{"id":31089,"date":"2026-09-03T04:47:00","date_gmt":"2026-09-02T20:47:00","guid":{"rendered":"https:\/\/csccm.org.cn\/?p=31089"},"modified":"2026-09-03T06:19:47","modified_gmt":"2026-09-02T22:19:47","slug":"jama-netw-open%e5%8f%91%e8%a1%a8%e8%ae%ba%e6%96%87%ef%bc%9a%e8%84%93%e6%af%92%e7%97%87%e4%b8%b4%e5%ba%8a%e8%a1%a8%e5%9e%8b%e7%9a%84%e5%a4%9a%e4%b8%ad%e5%bf%83%e9%aa%8c%e8%af%81","status":"publish","type":"post","link":"https:\/\/csccm.org.cn\/?p=31089","title":{"rendered":"[JAMA Netw Open\u53d1\u8868\u8bba\u6587]\uff1a\u8113\u6bd2\u75c7\u4e34\u5e8a\u8868\u578b\u7684\u591a\u4e2d\u5fc3\u9a8c\u8bc1"},"content":{"rendered":"\n

Original Investigation <\/p>\n\n\n\n

Infectious Diseases<\/p>\n\n\n\n

Multicenter Validation of Clinical Sepsis Phenotypes<\/h1>\n\n\n\n

Chang Ho Yoon, Daniel Sj\u00f6holm, Kristin E. Wickstr\u00f8m, et al<\/h3>\n\n\n\n

JAMA Netw Open 2026;9;(6):e2616134. doi:10.1001\/jamanetworkopen.2026.16134<\/h3>\n\n\n\n

Key Points<\/p>\n\n\n\n

Question<\/strong>  Are the 4 clinical phenotypes of sepsis derived from Sepsis Endotyping in Emergency Care (SENECA) data generalizable across independent, international patient cohorts?<\/p>\n\n\n\n

Findings<\/strong>  In this multisite retrospective cohort study of 48\u202f246 patient encounters, there was poor consistency between the SENECA-derived phenotypes and the phenotypes derived at 3 independent clinical sites.<\/p>\n\n\n\n

Meaning<\/strong>  This study found that the 4 clinical phenotypes of sepsis derived from SENECA data lack generalizability across independent cohorts, suggesting that they may not be suitable for universal clinical application in their current form.<\/a><\/p>\n\n\n\n

Abstract<\/p>\n\n\n\n

Importance<\/strong>  Four clinical phenotypes of sepsis based on data from electronic health records have been proposed. Although promising, the generalizability of these phenotypes remains uncertain, and multisite validation is needed.<\/p>\n\n\n\n

Objective<\/strong>  To validate, using the same methods and inclusion criteria, the 4 clinical phenotypes derived from Sepsis Endotyping in Emergency Care (SENECA) data.<\/p>\n\n\n\n

Design, Setting, and Participants<\/strong>  This multisite retrospective cohort study uses data on adult patients admitted to the emergency departments in Stockholm, Sweden (January 1, 2011, to September 1, 2023); Oxford, England (February 4, 2014, to June 20, 2021); and Oslo, Norway (January 4, 2019, to October 9, 2023) university hospitals. Included encounters are those with body fluid cultures taken, documented antibiotic administration, and Sequential Organ Failure Assessment scores of 2 or more, all within 6 hours of admission. Data analysis was conducted from November 2, 2023, to September 1, 2025.<\/p>\n\n\n\n

Main Outcomes and Measures<\/strong>  Consensus clustering with k<\/em>-means was used to derive 4 clinical phenotypes at each site, comparing them with the SENECA-derived phenotypes, as well as with one another.<\/p>\n\n\n\n

Results<\/strong>\u00a0\u00a0There were 30\u202f865 patient encounters in Stockholm (mean [SD] age, 68 [16] years; 18\u202f165 men [59%]), 15\u202f575 in Oxford (mean [SD] age, 71 [18] years; 9067 men [58%]), and 1806 in Oslo (mean [SD] age, 71 [17] years; 1068 men [59%]). There was little consistency between the SENECA clinical phenotypes and each site\u2019s own phenotypes, with a Cohen \u03ba of 0.32 for Stockholm, 0.37 for Oslo, and 0.40 for Oxford; the Adjusted Rand Indices were 0.21 for Stockholm, 0.27 for Oslo, and 0.26 for Oxford. There was also little consistency between the phenotypes derived in Stockholm, Oxford, and Oslo.<\/p>\n\n\n\n

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Conclusions and Relevance<\/strong>  This study suggests that the 4 clinical phenotypes of the SENECA data are not generalizable across 3 independent cohorts. This calls for further exploration of possible underlying sepsis subgroups using alternative approaches that mitigate the inherent stochasticity in many unsupervised and semisupervised clustering methods.<\/p>\n","protected":false},"excerpt":{"rendered":"

Original Investigation  Infectious Diseases Multic […]<\/p>\n","protected":false},"author":3,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[32,23],"tags":[],"_links":{"self":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31089"}],"collection":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/users\/3"}],"replies":[{"embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcomments&post=31089"}],"version-history":[{"count":2,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31089\/revisions"}],"predecessor-version":[{"id":31645,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=\/wp\/v2\/posts\/31089\/revisions\/31645"}],"wp:attachment":[{"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fmedia&parent=31089"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Fcategories&post=31089"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/csccm.org.cn\/index.php?rest_route=%2Fwp%2Fv2%2Ftags&post=31089"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}