Evidence map›Paper›PMID 34166284›Full record

Observational studyCritical care medicine2021

A Novel 29-Messenger RNA Host-Response Assay From Whole Blood Accurately Identifies Bacterial and Viral Infections in Patients Presenting to the Emergency Department With Suspected Infections: A Prospective Observational Study.

Wolfgang Bauer, Kai Kappert, Noa Galtung, Dana Lehmann, James Wacker, Henry K Cheng, Oliver Liesenfeld, Ljubomir Buturovic, Roland Luethy, Timothy E Sweeney and 2 more

Registry-linked trialAbstract readObservational Study
In one paragraph

Observational study in Critical care medicine, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT05639504 (Sepsis Prognosis and Diagnosis in the Emergency Department Using a Host Response Classifier), which is not on this map. Cited by 29 papers.

0numbers the graph read from it
0cells of the map it votes in
29citing 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.

NCT05639504 withdrawnnot on this mapstarted 2022, after this paper: background citation

Sepsis Prognosis and Diagnosis in the Emergency Department Using a Host Response Classifier (SPEED) UK - a Multi-Centre Observational Study

TypeobservationalSponsorInflammatixRan2022 to 2023Enrolled0ConditionsRespiratory Tract Infections, Urinary Tract Infections, Intra-Abdominal Infections, Skin and Soft Tissue InfectionArmsIMX-BVN-4 and IMX-SEV-4
3 · Its place in the literature

Who cites it

29 citing papers in PubMed.

  1. Article
  2. Observational
  3. Article
  4. Article
  5. Observational
  6. Article
  7. Article
  8. Article
  9. Article
  10. Article
  11. Article
  12. Article
  13. Article
  14. Article
  15. Observational
  16. Big data and deep learning for RNA biology.Experimental & molecular medicine · 2024
    Review
  17. Article
  18. Article
  19. Review
  20. Host Response Biomarkers for Sepsis in the Emergency Room.Critical care (London, England) · 2023
    Review
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

12 authors.

Wolfgang BauerDepartment of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
Kai KappertCharité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Berlin, Germany.
Noa GaltungDepartment of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
Dana LehmannDepartment of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.
James WackerInflammatix, Burlingame, CA.
Henry K ChengInflammatix, Burlingame, CA.
Oliver LiesenfeldInflammatix, Burlingame, CA.
Ljubomir ButurovicInflammatix, Burlingame, CA.
Roland LuethyInflammatix, Burlingame, CA.
Timothy E SweeneyInflammatix, Burlingame, CA.
Rudolf TauberCharité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Institute of Laboratory Medicine, Clinical Chemistry and Pathobiochemistry, Berlin, Germany.
Rajan SomasundaramDepartment of Emergency Medicine, Charité-Universitätsmedizin Berlin, Freie Universität Berlin, Humboldt-Universität zu Berlin, Berlin Institute of Health, Campus Benjamin Franklin, Berlin, Germany.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectivesThe rapid diagnosis of acute infections and sepsis remains a serious challenge. As a result of limitations in current diagnostics, guidelines recommend early antimicrobials for suspected sepsis patients to improve outcomes at a cost to antimicrobial stewardship. We aimed to develop and prospectively validate a new, 29-messenger RNA blood-based host-response classifier Inflammatix Bacterial Viral Non-Infected version 2 (IMX-BVN-2) to determine the likelihood of bacterial and viral infections.

designProspective observational study.

settingEmergency Department, Campus Benjamin Franklin, Charité-Universitätsmedizin Berlin, Germany. PATIENTS: Three hundred twelve adult patients presenting to the emergency department with suspected acute infections or sepsis with at least one vital sign change.

interventionsNone (observational study only). MEASUREMENTS AND MAIN

resultsGene expression levels from extracted whole blood RNA was quantified on a NanoString nCounter SPRINT (NanoString Technologies, Seattle, WA). Two predicted probability scores for the presence of bacterial and viral infection were calculated using the IMX-BVN-2 neural network classifier, which was trained on an independent development set. The IMX-BVN-2 bacterial score showed an area under the receiver operating curve for adjudicated bacterial versus ruled out bacterial infection of 0.90 (95% CI, 0.85-0.95) compared with 0.89 (95% CI, 0.84-0.94) for procalcitonin with procalcitonin being used in the adjudication. The IMX-BVN-2 viral score area under the receiver operating curve for adjudicated versus ruled out viral infection was 0.83 (95% CI, 0.77-0.89).

conclusionsIMX-BVN-2 demonstrated accuracy for detecting both viral infections and bacterial infections. This shows the potential of host-response tests as a novel and practical approach for determining the causes of infections, which could improve patient outcomes while upholding antimicrobial stewardship.

Indexed as

AgedAged, 80 and overArea Under CurveBacterial InfectionsBerlinBiomarkersEmergency Service, HospitalFemaleHumansMaleMiddle AgedProspective StudiesRNA, MessengerROC CurveVirus DiseasesBiomarkersRNA, Messenger

Identifiers

PMID34166284
PMCPMC8439671

What Socratic holds

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LicenceCC BY-NC-ND
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Registered trials

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 Socratic graph.