1 resultado para Android,Multihoming,LISP,LISPmob,Performance,Test,Development,Analysis
em Duke University
Filtro por publicador
- Aberdeen University (1)
- Abertay Research Collections - Abertay University’s repository (2)
- Academic Archive On-line (Karlstad University; Sweden) (2)
- Academic Research Repository at Institute of Developing Economies (1)
- Acceda, el repositorio institucional de la Universidad de Las Palmas de Gran Canaria. España (1)
- AMS Tesi di Dottorato - Alm@DL - Università di Bologna (12)
- AMS Tesi di Laurea - Alm@DL - Università di Bologna (9)
- ArchiMeD - Elektronische Publikationen der Universität Mainz - Alemanha (5)
- Archivo Digital para la Docencia y la Investigación - Repositorio Institucional de la Universidad del País Vasco (3)
- Aston University Research Archive (30)
- Biblioteca de Teses e Dissertações da USP (6)
- Biblioteca Digital | Sistema Integrado de Documentación | UNCuyo - UNCUYO. UNIVERSIDAD NACIONAL DE CUYO. (1)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (18)
- Biblioteca Digital da Produção Intelectual da Universidade de São Paulo (BDPI/USP) (4)
- Biblioteca Digital de Teses e Dissertações Eletrônicas da UERJ (4)
- Bioline International (1)
- BORIS: Bern Open Repository and Information System - Berna - Suiça (27)
- Brock University, Canada (8)
- Bucknell University Digital Commons - Pensilvania - USA (2)
- Bulgarian Digital Mathematics Library at IMI-BAS (1)
- CaltechTHESIS (1)
- Cambridge University Engineering Department Publications Database (10)
- CentAUR: Central Archive University of Reading - UK (25)
- Chinese Academy of Sciences Institutional Repositories Grid Portal (26)
- Cochin University of Science & Technology (CUSAT), India (5)
- Coffee Science - Universidade Federal de Lavras (4)
- Comissão Econômica para a América Latina e o Caribe (CEPAL) (13)
- CORA - Cork Open Research Archive - University College Cork - Ireland (5)
- Corvinus Research Archive - The institutional repository for the Corvinus University of Budapest (3)
- Dalarna University College Electronic Archive (5)
- Deakin Research Online - Australia (57)
- Digital Archives@Colby (1)
- Digital Commons - Michigan Tech (6)
- Digital Commons @ DU | University of Denver Research (2)
- Digital Commons at Florida International University (32)
- DigitalCommons@The Texas Medical Center (9)
- DigitalCommons@University of Nebraska - Lincoln (1)
- Doria (National Library of Finland DSpace Services) - National Library of Finland, Finland (1)
- DRUM (Digital Repository at the University of Maryland) (4)
- Duke University (1)
- eResearch Archive - Queensland Department of Agriculture; Fisheries and Forestry (2)
- FUNDAJ - Fundação Joaquim Nabuco (2)
- Glasgow Theses Service (2)
- Greenwich Academic Literature Archive - UK (1)
- Helda - Digital Repository of University of Helsinki (5)
- Indian Institute of Science - Bangalore - Índia (9)
- INSTITUTO DE PESQUISAS ENERGÉTICAS E NUCLEARES (IPEN) - Repositório Digital da Produção Técnico Científica - BibliotecaTerezine Arantes Ferra (1)
- Instituto Politécnico de Leiria (1)
- Instituto Politécnico do Porto, Portugal (7)
- Iowa Publications Online (IPO) - State Library, State of Iowa (Iowa), United States (1)
- Laboratório Nacional de Energia e Geologia - Portugal (1)
- Lume - Repositório Digital da Universidade Federal do Rio Grande do Sul (3)
- Memorial University Research Repository (2)
- National Center for Biotechnology Information - NCBI (2)
- Nottingham eTheses (1)
- Open University Netherlands (1)
- Plymouth Marine Science Electronic Archive (PlyMSEA) (1)
- Portal de Revistas Científicas Complutenses - Espanha (2)
- Publishing Network for Geoscientific & Environmental Data (3)
- QSpace: Queen's University - Canada (1)
- QUB Research Portal - Research Directory and Institutional Repository for Queen's University Belfast (29)
- Queensland University of Technology - ePrints Archive (107)
- RDBU - Repositório Digital da Biblioteca da Unisinos (2)
- ReCiL - Repositório Científico Lusófona - Grupo Lusófona, Portugal (1)
- Repositório Aberto da Universidade Aberta de Portugal (1)
- Repositório Alice (Acesso Livre à Informação Científica da Embrapa / Repository Open Access to Scientific Information from Embrapa) (1)
- Repositório Científico da Universidade de Évora - Portugal (1)
- Repositório Científico do Instituto Politécnico de Lisboa - Portugal (2)
- Repositorio de la Universidad de Cuenca (1)
- Repositório digital da Fundação Getúlio Vargas - FGV (12)
- Repositorio Institucional da UFLA (RIUFLA) (1)
- Repositório Institucional da Universidade de Aveiro - Portugal (3)
- Repositório Institucional da Universidade Estadual de São Paulo - UNESP (1)
- Repositório Institucional da Universidade Federal do Rio Grande - FURG (1)
- Repositório Institucional da Universidade Federal do Rio Grande do Norte (2)
- Repositorio Institucional de la Universidad de Málaga (1)
- Repositório Institucional UNESP - Universidade Estadual Paulista "Julio de Mesquita Filho" (163)
- Repositorio Institucional Universidad de Medellín (1)
- RUN (Repositório da Universidade Nova de Lisboa) - FCT (Faculdade de Cienecias e Technologia), Universidade Nova de Lisboa (UNL), Portugal (1)
- SAPIENTIA - Universidade do Algarve - Portugal (4)
- School of Medicine, Washington University, United States (3)
- The Scholarly Commons | School of Hotel Administration; Cornell University Research (1)
- Universidad de Alicante (6)
- Universidad del Rosario, Colombia (10)
- Universidad Politécnica de Madrid (18)
- Universidade Complutense de Madrid (1)
- Universidade de Lisboa - Repositório Aberto (2)
- Universidade Estadual Paulista "Júlio de Mesquita Filho" (UNESP) (1)
- Universidade Federal do Pará (6)
- Universidade Federal do Rio Grande do Norte (UFRN) (22)
- Universidade Metodista de São Paulo (4)
- Universidade Técnica de Lisboa (3)
- Universitat de Girona, Spain (1)
- Universitätsbibliothek Kassel, Universität Kassel, Germany (1)
- Université de Montréal, Canada (5)
- Université Laval Mémoires et thèses électroniques (1)
- University of Canberra Research Repository - Australia (1)
- University of Connecticut - USA (1)
- University of Michigan (32)
- University of Queensland eSpace - Australia (16)
- University of Southampton, United Kingdom (1)
- University of Washington (4)
- Worcester Research and Publications - Worcester Research and Publications - UK (1)
Resumo:
RATIONALE: Limitations in methods for the rapid diagnosis of hospital-acquired infections often delay initiation of effective antimicrobial therapy. New diagnostic approaches offer potential clinical and cost-related improvements in the management of these infections. OBJECTIVES: We developed a decision modeling framework to assess the potential cost-effectiveness of a rapid biomarker assay to identify hospital-acquired infection in high-risk patients earlier than standard diagnostic testing. METHODS: The framework includes parameters representing rates of infection, rates of delayed appropriate therapy, and impact of delayed therapy on mortality, along with assumptions about diagnostic test characteristics and their impact on delayed therapy and length of stay. Parameter estimates were based on contemporary, published studies and supplemented with data from a four-site, observational, clinical study. Extensive sensitivity analyses were performed. The base-case analysis assumed 17.6% of ventilated patients and 11.2% of nonventilated patients develop hospital-acquired infection and that 28.7% of patients with hospital-acquired infection experience delays in appropriate antibiotic therapy with standard care. We assumed this percentage decreased by 50% (to 14.4%) among patients with true-positive results and increased by 50% (to 43.1%) among patients with false-negative results using a hypothetical biomarker assay. Cost of testing was set at $110/d. MEASUREMENTS AND MAIN RESULTS: In the base-case analysis, among ventilated patients, daily diagnostic testing starting on admission reduced inpatient mortality from 12.3 to 11.9% and increased mean costs by $1,640 per patient, resulting in an incremental cost-effectiveness ratio of $21,389 per life-year saved. Among nonventilated patients, inpatient mortality decreased from 7.3 to 7.1% and costs increased by $1,381 with diagnostic testing. The resulting incremental cost-effectiveness ratio was $42,325 per life-year saved. Threshold analyses revealed the probabilities of developing hospital-acquired infection in ventilated and nonventilated patients could be as low as 8.4 and 9.8%, respectively, to maintain incremental cost-effectiveness ratios less than $50,000 per life-year saved. CONCLUSIONS: Development and use of serial diagnostic testing that reduces the proportion of patients with delays in appropriate antibiotic therapy for hospital-acquired infections could reduce inpatient mortality. The model presented here offers a cost-effectiveness framework for future test development.