Standardization of Clinical Assessment and Sample Collection Across All PERCH Study Sites

June 3, 2017 at 1:46 pm

Clinical Infectious Diseases June 15, 2017 V.64 Suppl.3

Jane Crawley; Christine Prosperi; Henry C. Baggett; W. Abdullah Brooks; Maria Deloria Knoll …

Background.

Variable adherence to standardized case definitions, clinical procedures, specimen collection techniques, and laboratory methods has complicated the interpretation of previous multicenter pneumonia etiology studies. To circumvent these problems, a program of clinical standardization was embedded in the Pneumonia Etiology Research for Child Health (PERCH) study.

Methods.

Between March 2011 and August 2013, standardized training on the PERCH case definition, clinical procedures, and collection of laboratory specimens was delivered to 331 clinical staff at 9 study sites in 7 countries (The Gambia, Kenya, Mali, South Africa, Zambia, Thailand, and Bangladesh), through 32 on-site courses and a training website. Staff competency was assessed throughout 24 months of enrollment with multiple-choice question (MCQ) examinations, a video quiz, and checklist evaluations of practical skills.

Results.

MCQ evaluation was confined to 158 clinical staff members who enrolled PERCH cases and controls, with scores obtained for >86% of eligible staff at each time-point. Median scores after baseline training were ≥80%, and improved by 10 percentage points with refresher training, with no significant intersite differences. Percentage agreement with the clinical trainer on the presence or absence of clinical signs on video clips was high (≥89%), with interobserver concordance being substantial to high (AC1 statistic, 0.62–0.82) for 5 of 6 signs assessed. Staff attained median scores of >90% in checklist evaluations of practical skills.

Conclusions.

Satisfactory clinical standardization was achieved within and across all PERCH sites, providing reassurance that any etiological or clinical differences observed across the study sites are true differences, and not attributable to differences in application of the clinical case definition, interpretation of clinical signs, or in techniques used for clinical measurements or specimen collection.

PDF

https://oup.silverchair-cdn.com/oup/backfile/Content_public/Journal/cid/64/suppl_3/10.1093_cid_cix077/5/cix077.pdf?Expires=1496599791&Signature=QXiPKWS2fyf1F8e6dTXBY9g7PE9ba~7de-29WPS7lrU4bMBZbIMibbxnixqUBVnWIRyjWQr6~jTNcqyrGpAiH1t3O2DVYfUeyFnyOoHQ4uxdK0XBKRAiymGhN-rvyidLzOUQhHGQY7pEeYLUsahp~EjPKqpl-5XqqPpmHuYNo-3mXEafMFpypg18fODxCVYfDL8D7b97YHh3oxiVhYFhlsriFxp1YQuQbGNJDDyGK1TQUzPPw0~LHGFPv2~taDyBSnNLGOBAPKA-I-7G6z-1rw6JseMqizy283v-8O8Kviwyb1mGNA1b48HBigG0RQv~swxqxjTbsZ33y0izIhJExQ__&Key-Pair-Id=APKAIUCZBIA4LVPAVW3Q

 

Advertisements

Entry filed under: Antimicrobianos, Bacterias, Bacteriemias, Epidemiología, Infecciones respiratorias, Infecciones virales, Inmunizaciones, Metodos diagnosticos, Sepsis, Update.

Bayesian Estimation of Pneumonia Etiology: Epidemiologic Considerations and Applications to the Pneumonia Etiology Research for Child Health Study Data Management and Data Quality in PERCH, a Large International Case-Control Study of Severe Childhood Pneumonia


Calendar

June 2017
M T W T F S S
« May    
 1234
567891011
12131415161718
19202122232425
2627282930  

Most Recent Posts


%d bloggers like this: