Economic impact of metagenomic next-generation sequencing versus traditional bacterial culture for postoperative central nervous system infections using a decision analysis mode: study protocol for a randomized controlled trial

作者：Ying Liang Tian, Ran Gao, Yumei Wang, Yimin Zhou, Shanshan Xu, Yuqing Duan, Wenyi Lv, Shuya Wang, Mengxue Hou, Yuqing Chen, Fangqiang Li, Wei Gao, Linlin Zhang, Zhou Jian-xin · 发表于：mSystems · 年份：2023 · DOI：10.1128/msystems.00581-23 · 被引用次数：16 · 研究领域：Infective Endocarditis Diagnosis and Management、Bacterial Infections and Vaccines、Bacterial Identification and Susceptibility Testing

ABSTRACT Central nervous system infections (CNSIs) are common complications after neurosurgery with a poor prognosis. The traditional microbiological culture methodology has a low detection rate and time consuming. Metagenomic next-generation sequencing (mNGS) has demonstrated the advantages of being faster, more accurate, and more comprehensive in clinical microbiology. Previous studies had suggested that mNGS had a high sensitivity in the diagnosis of CNSIs. Whether the application of mNGS has health economic value in clinical applications remains to be studied. We designed a prospective, single-center, superiority randomized controlled trial to compare the cost-effectiveness of mNGS with traditional methods for diagnosing CNSIs using a decision tree model. A total of 204 patients will be enrolled and randomly assigned to either the mNGS group or the traditional method group. The two groups of patients entered different decision points according to different clinical manifestations and examination results. They will be then given treatment decisions by a panel of specialists at the corresponding decision point. The primary outcome is the incremental cost-effectiveness ratio, which is the increased cost for every 1% increase in recovery rate. The secondary outcomes are a comparison of time cost, detection cost, and costs associated with antibiotics treatment between the two groups. IMPORTANCE Diagnosing and treating postoperative central nervous system infections (PCNSIs) re...