Table 2 Studies comparing clinical criteria to other diagnostic (Dx) tests
From: Diagnosis of ventilator-associated pneumonia: a systematic review of the literature
First author | Sample | Dx Tests | Gold standard | Results |
|---|---|---|---|---|
Fabregas, 1999, ** [11] | Medical ICU, 25 pts | Johanson criteria, CPIS, TBA(105), PSB (103), pBAL(104), BAL(104) | Pathology + Culture | • Johanson criteria (2 items): sens = 69%, spec = 75%. • Any Johanson criteria: Chest Rx: sens = 92%, spec = 33%; leukocytosis: sens = 77%, spec = 58%; fever: sens = 46%, spec = 42%; purulent secretions: sens = 69%, spec = 42% • CPIS: sens = 77%, spec = 42%. • TBA sens = 69%, spec = 92%. • pBAL sens = 39%, spec = 100%. • BAL sens = 77%, spec = 58%. • PSB sens = 62%, spec = 75%. • QtC added little to clinical diagnostic accuracy |
Papazian, 1995, ** [17] | Mixed ICU, 38 pts, consecutive | BBS (104) & mini-BAL (103) & PSB (103) & BAL (104) & CPIS | Pathology + Culture | • CPIS: sens = 72%; spec = 85% • BBS (104): sens = 83%, spec = 80% • mini-BAL (103): sens = 67%, spec = 80% • BAL: sens (104) = 58%, spec = 95% • PSB: sens (103) = 42%, spec = 95% • BBS was more accurate than PSB |
Croce, 2006 *, # [18] | Trauma ICU, 158 pts | CPIS (>6) | BAL (105) | • Frequency of VAP: BAL ≥ 105 = 42%, SIRS = 58% • Average CPIS: VAP = 6.9, SIRS = 6.8 • CPIS > 6: sens = 61%, spec = 43% |
Luyt, 2004 *, ** [19] | Mixed ICU, 201 pts | CPIS (>6) | PSB (103) BAL (104) | • CPIS: sens = 89%, spec = 44%, k = 0.33, PPV = 57%, NPV = 84% |
Schurink, 2004, ** [20] | Mixed ICU, 99 pts | CPIS | BAL (104) | • Frequency of VAP = 69% • ROC curve for CIPS > 6, 7 and 8 = 0.54, 0.64, 0.64; r = 0.115 • CPIS > 5: sens = 83%, spec = 17% • CIPS >6 or ≤ 6: k 0.16 |
Fartoukh, 2003, ** [21] | Mixed ICU, 68 pts | CE & PIS (>6) | BAL (104) or PTC (103) | • CE: sens = 50%, spec = 59% • CPIS > 6: sens = 60%, spec = 59% • Adding positive Gram stain to CIPS improves diagnostic accuracy |
Miller, 2006, ** [15] | Trauma ICU, 292 pts | NNIS | BAL (105) | • k = 0.73. • Sens = 84%, spec = 69%, PPV = 83%, NPV = 70% |
Pham, 2007*, ** [23] | Mixed ICU, 28 burn pts | CPIS | BAL | • CPIS: sens = 30%, spec = 80%, PPV = 70%, NPV = 50% |
Pugin, 1991, **, [16] | Surgical ICU, 28 pts, | CPIS & mini-BAL (BI ≥ 5) | BAL (BI ≥ 5) | • CPIS: sens = 93%, spec = 100%, r = 84% (CIPS and mini-BAL), r = 76% (CPIS and BAL) • Mini-BAL: sens = 73%, spec = 96% |