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Analysis of institutional authors

Jordan, AnaAuthorBrito-Zeron, PAuthorBosch, XCorresponding Author

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Diagnosing unexplained fever: can quick diagnosis units replace inpatient hospitalization?

Publicated to:European Journal Of Clinical Investigation. 44 (8): 707-718 - 2014-01-01 44(8), DOI: 10.1111/eci.12287

Authors: Brito-Zeron, Pilar; Nicolas-Ocejo, David; Jordan, Anna; Retamozo, Soledad; Lopez-Soto, Alfonso; Bosch, Xavier

Affiliations

Univ Barcelona, Hosp Clin, Dept Autoimmune Dis, Inst Invest Biomed August Pi & Sunyer IDIBAPS, E-08036 Barcelona, Spain - Author
Univ Barcelona, Hosp Clin, Dept Internal Med, Inst Invest Biomed August Pi & Sunyer IDIBAPS, E-08036 Barcelona, Spain - Author
Universitat de Barcelona - Author

Abstract

Outpatient quick diagnosis units (QDUs) have become an increasingly recognized alternative to hospitalization for the diagnosis of a number of potentially serious diseases. No study has prospectively evaluated the usefulness of QDU for the diagnosis of unexplained fever.We prospectively assessed patients referred to QDU due to fever of uncertain nature (FUN), defined as a temperature > 38 °C during at least 1 week and no diagnosis after a previous evaluation. We also evaluated consecutive patients with FUN who were hospitalized during the same period. QDU and hospital costs were analysed by micro-costing techniques.We evaluated 176 QDU patients and 168 controls. QDU patients were younger and required fewer investigations than controls. QDU patients had higher prevalence of viral infections (36% vs. 8%, P < 0·001) and lower prevalence of bacterial infections (6% vs. 46%, P < 0·001) and malignancies (2% vs. 14%, P < 0·001). While time-to-diagnosis of QDU patients was longer than length-of-stay of controls (25·82 vs.12·89 days, P < 0·001), 56% of QDU patients only required up to two visits. Cost per QDU patient was €644·59, while it was €4404·64 per hospitalized patient.QDU patients with FUN were younger and had less serious diseases than controls including more viral and less bacterial infections and fewer malignancies. Mainly owing to untimely diagnostic reports, time-to-diagnosis was longer in QDU patients. Cost-savings in QDU were substantial. Using objective tools to evaluate the condition severity and general health status of FUN patients could help decide the most appropriate setting for their diagnostic study.© 2014 Stichting European Society for Clinical Investigation Journal Foundation.

Keywords

autoimmune diseasesfeverfever of unknown origininfectionsmalignancyAutoimmune diseasesFeverFever of unknown originInfectionsMalignancyQuick diagnosis unitsSpring

Quality index

Bibliometric impact. Analysis of the contribution and dissemination channel

The work has been published in the journal European Journal Of Clinical Investigation due to its progression and the good impact it has achieved in recent years, according to the agency WoS (JCR), it has become a reference in its field. In the year of publication of the work, 2014, it was in position 30/154, thus managing to position itself as a Q1 (Primer Cuartil), in the category Medicine, General & Internal.

From a relative perspective, and based on the normalized impact indicator calculated from the Field Citation Ratio (FCR) of the Dimensions source, it yields a value of: 1.15, which indicates that, compared to works in the same discipline and in the same year of publication, it ranks as a work cited above average. (source consulted: Dimensions Jul 2025)

Specifically, and according to different indexing agencies, this work has accumulated citations as of 2025-07-01, the following number of citations:

  • WoS: 13
  • Scopus: 11
  • Europe PMC: 9

Impact and social visibility

From the perspective of influence or social adoption, and based on metrics associated with mentions and interactions provided by agencies specializing in calculating the so-called "Alternative or Social Metrics," we can highlight as of 2025-07-01:

  • The use of this contribution in bookmarks, code forks, additions to favorite lists for recurrent reading, as well as general views, indicates that someone is using the publication as a basis for their current work. This may be a notable indicator of future more formal and academic citations. This claim is supported by the result of the "Capture" indicator, which yields a total of: 59 (PlumX).

Leadership analysis of institutional authors

There is a significant leadership presence as some of the institution’s authors appear as the first or last signer, detailed as follows: First Author (Brito Zeron, Maria del Pilar) and Last Author (Bosch Genover, Xavier).

the author responsible for correspondence tasks has been Bosch Genover, Xavier.