CHEST Guidelines-Difficulties-in-the-Concurrent-Diagnoses-of-Sarcoi

Difficulties-in-the-Concurrent-Diagnoses-of-Sarcoi

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The document discusses responses and considerations related to two medical studies published in the CHEST journal. The first study, the DecatSepsis trial, involved examining the effects of dexmedetomidine on patients with septic shock. Moataz Maher Emara and colleagues addressed concerns regarding the trial, including its methodology related to delirium and the use of hydrocortisone, as well as the absence of continuous renal replacement therapy from the analysis. Despite these concerns, they believe the study's exploratory nature and findings remain valid. They acknowledge that while dexmedetomidine's potential benefits on delirium and hydrocortisone usage was assessed, its effects could not be definitively confirmed due to the study's limitations.<br /><br />The second section involves a critique of a study by Rossides and colleagues that explored the association between immune-mediated diseases (IMDs) and sarcoidosis using International Classification of Diseases (ICD) codes in a Swedish cohort. The critique, provided by Johnny F. Jaber and other authors, questions the study's reliance on ICD codes for diagnosis without pathological or serological confirmation, citing a possible overestimation of diagnoses. Furthermore, they highlight concerns over the study’s generalizability outside Sweden due to population differences.<br /><br />In response, Rossides and colleagues defended their study methodology, emphasizing the high positive predictive value of ICD codes for sarcoidosis within a Swedish context and advocating for the use of stringent ICD coding criteria to enhance accuracy. They acknowledge the limitations regarding generalizability and recommend that future research, incorporating diverse populations and thorough diagnostic data, could yield a more comprehensive understanding of these associations. Both discussions highlight the complexity of medical research and the need for careful methodological consideration to ensure accuracy and applicability of findings.

Keywords

DecatSepsis trial

dexmedetomidine

septic shock

delirium

hydrocortisone

renal replacement therapy

immune-mediated diseases

sarcoidosis

ICD codes

medical research