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Diagnostic stewardship and the 2017 update of the IDSA-SHEA Clinical Practice Guidelines for Clostridium difficile Infection

  • Gregory R. Madden ORCID logo , Melinda D. Poulter and Costi D. Sifri EMAIL logo
Published/Copyright: July 10, 2018
Diagnosis
From the journal Diagnosis Volume 5 Issue 3

Abstract

Diagnostic stewardship is an increasingly recognized means to reduce unnecessary tests and diagnostic errors. As a leading cause of healthcare-associated infection for which accurate laboratory diagnosis remains a challenge, Clostridium difficile offers an ideal opportunity to apply the principles of diagnostic stewardship. The recently updated 2017 Infectious Diseases Society of America (IDSA)-Society for Healthcare Epidemiology of America (SHEA) Clinical Practice Guidelines for C. difficile infection now recommend separate diagnostic strategies depending on whether an institution has adopted diagnostic stewardship in test decision making. IDSA-SHEA endorsement of diagnostic stewardship for C. difficile highlights the increasing role of diagnostic stewardship in hospitals. In this opinion piece, we introduce the concept of diagnostic stewardship by discussing the new IDSA-SHEA diagnostic recommendations for laboratory diagnosis of C. difficile. We outline recent examples of diagnostic stewardship, challenges to implementation, potential downsides and propose future areas of study.

Keywords: Clostridium difficile; diagnostic error; diagnostic stewardship
Corresponding author: Costi D. Sifri, MD, Division of Infectious Diseases and International Health, Department of Medicine, University of Virginia Health System, P.O. Box 800473, Charlottesville, VA 22908-0473, USA, Phone: +(434) 924-0260, Fax: +(434) 924-1225

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: This research was supported by the National Institutes of Health Infectious Diseases Training Grant (no. 5T-32AI007046-41, Funder Id: 10.13039/100000060).

  3. Employment or leadership: None declared.

  4. Honorarium: None declared.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

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Received: 2018-04-12
Accepted: 2018-06-08
Published Online: 2018-07-10
Published in Print: 2018-09-25

©2018 Walter de Gruyter GmbH, Berlin/Boston

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The need for cognition and the curse of cognition
  4. Review
  5. Beyond Dr. Google: the evidence on consumer-facing digital tools for diagnosis
  6. Opinion Papers
  7. Improving diagnosis by improving education: a policy brief on education in healthcare professions
  8. Diagnostic stewardship and the 2017 update of the IDSA-SHEA Clinical Practice Guidelines for Clostridium difficile Infection
  9. The approach to a diagnostic dilemma
  10. Original Articles
  11. Cognitive error in an academic emergency department
  12. How common are cognitive errors in cases presented at emergency medicine resident morbidity and mortality conferences?
  13. Mind the overlap: how system problems contribute to cognitive failure and diagnostic errors
  14. Pediatric hypertension: diagnostic patterns derived from electronic health records
  15. Combined international external quality assessment results of medical laboratory performance and reporting of samples with known antimicrobial resistance
  16. Letter to the Editor
  17. Interruptions, work environment and work load perceptions in laboratory medicine: patient safety is a “moving target”
  18. Congress Abstracts
  19. 2nd European Conference on Diagnostic Error in Medicine August 30-31, 2018, Bern, Switzerland
https://doi.org/10.1515/dx-2018-0012
Keywords for this article
Clostridium difficile; diagnostic error; diagnostic stewardship

Articles in the same Issue

  1. Frontmatter
  2. Editorial
  3. The need for cognition and the curse of cognition
  4. Review
  5. Beyond Dr. Google: the evidence on consumer-facing digital tools for diagnosis
  6. Opinion Papers
  7. Improving diagnosis by improving education: a policy brief on education in healthcare professions
  8. Diagnostic stewardship and the 2017 update of the IDSA-SHEA Clinical Practice Guidelines for Clostridium difficile Infection
  9. The approach to a diagnostic dilemma
  10. Original Articles
  11. Cognitive error in an academic emergency department
  12. How common are cognitive errors in cases presented at emergency medicine resident morbidity and mortality conferences?
  13. Mind the overlap: how system problems contribute to cognitive failure and diagnostic errors
  14. Pediatric hypertension: diagnostic patterns derived from electronic health records
  15. Combined international external quality assessment results of medical laboratory performance and reporting of samples with known antimicrobial resistance
  16. Letter to the Editor
  17. Interruptions, work environment and work load perceptions in laboratory medicine: patient safety is a “moving target”
  18. Congress Abstracts
  19. 2nd European Conference on Diagnostic Error in Medicine August 30-31, 2018, Bern, Switzerland
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