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Composite endpoints for malaria case-management: not simplifying the picture?

Rapid diagnostic tests (RDTs) for infection with Plasmodium spp. offer two main potential advantages related to malaria treatment: 1) ensuring that individuals with malaria are promptly treated with an effective artemisinin-based combination therapy, and 2) ensuring that individuals without malaria...

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Autores principales: Cairns, Matthew E, Leurent, Baptiste, Milligan, Paul J
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300677/
https://www.ncbi.nlm.nih.gov/pubmed/25496292
http://dx.doi.org/10.1186/1475-2875-13-494
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author Cairns, Matthew E
Leurent, Baptiste
Milligan, Paul J
author_facet Cairns, Matthew E
Leurent, Baptiste
Milligan, Paul J
author_sort Cairns, Matthew E
collection PubMed
description Rapid diagnostic tests (RDTs) for infection with Plasmodium spp. offer two main potential advantages related to malaria treatment: 1) ensuring that individuals with malaria are promptly treated with an effective artemisinin-based combination therapy, and 2) ensuring that individuals without malaria do not receive an anti-malarial they do not need (and instead receive a more appropriate treatment). Some studies of the impact of RDTs on malaria case management have combined these two different successes into a binary outcome describing ‘correct management’. However combining correct management of positives and negatives into a single summary measure can be misleading. The problems, which are analogous to those encountered in the evaluation of diagnostic tests, can largely be avoided if data for patients with and without malaria are presented and analysed separately. Where a combined metric is necessary, then one of the established approaches to summarise the performance of diagnostic tests could be considered, although these are not without their limitations. Two graphical approaches to help understand case management performance are illustrated.
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spelling pubmed-43006772015-01-22 Composite endpoints for malaria case-management: not simplifying the picture? Cairns, Matthew E Leurent, Baptiste Milligan, Paul J Malar J Commentary Rapid diagnostic tests (RDTs) for infection with Plasmodium spp. offer two main potential advantages related to malaria treatment: 1) ensuring that individuals with malaria are promptly treated with an effective artemisinin-based combination therapy, and 2) ensuring that individuals without malaria do not receive an anti-malarial they do not need (and instead receive a more appropriate treatment). Some studies of the impact of RDTs on malaria case management have combined these two different successes into a binary outcome describing ‘correct management’. However combining correct management of positives and negatives into a single summary measure can be misleading. The problems, which are analogous to those encountered in the evaluation of diagnostic tests, can largely be avoided if data for patients with and without malaria are presented and analysed separately. Where a combined metric is necessary, then one of the established approaches to summarise the performance of diagnostic tests could be considered, although these are not without their limitations. Two graphical approaches to help understand case management performance are illustrated. BioMed Central 2014-12-13 /pmc/articles/PMC4300677/ /pubmed/25496292 http://dx.doi.org/10.1186/1475-2875-13-494 Text en © Cairns et al.; licensee BioMed Central Ltd. 2014 This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly credited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Commentary
Cairns, Matthew E
Leurent, Baptiste
Milligan, Paul J
Composite endpoints for malaria case-management: not simplifying the picture?
title Composite endpoints for malaria case-management: not simplifying the picture?
title_full Composite endpoints for malaria case-management: not simplifying the picture?
title_fullStr Composite endpoints for malaria case-management: not simplifying the picture?
title_full_unstemmed Composite endpoints for malaria case-management: not simplifying the picture?
title_short Composite endpoints for malaria case-management: not simplifying the picture?
title_sort composite endpoints for malaria case-management: not simplifying the picture?
topic Commentary
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4300677/
https://www.ncbi.nlm.nih.gov/pubmed/25496292
http://dx.doi.org/10.1186/1475-2875-13-494
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