ArticleBMC infectious diseases2026
Design and validation of revised medication assessment tool for community-acquired Pneumonia: rMAT-CAP.
Article in BMC infectious diseases, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
backgroundEvaluating therapeutic appropriateness is a cornerstone of antimicrobial stewardship. The original Medication Assessment Tool for Community-Acquired Pneumonia (MAT-CAP), developed in Norway, requires adaptation to account for evolving IDSA/ATS recommendations and region-specific antimicrobial resistance patterns in the UAE. To revise, adapt, and validate a Medication Assessment Tool for Community-Acquired Pneumonia (rMAT-CAP), adapted to the UAE healthcare context.
methodsA methodological study was conducted in three phases: (1) systematic revision of MAT-CAP indicators in accordance with 2019 IDSA/ATS guidelines and UAE resistance data; (2) content validation through a multidisciplinary Delphi panel of 10 experts; and (3) psychometric validation using inter-rater reliability and criterion validity assessments based on 30 anonymized CAP cases.
resultsThe rMAT-CAP comprised 13 explicit, guideline-aligned criteria covering empirical therapy, microbiological diagnostics, dose adjustment, IV-to-oral switch, and treatment duration. Content validity indices were excellent (mean I-CVI = 0.95; S-CVI/Ave = 0.95). Inter-rater reliability demonstrated almost perfect agreement for the drug domain (κ = 0.87; absolute agreement 90.0%, 95% CI: 73.5-97.9%), substantial agreement for the dose domain (κ = 0.64; absolute agreement 73.3%, 95% CI: 54.1-86.6%), and moderate agreement for the duration domain (κ = 0.45; absolute agreement 80.0%, 95% CI: 61.4-91.1%). Criterion validity showed strong diagnostic performance: sensitivity 100% (95% CI: 83.9-100%), specificity 62.5% (95% CI: 30.6-86.3%), PPV 88.0% (95% CI: 69.0-96.7%), NPV 100% (95% CI: 56.6-100%), and overall accuracy 90.0% (95% CI: 73.5-97.9%).
conclusionThe rMAT-CAP is a valid, reliable, and contextually relevant tool for evaluating therapeutic appropriateness in CAP management. Its structured approach supports antimicrobial stewardship initiatives and facilitates standardized audit and feedback in UAE hospitals.
trial registrationClinical trial number: not applicable.
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