Real-world evidence supports use of procalcitonin
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Procalcitonin (PCT) testing on the first day of ICU admission for adult patients with sepsis is associated with reduced length of stay, less antibiotic exposure, and reduced hospital and pharmacy costs, Robert A. Balk, MD, and his associates reported.

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The significant findings of Balk et al. suggest that “real world” evidence may support procalcitonin as an effective tool to improve antibiotic management and reduce costs of health care for critically ill patients. Data from public databases and patient registries can play key roles in evaluating biomarkers, since physicians preparing randomized trials may behave differently than in typical care settings.

Results of the recent randomized [Simplified Acute Physiology Score] trial in connection with real-life data reported by Dr. Balk and colleagues are convincing and should lead physicians to more widespread use of PCT protocols for management of patients in the critical care settings.

The study findings also add the U.S. experience to the knowledge base as most of the interventional research has been done in Europe and Asia.

Given the promising results from the randomized trials, it is important to know how PCT impacts the clinical management of patients in real-world settings. Such information can be used to further broaden and expand the findings from the randomized trials to usual care.

Philipp Schuetz, MD, MPH, of the University of Basel, Switzerland, receives research support from Thermo Fisher and bioMerieux, which make PCT tests. Peter M. Wahl, ScD, is a full-time employee of Covance Inc., of Princeton, N.J., which makes diagnostic tests and owns clinical laboratories. Their comments were made in an editorial accompanying Dr. Balk’s report (Chest. 2017;151[1]:6-8. doi:10.1016/j.chest.2016.07.014).

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The significant findings of Balk et al. suggest that “real world” evidence may support procalcitonin as an effective tool to improve antibiotic management and reduce costs of health care for critically ill patients. Data from public databases and patient registries can play key roles in evaluating biomarkers, since physicians preparing randomized trials may behave differently than in typical care settings.

Results of the recent randomized [Simplified Acute Physiology Score] trial in connection with real-life data reported by Dr. Balk and colleagues are convincing and should lead physicians to more widespread use of PCT protocols for management of patients in the critical care settings.

The study findings also add the U.S. experience to the knowledge base as most of the interventional research has been done in Europe and Asia.

Given the promising results from the randomized trials, it is important to know how PCT impacts the clinical management of patients in real-world settings. Such information can be used to further broaden and expand the findings from the randomized trials to usual care.

Philipp Schuetz, MD, MPH, of the University of Basel, Switzerland, receives research support from Thermo Fisher and bioMerieux, which make PCT tests. Peter M. Wahl, ScD, is a full-time employee of Covance Inc., of Princeton, N.J., which makes diagnostic tests and owns clinical laboratories. Their comments were made in an editorial accompanying Dr. Balk’s report (Chest. 2017;151[1]:6-8. doi:10.1016/j.chest.2016.07.014).

Body

 

The significant findings of Balk et al. suggest that “real world” evidence may support procalcitonin as an effective tool to improve antibiotic management and reduce costs of health care for critically ill patients. Data from public databases and patient registries can play key roles in evaluating biomarkers, since physicians preparing randomized trials may behave differently than in typical care settings.

Results of the recent randomized [Simplified Acute Physiology Score] trial in connection with real-life data reported by Dr. Balk and colleagues are convincing and should lead physicians to more widespread use of PCT protocols for management of patients in the critical care settings.

The study findings also add the U.S. experience to the knowledge base as most of the interventional research has been done in Europe and Asia.

Given the promising results from the randomized trials, it is important to know how PCT impacts the clinical management of patients in real-world settings. Such information can be used to further broaden and expand the findings from the randomized trials to usual care.

Philipp Schuetz, MD, MPH, of the University of Basel, Switzerland, receives research support from Thermo Fisher and bioMerieux, which make PCT tests. Peter M. Wahl, ScD, is a full-time employee of Covance Inc., of Princeton, N.J., which makes diagnostic tests and owns clinical laboratories. Their comments were made in an editorial accompanying Dr. Balk’s report (Chest. 2017;151[1]:6-8. doi:10.1016/j.chest.2016.07.014).

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Real-world evidence supports use of procalcitonin
Real-world evidence supports use of procalcitonin

 

Procalcitonin (PCT) testing on the first day of ICU admission for adult patients with sepsis is associated with reduced length of stay, less antibiotic exposure, and reduced hospital and pharmacy costs, Robert A. Balk, MD, and his associates reported.

 

Procalcitonin (PCT) testing on the first day of ICU admission for adult patients with sepsis is associated with reduced length of stay, less antibiotic exposure, and reduced hospital and pharmacy costs, Robert A. Balk, MD, and his associates reported.

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Key clinical point: Procalcitonin (PCT) testing on the first day of ICU admission for critically ill adults with sepsis is associated with reduced ICU length of stay and reduced hospital and pharmacy costs.

Major finding: Total hospital and ICU costs were $2,759 and $1,310 less, respectively, for PCT managed patients, while inpatient mortality for patients who received PCT was 19% vs. 18.3% for those who did not receive PCT.

Data source: A retrospective study of data on more than 730,000 adult patients who had a potential sepsis, SIRS, septicemia, or shock-related diagnosis on admission or discharge, and were treated in the ICU.

Disclosures: Dr. Balk has received advisory board fees from bioMerieux USA, Roche Diagnostics, and Thermo Fisher Scientific; Zhun Cao, PhD, Craig Lipkin, and Scott B. Robinson are employees of Premier Research Services. Samuel Bozzette is an employee of bioMerieux, which provided funding for the study.