High Variability in Sepsis Guidelines in UK: Why Does It Matter?

Alison Bray, Emmanouela Kampouraki, Amanda Winter, Aaron Jesuthasan, Ben Messer and Sara Graziadio
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Alison Bray: Northern Medical Physics & Clinical Engineering, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
Emmanouela Kampouraki: Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
Amanda Winter: NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
Aaron Jesuthasan: Translational and Clinical Research Institute, Newcastle University, Newcastle upon Tyne NE2 4HH, UK
Ben Messer: Department of Anaesthetics, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK
Sara Graziadio: NIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne NE1 4LP, UK

IJERPH, 2020, vol. 17, issue 6, 1-18

Abstract: It is recommended that developers of Point Of Care Tests (POCTs) assess the care pathway of the patient population of interest in order to understand if the POCT fits within the pathway and has the potential to improve it. If the variation of the pathway across potential hospitals is large, then it is likely that the evaluation of effectiveness is harder and the route towards large-scale takes adoption longer. Evaluating care pathways can be a time-consuming activity when conducted through clinical audits or interviews with healthcare professionals. We have developed a more rapid methodology which extrapolates the care pathway from local hospital guidelines and assesses their variation. Sepsis kills 46,000 people per year in the UK with societal costs of up to £10 billion. Therefore, there is a clinical need for an optimized pathway. By applying our method in this field, we were able to assess the variation in current hospital guidelines for sepsis and infer the potential impact this may have on the evidence development on innovations in this applications. We obtained 15 local sepsis guidelines. Two independent reviewers extracted: use of the national early warning score (NEWS), signs and risk factors informing the decision to prescribe antibiotics, and the number of decisional steps up to this point. Considerable variation was observed in all the variables, which is likely to have an impact on future clinical and economic evaluations and adoption of POCT for the identification of patients with sepsis.

Keywords: sepsis; diagnosis; guidelines; POCT; evaluation (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2020
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