Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process

Background. We sought to develop diagnostic test guidance definitions for pediatric enteric infections to facilitate the interpretation of positive test results in the era of multianalyte molecular diagnostic test platforms. Methods. We employed a systematic, two-phase, modified Delphi consensus pro...

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Main Authors: Antonia S. Stang, Melanie Trudeau, Otto G. Vanderkooi, Bonita E. Lee, Linda Chui, Xiao-Li Pang, Vanessa Allen, Carey-Ann D. Burnham, David M. Goldfarb, Judy MacDonald, Brendon Parsons, Astrid Petrich, Frank Pollari, Phillip I. Tarr, Graham Tipples, Ran Zhuo, Stephen B. Freedman
Format: Article
Language:English
Published: Wiley 2018-01-01
Series:Canadian Journal of Infectious Diseases and Medical Microbiology
Online Access:http://dx.doi.org/10.1155/2018/2589826
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author Antonia S. Stang
Melanie Trudeau
Otto G. Vanderkooi
Bonita E. Lee
Linda Chui
Xiao-Li Pang
Vanessa Allen
Carey-Ann D. Burnham
David M. Goldfarb
Judy MacDonald
Brendon Parsons
Astrid Petrich
Frank Pollari
Phillip I. Tarr
Graham Tipples
Ran Zhuo
Stephen B. Freedman
author_facet Antonia S. Stang
Melanie Trudeau
Otto G. Vanderkooi
Bonita E. Lee
Linda Chui
Xiao-Li Pang
Vanessa Allen
Carey-Ann D. Burnham
David M. Goldfarb
Judy MacDonald
Brendon Parsons
Astrid Petrich
Frank Pollari
Phillip I. Tarr
Graham Tipples
Ran Zhuo
Stephen B. Freedman
author_sort Antonia S. Stang
collection DOAJ
description Background. We sought to develop diagnostic test guidance definitions for pediatric enteric infections to facilitate the interpretation of positive test results in the era of multianalyte molecular diagnostic test platforms. Methods. We employed a systematic, two-phase, modified Delphi consensus process consisting of three web-based surveys and an expert panel face-to-face meeting. In phase 1, we surveyed an advisory panel of North American experts to select pathogens requiring diagnostic test guidance definition development. In phase 2, we convened a 14-member expert panel to develop, refine, and select the final definitions through two web-based questionnaires interspersed with a face-to-face meeting. Both questionnaires asked panelists to rate the degree to which they agreed that if the definition is met the pathogen is likely to be causative of clinical illness. Results. The advisory panel survey identified 19 pathogens requiring definitions. In the expert panel premeeting survey, 13 of the 19 definitions evaluated were rated as being highly likely (“agree” or “strongly agree”) to be responsible for acute gastroenteritis symptoms by ≥67% of respondent panel members. The definitions for the remaining six pathogens (Aeromonas, Clostridium difficile, Edwardsiella, nonenteric adenovirus, astrovirus, and Entamoeba histolytica) were indeterminate. After the expert panel meeting, only two of the modified definitions, C. difficile and E. histolytica/dispar, failed to achieve the a priori specified threshold of ≥67% agreement. Conclusions. We developed diagnostic test guidance definitions to assist healthcare providers for 17 enteric pathogens. We identified two pathogens that require further research and definition development.
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spelling doaj-art-ec4860c8080b48cb9de07823f2e2a6822025-08-20T03:21:24ZengWileyCanadian Journal of Infectious Diseases and Medical Microbiology1712-95321918-14932018-01-01201810.1155/2018/25898262589826Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus ProcessAntonia S. Stang0Melanie Trudeau1Otto G. Vanderkooi2Bonita E. Lee3Linda Chui4Xiao-Li Pang5Vanessa Allen6Carey-Ann D. Burnham7David M. Goldfarb8Judy MacDonald9Brendon Parsons10Astrid Petrich11Frank Pollari12Phillip I. Tarr13Graham Tipples14Ran Zhuo15Stephen B. Freedman16Departments of Pediatrics, Emergency Medicine and Community Health Sciences, University of Calgary, Alberta Children’s Hospital Research Institute, Calgary, Alberta, CanadaDepartment of Pediatrics, University of Calgary, Calgary, Alberta, CanadaDepartments of Pediatrics, Microbiology, Immunology and Infectious Diseases, Pathology & Laboratory Medicine and Community Health Sciences, University of Calgary, Alberta Children’s Hospital Research Institute, Calgary, Alberta, CanadaDepartment of Pediatrics, University of Alberta, Edmonton, Alberta, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, CanadaPublic Health Ontario Laboratories, University of Toronto, Toronto, Ontario, CanadaDepartments of Pathology & Immunology, Molecular Microbiology, and Pediatrics, Washington University in St. Louis School of Medicine, St. Louis, MO, USADepartment of Pathology and Laboratory Medicine, BC Children’s Hospital, Vancouver, British Columbia, CanadaPopulation, Public and Indigenous Health, Cumming School of Medicine, University of Calgary, Calgary, Alberta, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, CanadaDepartment of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, CanadaEnterics Surveillance and Population Studies Division, Centre for Food-Borne, Environmental and Zoonotic Infectious Diseases, Public Health Agency of Canada, Guelph, Ontario, CanadaDivision of Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Washington University School of Medicine, St. Louis, MO, USADepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, CanadaDepartment of Laboratory Medicine and Pathology, University of Alberta, Edmonton, Alberta, CanadaSections of Pediatric Emergency Medicine and Gastroenterology, Departments of Pediatrics, University of Calgary, Alberta Children’s Hospital, Calgary, Alberta, CanadaBackground. We sought to develop diagnostic test guidance definitions for pediatric enteric infections to facilitate the interpretation of positive test results in the era of multianalyte molecular diagnostic test platforms. Methods. We employed a systematic, two-phase, modified Delphi consensus process consisting of three web-based surveys and an expert panel face-to-face meeting. In phase 1, we surveyed an advisory panel of North American experts to select pathogens requiring diagnostic test guidance definition development. In phase 2, we convened a 14-member expert panel to develop, refine, and select the final definitions through two web-based questionnaires interspersed with a face-to-face meeting. Both questionnaires asked panelists to rate the degree to which they agreed that if the definition is met the pathogen is likely to be causative of clinical illness. Results. The advisory panel survey identified 19 pathogens requiring definitions. In the expert panel premeeting survey, 13 of the 19 definitions evaluated were rated as being highly likely (“agree” or “strongly agree”) to be responsible for acute gastroenteritis symptoms by ≥67% of respondent panel members. The definitions for the remaining six pathogens (Aeromonas, Clostridium difficile, Edwardsiella, nonenteric adenovirus, astrovirus, and Entamoeba histolytica) were indeterminate. After the expert panel meeting, only two of the modified definitions, C. difficile and E. histolytica/dispar, failed to achieve the a priori specified threshold of ≥67% agreement. Conclusions. We developed diagnostic test guidance definitions to assist healthcare providers for 17 enteric pathogens. We identified two pathogens that require further research and definition development.http://dx.doi.org/10.1155/2018/2589826
spellingShingle Antonia S. Stang
Melanie Trudeau
Otto G. Vanderkooi
Bonita E. Lee
Linda Chui
Xiao-Li Pang
Vanessa Allen
Carey-Ann D. Burnham
David M. Goldfarb
Judy MacDonald
Brendon Parsons
Astrid Petrich
Frank Pollari
Phillip I. Tarr
Graham Tipples
Ran Zhuo
Stephen B. Freedman
Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
Canadian Journal of Infectious Diseases and Medical Microbiology
title Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
title_full Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
title_fullStr Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
title_full_unstemmed Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
title_short Diagnostic Interpretation Guidance for Pediatric Enteric Pathogens: A Modified Delphi Consensus Process
title_sort diagnostic interpretation guidance for pediatric enteric pathogens a modified delphi consensus process
url http://dx.doi.org/10.1155/2018/2589826
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