Monday, February 14, 2022


First10EM - By Justin Morgenstern - February 14, 2022
…”Procalcitonin just isn’t that great. The diagnostic accuracy (sensitivity/specificity) of the test is only moderate at best, and the numbers in these studies can’t be taken at face value. Because the threshold for calling procalcitonin positive or negative was often not prespecified, the authors could choose the threshold that provided the best numbers. Furthermore, most bacterial infections (such as pneumonia) don’t have a perfect gold standard, so there is even more room for bias when assessing the accuracy of procalcitonin.
Even if procalcitonin was very accurate, it shouldn’t be measured in a vacuum. We don’t need to know whether tests work, but rather whether they add anything to what we already have. Not many studies compared procalcitonin directly to physician judgment, but when the comparison is made, judgment appears to outperform procalcitonin. (Maisel 2012)
Either way, the only data supporting procalcitonin appears to be in the inpatient setting. From an emergency department standpoint, there just doesn’t seem to be any role for procalcitonin at this point in time…”