Compared Performance of the 2023 Duke-International Society for Cardiovascular Infectious Diseases, the 2000 Modified Duke, and the 2015 ESC Criteria for the Diagnosis of Infective Endocarditis in a French Multicenter Prospective Cohort.
2023 Duke-ISCVID criteria
Diagnosis classification
Infective endocarditis
accuracy
sensitivity
specificity
Journal
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
ISSN: 1537-6591
Titre abrégé: Clin Infect Dis
Pays: United States
ID NLM: 9203213
Informations de publication
Date de publication:
08 Feb 2024
08 Feb 2024
Historique:
received:
02
06
2023
revised:
03
09
2023
accepted:
26
01
2024
medline:
8
2
2024
pubmed:
8
2
2024
entrez:
8
2
2024
Statut:
aheadofprint
Résumé
The 2023 Duke-ISCVID Criteria for infective endocarditis (IE) were proposed as an updated diagnostic classification of IE. Using an open prospective multicenter cohort of patients treated for IE, we compared the performance of these new criteria to that of the 2000 Modified Duke and 2015 ESC criteria. Cases of patients treated for IE between January 2017 and October 2022 were adjudicated as certain IE or not. Each case was also categorized as either definite or possible/rejected within each classification. Sensitivity, specificity, and accuracy were estimated, with 95% confidence intervals. Of the 1194 patients analyzed (mean age 66.1 years, 71.2% men), 414 (34.7%) had a prosthetic valve and 284 (23.8%) had a cardiac implanted electronic device (CIED); 946 (79.2%) were adjudicated as certain IE; 978 (81.9%), 997 (83.5%), and 1057 (88.5%) were classified as definite IE in the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID criteria, respectively. The sensitivity of each set of criteria was 93.2% [91.6-94.8], 95.0% [93.7-96.4], and 97.6% [96.6-98.6], respectively (p<.001 for all 2-by-2 comparisons). Corresponding specificity rates were 61.3% [55.2-67.4), 60.5% [54.4-66.6], and 46.0% [39.8-52.2], respectively. In patients without CIED, sensitivity rates were 94.8% [93.2-96.4], 96.5% [95.1-97.8], and 97.7% [96.6-98.8] and specificity rates were 59.0% [51.6-66.3], 56.6% [49.3-64.0], and 53.8% [46.3-61.2], respectively. Overall, the 2023 Duke-ISCVID criteria had a significantly higher sensitivity but a significantly lower specificity, compared to older criteria. This decreased specificity was mainly attributable to patients with CIED.
Sections du résumé
BACKGROUND
BACKGROUND
The 2023 Duke-ISCVID Criteria for infective endocarditis (IE) were proposed as an updated diagnostic classification of IE. Using an open prospective multicenter cohort of patients treated for IE, we compared the performance of these new criteria to that of the 2000 Modified Duke and 2015 ESC criteria.
METHODS
METHODS
Cases of patients treated for IE between January 2017 and October 2022 were adjudicated as certain IE or not. Each case was also categorized as either definite or possible/rejected within each classification. Sensitivity, specificity, and accuracy were estimated, with 95% confidence intervals.
RESULTS
RESULTS
Of the 1194 patients analyzed (mean age 66.1 years, 71.2% men), 414 (34.7%) had a prosthetic valve and 284 (23.8%) had a cardiac implanted electronic device (CIED); 946 (79.2%) were adjudicated as certain IE; 978 (81.9%), 997 (83.5%), and 1057 (88.5%) were classified as definite IE in the 2000 modified Duke, 2015 ESC, and 2023 Duke-ISCVID criteria, respectively. The sensitivity of each set of criteria was 93.2% [91.6-94.8], 95.0% [93.7-96.4], and 97.6% [96.6-98.6], respectively (p<.001 for all 2-by-2 comparisons). Corresponding specificity rates were 61.3% [55.2-67.4), 60.5% [54.4-66.6], and 46.0% [39.8-52.2], respectively. In patients without CIED, sensitivity rates were 94.8% [93.2-96.4], 96.5% [95.1-97.8], and 97.7% [96.6-98.8] and specificity rates were 59.0% [51.6-66.3], 56.6% [49.3-64.0], and 53.8% [46.3-61.2], respectively.
CONCLUSION
CONCLUSIONS
Overall, the 2023 Duke-ISCVID criteria had a significantly higher sensitivity but a significantly lower specificity, compared to older criteria. This decreased specificity was mainly attributable to patients with CIED.
Identifiants
pubmed: 38330171
pii: 7603542
doi: 10.1093/cid/ciae035
pii:
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Investigateurs
Nelly Agrinier
(N)
François Alla
(F)
Guillaume Béraud
(G)
Elisabeth Botelho-Nevers
(E)
Catherine Chirouze
(C)
François Delahaye
(F)
Xavier Duval
(X)
François Goehringer
(F)
Bruno Hoen
(B)
Bernard Iung
(B)
Christine Selton Suty
(CS)
Christophe Strady
(C)
Pierre Tattevin
(P)
Corentine Alauzet
(C)
Patrick Assayag
(P)
Kasra Azarnoush
(K)
Mathieu Blot
(M)
Yohann Bohbot
(Y)
Kevin Bouiller
(K)
Marielle Buisson
(M)
Elodie Curlier
(E)
Enrica Dorigo
(E)
Michel Duong
(M)
Mazen Elfarra
(M)
Clémentine Esteve
(C)
Laura Filippetti
(L)
Damien Fournier
(D)
Nathalie Grand
(N)
Raphaëlle Huguet
(R)
Emila Ilic-Habensus
(E)
Audrey Le Bot
(A)
Benjamin Lefèvre
(B)
Raphaël Lepeule
(R)
Sophie Mahy
(S)
Charles Monnin
(C)
Basile Mouhat
(B)
Franck Noël
(F)
Nathalie Pansu
(N)
Lucas Perez
(L)
Andranik Petrosyan
(A)
Romain Pierrard
(R)
Matthieu Revest
(M)
Thibault Sixt
(T)
Anne Suzat
(A)
Charles Tassigny
(C)
Noémie Tissot
(N)
Dehbia Aboudaoud
(D)
Hassina Bouguerra
(H)
Catherine Campagnac
(C)
Carole Charles
(C)
Giulia Corradi
(G)
Sandra Dupuy
(S)
Eola Francius
(E)
Sandrine Gerset
(S)
Sandrine Gohier
(S)
Mesut Gun
(M)
Maryse André
(M)
Véronique Ronat
(V)
Tubanur Unal Albayrak
(TU)
Marie-Line Erpelding
(ML)
Nadine Juge
(N)
Benoit Lalloué
(B)
Willy Ngueyon Sime
(WN)
Marie Sponga
(M)
Jean-Marc Virion
(JM)
Informations de copyright
© The Author(s) 2024. Published by Oxford University Press on behalf of Infectious Diseases Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.