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Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR).

Publication ,  Journal Article
Evans, SR; Rubin, D; Follmann, D; Pennello, G; Huskins, WC; Powers, JH; Schoenfeld, D; Chuang-Stein, C; Cosgrove, SE; Fowler, VG; Lautenbach, E ...
Published in: Clin Infect Dis
September 1, 2015

Clinical trials that compare strategies to optimize antibiotic use are of critical importance but are limited by competing risks that distort outcome interpretation, complexities of noninferiority trials, large sample sizes, and inadequate evaluation of benefits and harms at the patient level. The Antibacterial Resistance Leadership Group strives to overcome these challenges through innovative trial design. Response adjusted for duration of antibiotic risk (RADAR) is a novel methodology utilizing a superiority design and a 2-step process: (1) categorizing patients into an overall clinical outcome (based on benefits and harms), and (2) ranking patients with respect to a desirability of outcome ranking (DOOR). DOORs are constructed by assigning higher ranks to patients with (1) better overall clinical outcomes and (2) shorter durations of antibiotic use for similar overall clinical outcomes. DOOR distributions are compared between antibiotic use strategies. The probability that a randomly selected patient will have a better DOOR if assigned to the new strategy is estimated. DOOR/RADAR represents a new paradigm in assessing the risks and benefits of new strategies to optimize antibiotic use.

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Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

September 1, 2015

Volume

61

Issue

5

Start / End Page

800 / 806

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Research Design
  • Patient Safety
  • Microbiology
  • Humans
  • Drug Resistance, Bacterial
  • Clinical Trials as Topic
  • Bacterial Infections
  • Anti-Bacterial Agents
 

Citation

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Evans, S. R., Rubin, D., Follmann, D., Pennello, G., Huskins, W. C., Powers, J. H., … Chambers, H. F. (2015). Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR). Clin Infect Dis, 61(5), 800–806. https://doi.org/10.1093/cid/civ495
Evans, Scott R., Daniel Rubin, Dean Follmann, Gene Pennello, W Charles Huskins, John H. Powers, David Schoenfeld, et al. “Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR).Clin Infect Dis 61, no. 5 (September 1, 2015): 800–806. https://doi.org/10.1093/cid/civ495.
Evans SR, Rubin D, Follmann D, Pennello G, Huskins WC, Powers JH, et al. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR). Clin Infect Dis. 2015 Sep 1;61(5):800–6.
Evans, Scott R., et al. “Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR).Clin Infect Dis, vol. 61, no. 5, Sept. 2015, pp. 800–06. Pubmed, doi:10.1093/cid/civ495.
Evans SR, Rubin D, Follmann D, Pennello G, Huskins WC, Powers JH, Schoenfeld D, Chuang-Stein C, Cosgrove SE, Fowler VG, Lautenbach E, Chambers HF. Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR). Clin Infect Dis. 2015 Sep 1;61(5):800–806.
Journal cover image

Published In

Clin Infect Dis

DOI

EISSN

1537-6591

Publication Date

September 1, 2015

Volume

61

Issue

5

Start / End Page

800 / 806

Location

United States

Related Subject Headings

  • Treatment Outcome
  • Risk
  • Research Design
  • Patient Safety
  • Microbiology
  • Humans
  • Drug Resistance, Bacterial
  • Clinical Trials as Topic
  • Bacterial Infections
  • Anti-Bacterial Agents