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

Malaria Journal

Commentary

Paul J Milligan¹  Matthew E Cairns¹  Baptiste Leurent¹ 

[1] MRC Tropical Epidemiology Group, London School of Hygiene and Tropical Medicine, Keppel Street, WC1E 7HT, London, UK;

关键词: Malaria;    Case Management;    Rapid Diagnostic Test;    Management Rate;    Correct Management;   

DOI  :  10.1186/1475-2875-13-494

 received in 2014-07-28, accepted in 2014-11-18,  发布年份 2014

来源: Springer

【 摘 要 】

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.

【 授权许可】

CC BY   
© Cairns et al.; licensee BioMed Central Ltd. 2014