mirror of https://github.com/msberends/AMR.git
126 lines
6.1 KiB
R
Executable File
126 lines
6.1 KiB
R
Executable File
% Generated by roxygen2: do not edit by hand
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% Please edit documentation in R/first_isolates.R
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\name{first_isolate}
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\alias{first_isolate}
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\title{Determine first (weighted) isolates}
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\source{
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Methodology of this function is based on: "M39 Analysis and Presentation of Cumulative Antimicrobial Susceptibility Test Data, 4th Edition", 2014, Clinical and Laboratory Standards Institute. \url{https://clsi.org/standards/products/microbiology/documents/m39/}.
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}
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\usage{
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first_isolate(tbl, col_date, col_patient_id, col_bactid = NA,
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col_testcode = NA, col_specimen = NA, col_icu = NA,
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col_keyantibiotics = NA, episode_days = 365, testcodes_exclude = "",
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icu_exclude = FALSE, filter_specimen = NA, output_logical = TRUE,
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type = "keyantibiotics", ignore_I = TRUE, points_threshold = 2,
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info = TRUE, col_genus = NA, col_species = NA)
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}
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\arguments{
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\item{tbl}{a \code{data.frame} containing isolates.}
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\item{col_date}{column name of the result date (or date that is was received on the lab)}
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\item{col_patient_id}{column name of the unique IDs of the patients}
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\item{col_bactid}{column name of the unique IDs of the microorganisms (should occur in the \code{\link{microorganisms}} dataset)}
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\item{col_testcode}{column name of the test codes. Use \code{col_testcode = NA} to \strong{not} exclude certain test codes (like test codes for screening). In that case \code{testcodes_exclude} will be ignored. Supports tidyverse-like quotation.}
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\item{col_specimen}{column name of the specimen type or group}
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\item{col_icu}{column name of the logicals (\code{TRUE}/\code{FALSE}) whether a ward or department is an Intensive Care Unit (ICU)}
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\item{col_keyantibiotics}{column name of the key antibiotics to determine first \emph{weighted} isolates, see \code{\link{key_antibiotics}}. Supports tidyverse-like quotation.}
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\item{episode_days}{episode in days after which a genus/species combination will be determined as 'first isolate' again}
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\item{testcodes_exclude}{character vector with test codes that should be excluded (case-insensitive)}
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\item{icu_exclude}{logical whether ICU isolates should be excluded}
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\item{filter_specimen}{specimen group or type that should be excluded}
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\item{output_logical}{return output as \code{logical} (will else be the values \code{0} or \code{1})}
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\item{type}{type to determine weighed isolates; can be \code{"keyantibiotics"} or \code{"points"}, see Details}
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\item{ignore_I}{logical to determine whether antibiotic interpretations with \code{"I"} will be ignored when \code{type = "keyantibiotics"}, see Details}
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\item{points_threshold}{points until the comparison of key antibiotics will lead to inclusion of an isolate when \code{type = "points"}, see Details}
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\item{info}{print progress}
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\item{col_genus}{(deprecated, use \code{col_bactid} instead) column name of the genus of the microorganisms}
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\item{col_species}{(deprecated, use \code{col_bactid} instead) column name of the species of the microorganisms}
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}
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\value{
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A vector to add to table, see Examples.
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}
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\description{
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Determine first (weighted) isolates of all microorganisms of every patient per episode and (if needed) per specimen type.
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}
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\details{
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\strong{WHY THIS IS SO IMPORTANT} \cr
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To conduct an analysis of antimicrobial resistance, you should only include the first isolate of every patient per episode \href{https://www.ncbi.nlm.nih.gov/pubmed/17304462}{[1]}. If you would not do this, you could easily get an overestimate or underestimate of the resistance of an antibiotic. Imagine that a patient was admitted with an MRSA and that it was found in 5 different blood cultures the following week. The resistance percentage of oxacillin of all \emph{S. aureus} isolates would be overestimated, because you included this MRSA more than once. It would be \href{https://en.wikipedia.org/wiki/Selection_bias}{selection bias}.
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\strong{DETERMINING WEIGHTED ISOLATES} \cr
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\strong{1. Using} \code{type = "keyantibiotics"} \strong{and parameter} \code{ignore_I} \cr
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To determine weighted isolates, the difference between key antibiotics will be checked. Any difference from S to R (or vice versa) will (re)select an isolate as a first weighted isolate. With \code{ignore_I = FALSE}, also differences from I to S|R (or vice versa) will lead to this. This is a reliable method and 30-35 times faster than method 2. \cr
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\strong{2. Using} \code{type = "points"} \strong{and parameter} \code{points_threshold} \cr
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To determine weighted isolates, difference between antimicrobial interpretations will be measured with points. A difference from I to S|R (or vice versa) means 0.5 points, a difference from S to R (or vice versa) means 1 point. When the sum of points exceeds \code{points_threshold}, an isolate will be (re)selected as a first weighted isolate. This method is being used by the Infection Prevention department (Dr M. Lokate) of the University Medical Center Groningen (UMCG).
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}
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\examples{
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# septic_patients is a dataset available in the AMR package
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?septic_patients
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my_patients <- septic_patients
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library(dplyr)
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my_patients$first_isolate <- my_patients \%>\%
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first_isolate(col_date = "date",
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col_patient_id = "patient_id",
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col_bactid = "bactid")
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\dontrun{
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# set key antibiotics to a new variable
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tbl$keyab <- key_antibiotics(tbl)
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tbl$first_isolate <-
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first_isolate(tbl)
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tbl$first_isolate_weighed <-
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first_isolate(tbl,
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col_keyantibiotics = 'keyab')
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tbl$first_blood_isolate <-
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first_isolate(tbl,
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filter_specimen = 'Blood')
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tbl$first_blood_isolate_weighed <-
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first_isolate(tbl,
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filter_specimen = 'Blood',
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col_keyantibiotics = 'keyab')
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tbl$first_urine_isolate <-
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first_isolate(tbl,
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filter_specimen = 'Urine')
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tbl$first_urine_isolate_weighed <-
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first_isolate(tbl,
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filter_specimen = 'Urine',
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col_keyantibiotics = 'keyab')
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tbl$first_resp_isolate <-
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first_isolate(tbl,
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filter_specimen = 'Respiratory')
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tbl$first_resp_isolate_weighed <-
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first_isolate(tbl,
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filter_specimen = 'Respiratory',
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col_keyantibiotics = 'keyab')
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}
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}
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\keyword{first}
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\keyword{isolate}
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\keyword{isolates}
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