Evidence map›Paper›PMID 41063310›Full record

ArticleAntimicrobial resistance and infection control2025

Central venous catheter infections: building a causal model with expert domain knowledge to inform future clinical trials.

Jessica A Schults, Yue Wu, Thomas Snelling, Gladymar Pérez Chacón, Daner Ball, Karina Charles, Julie Marsh, Charlie McLeod, Hideto Yasuda, Claire M Rickard

Abstract read
In one paragraph

Article in Antimicrobial resistance and infection control, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
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

2 citing papers in PubMed.

  1. Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

10 authors.

Jessica A SchultsHerston Infectious Diseases Institute, Metro North Health, Brisbane, QLD, Australia. j.schults@uq.edu.au.
Yue WuSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Thomas SnellingSydney School of Public Health, Faculty of Medicine and Health, The University of Sydney, Camperdown, NSW, Australia.
Gladymar Pérez ChacónWesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute, Nedlands, WA, Australia.
Daner BallHerston Infectious Diseases Institute, Metro North Health, Brisbane, QLD, Australia.
Karina CharlesHerston Infectious Diseases Institute, Metro North Health, Brisbane, QLD, Australia.
Julie MarshWesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute, Nedlands, WA, Australia.
Charlie McLeodWesfarmers Centre of Vaccines and Infectious Diseases, The Kids Research Institute, Nedlands, WA, Australia.
Hideto YasudaDepartment of Emergency and Critical Care Medicine, Jichi Medical University Saimata Medical Center, Saitama, Japan.
Claire M RickardHerston Infectious Diseases Institute, Metro North Health, Brisbane, QLD, Australia.

Funding

National Health and Medical Research Council GNT2016399
6 · The paper itself

Abstract

aimCentral venous catheters (CVCs) are essential for long-term therapies but carry a high risk of central line-associated bloodstream infections (CLABSIs), which significantly impact patient outcomes and healthcare costs. This study aimed to develop a causal model for CLABSI using expert knowledge to guide future clinical trials and prevention strategies.

methodsWe constructed a directed acyclic graph (DAG) informed by literature and expert knowledge elicitation. A multidisciplinary team of clinicians, including infectious disease and vascular access experts, participated in interviews and workshops to refine the DAG, resulting in a final model with 30 variables representing CLABSI development.

findingsThe expert-elicited DAG identified two main pathways, patient-related and CVC-related, each contributing to CLABSI risk. Variables and relationships in the DAG highlighted key patient characteristics, CVC management practices, and overlapping factors influencing infection. This model serves as a novel framework to understand CLABSI causation and supports trial design by identifying confounding factors, causal pathways, and meaningful endpoints. CONCLUSIONS/IMPLICATIONS: Our causal DAG provides a structured representation of CLABSI risk factors, which may support the design of clinical trials examining interventions to reduce CVC-related infections. By clarifying causal mechanisms, the DAG can enhance the specificity of endpoints and improve the rigor of prevention strategies.

Indexed as

Catheterization, Central VenousCatheter-Related InfectionsCentral Venous CathetersClinical Trials as TopicHumansRisk FactorsCausal modellingCentral venous catheterCLABSIClinical trial designDirected acyclic graphInfection controlInfection prevention

Identifiers

PMID41063310
PMCPMC12506371

What OpenQuestion holds

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LicenceCC BY
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Registered trials

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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.