Agreement regarding SSI diagnosis and depth varied across specialties and selleck chemicals llc across individuals within each specialty. Reading the SSI definition produced small improvements in agreement about SSI diagnosis and depth. Our study further supports the existence of considerable uncertainty regarding SSI detection at the European level. Our results are probably reliable, as we placed the participants in unbiased conditions by asking them to score the same case-vignettes through an Internet database. This method ensured that the participants were not influenced by factors such as perceived SSI risk in a particular unit or patient. Considering such factors would probably have increased disagreement among participants. Disagreement may be higher regarding the diagnosis of post-discharge SSIs or of SSIs in patients with minimal wound discharge and no microbiological results.

We found scoring differences across participants, across countries, and across case-vignette types. Agreement for SSI diagnosis and depth was good in Germany within ICPs, within surgeons, and between both specialties. In Germany, the regular cross-hospital evaluations of diagnostic accuracy through case-vignettes, conducted as part of the KISS surveillance network, probably improve agreement [1]. Several other countries, such as The Netherlands, France, and the UK have had SSI surveillance networks for many years, which may have improved diagnostic accuracy via the sharing of surveillance methods and SSI rates. Providing the SSI definition did not improve the correlation between scores in our study, in keeping with a previous study demonstrating variable interpretations of the same definition [10].

Our results further support the need for a multidisciplinary approach to SSI surveillance [27]. Our data from 10 European countries consistently showed differences in agreement in each country, suggesting that our results may be also relevant to other countries. Our study has several limitations. First, the vignettes were scored for the presence or absence of SSI by each participant working alone. SSI is often a difficult diagnosis that is typically made after discussion among surgeons and ICPs. Thus, SSI surveillance aims not only to obtain accurate SSI rates, but also to enhance teamwork between surgical and infection-control teams in order to ensure the implementation of effective preventive strategies.

Drug_discovery Our results indicate that surveillance should not be performed by individuals in a single specialty [27]. Second, the vignettes were scored via an online database. The vignettes were built from real cases, and the diagnosis of SSI may have been easier for surgeons or ICPs who had had direct contact with the patients. Third, the study was not designed to assess the accuracy of SSI diagnosis. Instead, we focused on agreement among ICPs and surgeons.