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Assessment of Clinical Criteria for Sepsis For the Third International Consensus Definitions for Sepsis and Septic Shock (Sepsis-3)

Journal Club Summary

Methodology Score: 3.5/5              
Usefulness Score: 3 /5

Seymour CW, et al. 
JAMA. 2016 Feb 23;315(8):762-74

Editorial: New Definitions for Sepsis and Septic Shock Continuing Evolution but With Much Still to Be Done
Abraham E.
JAMA. 2016;315(8):757-759

This is a retrospective cohort study that looked to validate the use current sepsis scores (SOFA, SIRS, LODS) as clinical criteria for sepsis, and to derive and validate a new, simple clinical score, qSOFA which includes RR, BP and GCS, that can be calculated with information that can be gathered quickly at the bedside. They were able to collect a large amount of encounters encompassing different types of population adding to the robustness of the derivation and validation. However, it was only validated retrospectively and not prospectively. Currently, the Sepsis-3 guideline, including qSOFA, is not endorses by SAEM or ACEP, given emergency physicians were not involved in the task force.
By: Dr. Isabelle Miles

Epi lesson: 

When describing the validity of measurement tools, various terms are commonly used:
Construct validity (which is of main concern), refers to how well a test measures what it claims to measure. 
Criterion validity refers to the extent with which a test can predict an outcome now or in the future. Content validity refers to the extent to which a measure represents all facets of a given construct. Face validity is the extent to which a test is subjectively viewed by stakeholders as measuring the construct it claims to measure. 


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