The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study

\ua9 The Author(s) 2024. Published by Oxford University Press on behalf of British Society for Antimicrobial Chemotherapy.Background: Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK. Objectives: Evaluating cost-effectiveness of using PCT to guide antibiotic decisions in individuals hospitalized with COVID-19, as part of a wider research programme. Methods: Retrospective individual-level data on patients hospitalized with COVID-19 were collected from 11 NHS acute hospital Trusts and Health Boards from England and Wales, which varied in their use of baseline PCT testing during the first COVID-19 pandemic wave. A matched analysis (part of a wider analysis reported elsewhere) created groups of patients whose PCT was/was not tested at baseline. A model was created with combined decision tree/Markov phases, parameterized with quality-of-life/unit cost estimates from the literature, and used to estimate costs and quality-adjusted life years (QALYs). Cost-effectiveness was judged at a \ua320000/QALY threshold. Uncertainty was characterized using bootstrapping. Results: People who had baseline PCT testing had shorter general ward/ICU stays and spent less time on antibiotics, though with overlap between the groups’ 95% CIs. Those with baseline PCT testing accrued more QALYs (8.76 versus 8.62) and lower costs (\ua39830 versus \ua310 700). The point estimate was baseline PCT testing being dominant over no baseline testing, though with uncertainty: the probability of cost-effectiveness was 0.579 with a 1 year horizon and 0.872 with a lifetime horizon. Conclusions: Using PCT to guide antibiotic therapy in individuals hospitalized with COVID-19 is more likely to be cost-effective than not, albeit with uncertainty

The cost-effectiveness of procalcitonin for guiding antibiotic prescribing in individuals hospitalized with COVID-19: part of the PEACH study

Background Many hospitals introduced procalcitonin (PCT) testing to help diagnose bacterial coinfection in individuals with COVID-19, and guide antibiotic decision-making during the COVID-19 pandemic in the UK. Objectives Evaluating cost-effectiveness of using PCT to guide antibiotic decisions in individuals hospitalized with COVID-19, as part of a wider research programme. Methods Retrospective individual-level data on patients hospitalized with COVID-19 were collected from 11 NHS acute hospital Trusts and Health Boards from England and Wales, which varied in their use of baseline PCT testing during the first COVID-19 pandemic wave. A matched analysis (part of a wider analysis reported elsewhere) created groups of patients whose PCT was/was not tested at baseline. A model was created with combined decision tree/Markov phases, parameterized with quality-of-life/unit cost estimates from the literature, and used to estimate costs and quality-adjusted life years (QALYs). Cost-effectiveness was judged at a £20 000/QALY threshold. Uncertainty was characterized using bootstrapping. Results People who had baseline PCT testing had shorter general ward/ICU stays and spent less time on antibiotics, though with overlap between the groups’ 95% CIs. Those with baseline PCT testing accrued more QALYs (8.76 versus 8.62) and lower costs (£9830 versus £10 700). The point estimate was baseline PCT testing being dominant over no baseline testing, though with uncertainty: the probability of cost-effectiveness was 0.579 with a 1 year horizon and 0.872 with a lifetime horizon. Conclusions Using PCT to guide antibiotic therapy in individuals hospitalized with COVID-19 is more likely to be cost-effective than not, albeit with uncertainty

Wpływ obróbki zamrażalniczej, odwadniania osmotycznego i czasu przechowywania na rehydrację próżniowo wysuszonych truskawek

Dried fruits – strawberries – were rehydrated by dipping them in water at room temperature and their rehydration characteristics were examined. The aim of this study was to analyze the influence of the preparation method (the impact of freezing treatment at -18ºC, osmotic dehydration in sucrose solution 61.5%) of raw material and storage (from 32 days to 399 days) on the rehydration of dried strawberries. Dried strawberries obtained by the vacuum method from frozen fruits have larger relative weight gain with prolongation of rehydration time than dried fruits obtained from raw strawberries. Osmotic dehydration of strawberries before vacuum drying did not cause a significant difference in rehydration of dried strawberries stored for a long period. Vacuum dried strawberries stored for about 360 days longer at ambient temperature obtained slightly lower relative weight gain and higher solids content.Suszone owoce – truskawki – poddano rehydracji poprzez zanurzenie w wodzie o temperaturze otoczenia i zbadano ich rehydracyjne właściwości. Celem pracy była analiza wpływu metody obróbki wstępnej (wpływ zamrożenia w -18°C, osmotyczne odwodnienie w roztworze sacharozy 61,5%) surowca i przechowywania (od 32 dni do 399 dni) na rehydrację wysuszonych truskawek. Próżniowo wysuszone truskawki z mrożonych owoców uzyskują większy względny przyrost masy wraz z wydłużaniem czasów rehydracji w porównaniu do suszy z truskawek surowych. Osmotyczne odwodnianie truskawek przed suszeniem próżniowym nie spowodowało znaczącej różnicy w rehydracji suszu truskawkowego długo przechowywanego. Wysuszone próżniowo truskawki przechowywane o około 360 dni dłużej w temperaturze otoczenia uzyskały nieznacznie niższy względny przyrost masy i wyższą zawartość suchej substancji

CROP TYPE MAPPING FROM A SEQUENCE OF TERRASAR-X IMAGES WITH DYNAMIC CONDITIONAL RANDOM FIELDS

Crop phenology is dynamic as it changes with times of the year. Such biophysical processes also look spectrally different to remote sensing satellites. Some crops may depict similar spectral properties if their phenology coincide, but differ later when their phenology diverge. Thus, conventional approaches that select only images from phenological stages where crops are distinguishable for classification, have low discrimination. In contrast, stacking images within a cropping season limits discrimination to a single feature space that can suffer from overlapping classes. Since crop backscatter varies with time, it can aid discrimination. Therefore, our main objective is to develop a crop sequence classification method using multitemporal TerraSAR-X images. We adopt first order markov assumption in undirected temporal graph sequence. This property is exploited to implement Dynamic Conditional Random Fields (DCRFs). Our DCRFs model has a repeated structure of temporally connected Conditional Random Fields (CRFs). Each node in the sequence is connected to its predecessor via conditional probability matrix. The matrix is computed using posterior class probabilities from association potential. This way, there is a mutual temporal exchange of phenological information observed in TerraSAR-X images. When compared to independent epoch classification, the designed DCRF model improved crop discrimination at each epoch in the sequence. However, government, insurers, agricultural market traders and other stakeholders are interested in the quantity of a certain crop in a season. Therefore, we further develop a DCRF ensemble classifier. The ensemble produces an optimal crop map by maximizing over posterior class probabilities selected from the sequence based on maximum F1-score and weighted by correctness. Our ensemble technique is compared to standard approach of stacking all images as bands for classification using Maximum Likelihood Classifier (MLC) and standard CRFs. It outperforms MLC and CRFs by 7.70% and 6.42% in overall accuracy, respectively

CROP TYPE MAPPING FROM A SEQUENCE OF TERRASAR-X IMAGES WITH DYNAMIC CONDITIONAL RANDOM FIELDS

Crop phenology is dynamic as it changes with times of the year. Such biophysical processes also look spectrally different to remote sensing satellites. Some crops may depict similar spectral properties if their phenology coincide, but differ later when their phenology diverge. Thus, conventional approaches that select only images from phenological stages where crops are distinguishable for classification, have low discrimination. In contrast, stacking images within a cropping season limits discrimination to a single feature space that can suffer from overlapping classes. Since crop backscatter varies with time, it can aid discrimination. Therefore, our main objective is to develop a crop sequence classification method using multitemporal TerraSAR-X images. We adopt first order markov assumption in undirected temporal graph sequence. This property is exploited to implement Dynamic Conditional Random Fields (DCRFs). Our DCRFs model has a repeated structure of temporally connected Conditional Random Fields (CRFs). Each node in the sequence is connected to its predecessor via conditional probability matrix. The matrix is computed using posterior class probabilities from association potential. This way, there is a mutual temporal exchange of phenological information observed in TerraSAR-X images. When compared to independent epoch classification, the designed DCRF model improved crop discrimination at each epoch in the sequence. However, government, insurers, agricultural market traders and other stakeholders are interested in the quantity of a certain crop in a season. Therefore, we further develop a DCRF ensemble classifier. The ensemble produces an optimal crop map by maximizing over posterior class probabilities selected from the sequence based on maximum F1-score and weighted by correctness. Our ensemble technique is compared to standard approach of stacking all images as bands for classification using Maximum Likelihood Classifier (MLC) and standard CRFs. It outperforms MLC and CRFs by 7.70% and 6.42% in overall accuracy, respectively