Developing a standard reference for urinary tract infection research through a multidisciplinary Delphi consensus study.
The text discusses a multidisciplinary Delphi consensus study aimed at establishing a reference standard for urinary tract infection (UTI) research. The lack of a consensus-based standard for UTI research has implications for the accuracy and comparability of studies related to UTIs, impacting both internal and external validity. This study involved 46 international UTI experts in a three-round Delphi study, achieving a high degree of consensus (94%) on the final reference standard. Major symptoms identified include new-onset dysuria, urinary frequency, and urgency, with specific criteria for distinguishing between UTI with and without systemic involvement. The study lowered the traditional bacteriuria threshold to 104 colony-forming units per mL and incorporated varying levels of pyuria into the standard.
The introduction highlights the significance of UTIs as a prevalent bacterial infection worldwide, emphasizing the need for a standardized reference standard to improve diagnostics and therapeutic approaches. Existing guidelines from organizations like the US FDA and EMA are noted to lack uniform definitions for UTI, complicating research comparisons across studies. A systematic review revealed low adherence to these guidelines, prompting the need for a multidisciplinary consensus-based reference standard tailored specifically for research purposes.
The study design included a Delphi method involving an expert panel to assess 48 items related to UTI signs, symptoms, urinalysis, and microbiology in the first round. Subsequent rounds refined the reference standard based on panel feedback and case vignette interpretations. The expert panel, consisting of 46 specialists from various countries and specialties, demonstrated high levels of agreement throughout the study, reaching consensus on the final reference standard in the third round. The reference standard includes criteria for symptoms, systemic involvement, pyuria, and culture results, addressing complexities and variations in UTI diagnosis.
Strengths of the study include the comprehensive approach, involvement of diverse experts, and a rigorous consensus-building process. Limitations include the complexity of the reference standard, lack of representation from low-income countries, and the need for further validation. The study emphasizes the potential impact of the reference standard on future UTI research, enhancing validity and comparability across studies and ultimately contributing to improved evidence-based practices for UTI management.
In conclusion, the study successfully established a consensus-based reference standard for UTI research, aligning perspectives from multiple specialties and countries. The standard aims to streamline UTI research, improve diagnostic accuracy, and facilitate data comparability, addressing a critical gap in the field. Future validation efforts and adherence to the reference standard in research studies will determine its effectiveness in enhancing the quality of evidence in UTI research.
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00778-8/fulltext
The introduction highlights the significance of UTIs as a prevalent bacterial infection worldwide, emphasizing the need for a standardized reference standard to improve diagnostics and therapeutic approaches. Existing guidelines from organizations like the US FDA and EMA are noted to lack uniform definitions for UTI, complicating research comparisons across studies. A systematic review revealed low adherence to these guidelines, prompting the need for a multidisciplinary consensus-based reference standard tailored specifically for research purposes.
The study design included a Delphi method involving an expert panel to assess 48 items related to UTI signs, symptoms, urinalysis, and microbiology in the first round. Subsequent rounds refined the reference standard based on panel feedback and case vignette interpretations. The expert panel, consisting of 46 specialists from various countries and specialties, demonstrated high levels of agreement throughout the study, reaching consensus on the final reference standard in the third round. The reference standard includes criteria for symptoms, systemic involvement, pyuria, and culture results, addressing complexities and variations in UTI diagnosis.
Strengths of the study include the comprehensive approach, involvement of diverse experts, and a rigorous consensus-building process. Limitations include the complexity of the reference standard, lack of representation from low-income countries, and the need for further validation. The study emphasizes the potential impact of the reference standard on future UTI research, enhancing validity and comparability across studies and ultimately contributing to improved evidence-based practices for UTI management.
In conclusion, the study successfully established a consensus-based reference standard for UTI research, aligning perspectives from multiple specialties and countries. The standard aims to streamline UTI research, improve diagnostic accuracy, and facilitate data comparability, addressing a critical gap in the field. Future validation efforts and adherence to the reference standard in research studies will determine its effectiveness in enhancing the quality of evidence in UTI research.
Source: https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(23)00778-8/fulltext
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