Glover, Rebecca; Al-Haboubi, Mustafa; Petticrew, Mark; Eastmure, Elizabeth; Peacock, Sharon; Mays, Nicholas; (2024) Applying the Sankey diagram to a systematic review and meta-analysis of rapid diagnostic tests for antimicrobial resistance: a novel method for showing flow of evidence through a review. Journal of Clinical Epidemiology. ISSN 0895-4356 https://researchonline.lshtm.ac.uk/id/eprint/4672065 (In Press)
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Abstract
Objectives: To assess the effectiveness of rapid diagnostic tests (RDTs) for bacterial identification and antibiotic susceptibility testing in clinical and antibiotic stewardship outcomes compared with standard practice in hospitals, and to apply a Sankey diagram to present the findings and illustrate study heterogeneity. Study design: Systematic review and meta-analysis of experimental and observational studies which included at least one prescribing or clinical outcome of RDTs in hospital in-patients. Sub-group analysis was used to assess heterogeneity in summary effect estimates. A Sankey diagram was then used to show the pattern and quality of evidenceon RDT outcomes. Results: 58 studies from 14 countries were included. The introduction of RDTs did not significantly reduce in-hospital mortality (RR 0.83, 95% CI 0.60 - 1.15) or length of stay (weighted mean difference = -0.36, 95% CI -1.67 to 0.96). There was high heterogeneity in outcomes. Conclusion: There is no clear evidence that the routine use of RDTs for bacterial identification and antibiotic susceptibility testing improves clinical outcomes in hospital inpatients. Sankey diagrams may be a useful further way succinctly to present the pattern and quality of evidence in systematic reviews, especially when it is heterogeneous and not easily amenable to meta-analysis.
Item Type | Article |
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Faculty and Department |
Faculty of Public Health and Policy > Dept of Health Services Research and Policy Faculty of Public Health and Policy > Public Health, Environments and Society |
Elements ID | 157701 |
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