by day 7-8 may be a valid end point to use in adjudication protocols.
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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.