title: Toward an operative diagnosis in sepsis: a latent class approach.
abstract: BACKGROUND
  Recent data have suggested that 18 million of new sepsis cases occur each year worldwide, with a mortality rate of almost 30%. There is not consensus on the clinical definition of sepsis and, because of lack of training or simply unawareness, clinicians often miss or delay this diagnosis. This is especially worrying; since there is strong evidence supporting that early treatment is associated with greater clinical success. There are some difficulties for sepsis diagnosis such as the lack of an appropriate gold standard to identify this clinical condition. This situation has hampered the assessment of the accuracy of clinical signs and biomarkers to diagnose sepsis.
  
  
  METHODS
  Cross-sectional study to determine the operative characteristics of three biological markers of inflammation and coagulation (D-dimer, C-reactive protein and Procalcitonin) as diagnostic tests for sepsis, in patients admitted to hospital care with a presumptive infection as main diagnosis.
  
  
  CONCLUSIONS
  There are alternative techniques that have been used to assess the accuracy of tests without gold standards, and they have been widely used in clinical disciplines such as psychiatry, even though they have not been tested in sepsis diagnosis. Considering the main importance of diagnosis as early as possible, we propose a latent class analysis to evaluate the accuracy of three biomarkers to diagnose sepsis.
authors.affiliation: Department of Internal Medicine and Grupo Académico de Epidemiología Clínica, School of Medicine, Universidad de Antioquia, Medellín, Colombia. giseladlr@une.net.co
authors.forename: Gisela D
authors.initials: GD
authors.lastname: De La Rosa
authors.forename: Marta L
authors.initials: ML
authors.lastname: Valencia
authors.forename: Clara M
authors.initials: CM
authors.lastname: Arango
authors.forename: Carlos I
authors.initials: CI
authors.lastname: Gomez
authors.forename: Alex
authors.initials: A
authors.lastname: Garcia
authors.forename: Sigifredo
authors.initials: S
authors.lastname: Ospina
authors.forename: Susana
authors.initials: S
authors.lastname: Osorno
authors.forename: Adriana
authors.initials: A
authors.lastname: Henao
authors.forename: Fabián A
authors.initials: FA
authors.lastname: Jaimes
mesh_terms: D000328:Adult; D015415:Biomarkers / Q000032:analysis*; D002097:C-Reactive Protein / Q000032:analysis; D002116:Calcitonin / Q000032:analysis; D015740:Calcitonin Gene-Related Peptide; D003105:Colombia; D003430:Cross-Sectional Studies; D004636:Emergency Service, Hospital; D004797:Enzyme-Linked Immunosorbent Assay; D005338:Fibrin Fibrinogen Degradation Products / Q000032:analysis; D006801:Humans; D011498:Protein Precursors / Q000032:analysis; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D018805:Sepsis / Q000175:diagnosis*
chemical_list: D015415:Biomarkers; C000606589:CALCA protein, human; D005338:Fibrin Fibrinogen Degradation Products; D011498:Protein Precursors; C036309:fibrin fragment D; D002116:Calcitonin; D002097:C-Reactive Protein; D015740:Calcitonin Gene-Related Peptide