Table 4.
Quality rating of studies
| References | Quality of study designs according Streefkerk et al | Quality assessment according to QUADAS-2 | |||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Indicator 1: Validation and test cohort (5 points), test cohort only (3 points), validation cohort only (1 point) | Indicator 2: Prevalence or incidence of nvHAP/HAP reported (5 points), not reported (1 point) | Indicator 3: Hospital-wide surveillance for nvHAP/HAP (5 points), surveillance in > 2 departments or wards (3 points), surveillance in 1 ward/department (1 point) | Indicator 4: Types of HAI under surveillance → not applicable | Indicator 5: Sensitivity, specificity and other performance measure reported (5points), sensitivity and specificity reported (3 points), sensitivity reported (1 point), no or other measure than sensitivity reported (0 points) | Indicator 6: time reduction was presented quantitatively (5 points), workload reduction was presented (3 points), no data on workload reduction presented (1 point) | Sum of Streefkerk et al. (Max = 25) | Question 1. Was a consecutive or random sample of patients enrolled? | Question 2. Was a case–control design avoided? | Question 3. Did the study avoid inappropriate exclusions? | Question 4. Were the index test results interpreted without knowledge of the results of the reference standard? | Question 5. Is the reference standard likely to correctly classify the target condition? | Question 6. Were the reference standard results interpreted without knowledge of the results of the index test? | Question 7. Did all patients receive a reference standard? | Question 8. Did all patients receive the same reference standard? | Question 9. Were all patients included in the analysis? | Sum of QUADAS-2 (Max = 9) | |
| Stern [22] | 1 | 5 | 5 | n.a | 0 | 3a | 14 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 7 |
| Jones [25] | 1 | 5 | 5 | n.a | 0 | 3a | 14 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 7 |
| Valentine [28] | 1 | 5 | 5 | n.a | 0 | 3a | 14 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 7 |
| Ramirez Battle [24] | 1 | 5 | 5 | n.a | 5 | 3a | 19 | 1 | 1 | 0b | 1 | 1 | 1 | 1c | 1 | 1 | 8 |
| Lacerna [10] | 1 | 5 | 5 | n.a | 0 | 3a | 14 | – | – | – | – | – | – | – | – | – | – |
| Ji [23] | 1 | 5 | 5 | n.a | 5 | 3a | 19 | 1 | 1 | 1 | 1 | 1d | 1 | 0 | 1 | 1 | 8 |
| Zilberberg [30] | 1 | 1 | 5 | n.a | 0 | 3a | 10 | – | – | – | – | – | – | – | – | – | – |
| Wolfensberger [21] | 1 | 5 | 5 | n.a | 1 | 3 | 15 | 1 | 1 | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 8 |
| Wolfensberger [27] | 1 | 5 | 3 | n.a | 5 | 3a | 17 | 1 | 1 | 1 | 1 | 1 | 0 | 0 | 1 | 1 | 7 |
| Fitzhenry [31] | 5 | 5 | 5 | n.a | 5 | 3a | 23 | 1 | 0e | 1 | 1 | 1 | 1 | 0 | 1 | 1 | 7 |
| Bouzbid [29] | 1 | 5 | 1 | n.a | 5 | 3a | 15 | 1 | 1 | 1 | 1 | 1 | 1 | 1f | 1 | 1 | 8 |
| Haas and Mendonca [19] | 1 | 5 | 1 | n.a | 5 | 3a | 15 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 1 | 9 |
HAI, healthcare–associated infection
aAutomated surveillance, 100% workload reduction assumed
bOnly patients with worsening oxygenation
cOf the preselected patients undergoing surveillance, see Quadas-2 Question 3
dClinically diagnosed nvHAP
ePatients with complication plus a 10% random sample
fPatients with stay > 48 h