Shiloh
Editor, Senior Moderator
Source: http://www.cidrap.umn.edu/news-perspective/2020/01/stewardship-resistance-scan-jan-21-2020
Stewardship / Resistance Scan for Jan 21, 2020
Award for gene library, diagnostics; Decision support stewardship
Filed Under:
Diagnostics; Antimicrobial Stewardship
[h=3]Researchers awarded $25 million for diagnostics based on gene signatures[/h] Imperial College London announced yesterday that it has won a €22.5 million ($25 million US) grant to work with researchers in 15 countries over 5 years to develop a rapid test to diagnose infectious diseases based on personalized gene signatures after taking the next 2 years to develop a library of gene signatures covering common infections and other diseases.
The new approach could speed diagnosis for serious conditions like pneumonia, tuberculosis, sepsis, meningitis, and inflammatory and immune diseases to under 2 hours, the College said in a news release. The researchers believe diagnoses could be made accurately and rapidly on the first blood sample taken when a patient attends a hospital or clinic by identifying the pattern of genes switched on in each patient's blood.
"In the future the whole basis of medical diagnosis could be based on molecular signatures," said Imperial team lead Mike Levin, MBE, PhD. Previous research by Imperial College investigators indicated that using unique gene signatures can predict a bacterial infection with 95% to 100% accuracy. Rapid diagnostics for infections can lower costs, improve patient outcomes, and reduce antimicrobial resistance.
The international group, comprising scientists from 11 European nations and Australia, Gambia, Nepal, and Taiwan, will, in the next 2 years, build a library of gene signatures in which the signatures of all common infectious and inflammatory diseases will be stored and made publicly available.
Jan 20 Imperial College news release
[h=3]Meta-analysis shows stewardship promise for decision support tools[/h] A meta-analysis demonstrates that clinical decision support systems (CDSSs) may effectively improve antibiotic prescribing, although there is limited evidence available on the use of such tools in primary care, according to a study yesterday in the Journal of Antimicrobial Chemotherapy.
Investigators noted that most of the 57 studies that reported on CDSS effectiveness were non-randomized trials with low methodologic quality, but they were able to separately assess the randomized controlled trials (RTCs), which were of moderate methodologic quality. Overall, 26 studies reported data on the appropriateness of antibiotic therapy, with 23 conducted in hospitals and 2 in primary care.
Of the hospital studies, 20 (including 2 RCTs) yielded sufficient data for the meta-analysis. The researchers found that appropriate antibiotic therapy was twice as likely to occur following the implementation of CDSSs (odds ratio [OR], 2.28, 95% confidence interval [CI], 1.82 to 2.86). Results for the 2 RCTs, however, were less rosy, with a 1.24 OR (95% CI, 0.95-1.62).
The use of CDSSs was also associated with an 18% relative decrease in mortality (OR 0.82, 95% CI, 0.73 to 0.91) among the 18 studies (2 RCTs) that analyzed that metric. CDSS implementation was also tied to less antibiotic use and decreased hospital stays, antibiotic duration, and cost of therapy.
The authors conclude, "Our findings suggest that a focus on system requirements and implementation processes would improve CDSS uptake and provide more definitive benefits for antibiotic stewardship."
Jan 20 J Antimicrob Chemother abstract
Stewardship / Resistance Scan for Jan 21, 2020
Award for gene library, diagnostics; Decision support stewardship
Filed Under:
Diagnostics; Antimicrobial Stewardship
[h=3]Researchers awarded $25 million for diagnostics based on gene signatures[/h] Imperial College London announced yesterday that it has won a €22.5 million ($25 million US) grant to work with researchers in 15 countries over 5 years to develop a rapid test to diagnose infectious diseases based on personalized gene signatures after taking the next 2 years to develop a library of gene signatures covering common infections and other diseases.
The new approach could speed diagnosis for serious conditions like pneumonia, tuberculosis, sepsis, meningitis, and inflammatory and immune diseases to under 2 hours, the College said in a news release. The researchers believe diagnoses could be made accurately and rapidly on the first blood sample taken when a patient attends a hospital or clinic by identifying the pattern of genes switched on in each patient's blood.
"In the future the whole basis of medical diagnosis could be based on molecular signatures," said Imperial team lead Mike Levin, MBE, PhD. Previous research by Imperial College investigators indicated that using unique gene signatures can predict a bacterial infection with 95% to 100% accuracy. Rapid diagnostics for infections can lower costs, improve patient outcomes, and reduce antimicrobial resistance.
The international group, comprising scientists from 11 European nations and Australia, Gambia, Nepal, and Taiwan, will, in the next 2 years, build a library of gene signatures in which the signatures of all common infectious and inflammatory diseases will be stored and made publicly available.
Jan 20 Imperial College news release
[h=3]Meta-analysis shows stewardship promise for decision support tools[/h] A meta-analysis demonstrates that clinical decision support systems (CDSSs) may effectively improve antibiotic prescribing, although there is limited evidence available on the use of such tools in primary care, according to a study yesterday in the Journal of Antimicrobial Chemotherapy.
Investigators noted that most of the 57 studies that reported on CDSS effectiveness were non-randomized trials with low methodologic quality, but they were able to separately assess the randomized controlled trials (RTCs), which were of moderate methodologic quality. Overall, 26 studies reported data on the appropriateness of antibiotic therapy, with 23 conducted in hospitals and 2 in primary care.
Of the hospital studies, 20 (including 2 RCTs) yielded sufficient data for the meta-analysis. The researchers found that appropriate antibiotic therapy was twice as likely to occur following the implementation of CDSSs (odds ratio [OR], 2.28, 95% confidence interval [CI], 1.82 to 2.86). Results for the 2 RCTs, however, were less rosy, with a 1.24 OR (95% CI, 0.95-1.62).
The use of CDSSs was also associated with an 18% relative decrease in mortality (OR 0.82, 95% CI, 0.73 to 0.91) among the 18 studies (2 RCTs) that analyzed that metric. CDSS implementation was also tied to less antibiotic use and decreased hospital stays, antibiotic duration, and cost of therapy.
The authors conclude, "Our findings suggest that a focus on system requirements and implementation processes would improve CDSS uptake and provide more definitive benefits for antibiotic stewardship."
Jan 20 J Antimicrob Chemother abstract