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Background <p>Evaluating therapeutic appropriateness is a cornerstone of antimicrobial stewardship. The original Medication Assessment Tool for Community-Acquired Pneumonia (MAT-CAP), developed in Norway, requires adaptation to account for evolving IDSA/ATS recommendations and region-specific antimicrobial resistance patterns in the UAE. To revise, adapt, and validate a Medication Assessment Tool for Community-Acquired Pneumonia (rMAT-CAP), adapted to the UAE healthcare context.</p> Methods <p>A methodological study was conducted in three phases: (1) systematic revision of MAT-CAP indicators in accordance with 2019 IDSA/ATS guidelines and UAE resistance data; (2) content validation through a multidisciplinary Delphi panel of 10 experts; and (3) psychometric validation using inter-rater reliability and criterion validity assessments based on 30 anonymized CAP cases.</p> Results <p>The rMAT-CAP comprised 13 explicit, guideline-aligned criteria covering empirical therapy, microbiological diagnostics, dose adjustment, IV-to-oral switch, and treatment duration. Content validity indices were excellent (mean I-CVI = 0.95; S-CVI/Ave = 0.95). Inter-rater reliability demonstrated almost perfect agreement for the drug domain (κ = 0.87; absolute agreement 90.0%, 95% CI: 73.5–97.9%), substantial agreement for the dose domain (κ = 0.64; absolute agreement 73.3%, 95% CI: 54.1–86.6%), and moderate agreement for the duration domain (κ = 0.45; absolute agreement 80.0%, 95% CI: 61.4–91.1%). Criterion validity showed strong diagnostic performance: sensitivity 100% (95% CI: 83.9–100%), specificity 62.5% (95% CI: 30.6–86.3%), PPV 88.0% (95% CI: 69.0–96.7%), NPV 100% (95% CI: 56.6–100%), and overall accuracy 90.0% (95% CI: 73.5–97.9%).</p> Conclusion <p>The rMAT-CAP is a valid, reliable, and contextually relevant tool for evaluating therapeutic appropriateness in CAP management. Its structured approach supports antimicrobial stewardship initiatives and facilitates standardized audit and feedback in UAE hospitals.</p> Trial registration <p>Clinical trial number: not applicable.</p>

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Design and validation of revised medication assessment tool for community-acquired Pneumonia: rMAT-CAP

  • 期刊论文

  • 出版模式：

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  • 发表日期：

    2026年5月30日

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  • Sahar Elnajjar,
  • Sabariah Noor Harun,
  • Semira Beshir,
  • Ali Qureshi,
  • Dujana Al Hamed,
  • Hebah Al Jaghoub,
  • Hamzeh Al Subbah,
  • Danish Khowaja

摘要

Background

Evaluating therapeutic appropriateness is a cornerstone of antimicrobial stewardship. The original Medication Assessment Tool for Community-Acquired Pneumonia (MAT-CAP), developed in Norway, requires adaptation to account for evolving IDSA/ATS recommendations and region-specific antimicrobial resistance patterns in the UAE. To revise, adapt, and validate a Medication Assessment Tool for Community-Acquired Pneumonia (rMAT-CAP), adapted to the UAE healthcare context.

Methods

A methodological study was conducted in three phases: (1) systematic revision of MAT-CAP indicators in accordance with 2019 IDSA/ATS guidelines and UAE resistance data; (2) content validation through a multidisciplinary Delphi panel of 10 experts; and (3) psychometric validation using inter-rater reliability and criterion validity assessments based on 30 anonymized CAP cases.

Results

The rMAT-CAP comprised 13 explicit, guideline-aligned criteria covering empirical therapy, microbiological diagnostics, dose adjustment, IV-to-oral switch, and treatment duration. Content validity indices were excellent (mean I-CVI = 0.95; S-CVI/Ave = 0.95). Inter-rater reliability demonstrated almost perfect agreement for the drug domain (κ = 0.87; absolute agreement 90.0%, 95% CI: 73.5–97.9%), substantial agreement for the dose domain (κ = 0.64; absolute agreement 73.3%, 95% CI: 54.1–86.6%), and moderate agreement for the duration domain (κ = 0.45; absolute agreement 80.0%, 95% CI: 61.4–91.1%). Criterion validity showed strong diagnostic performance: sensitivity 100% (95% CI: 83.9–100%), specificity 62.5% (95% CI: 30.6–86.3%), PPV 88.0% (95% CI: 69.0–96.7%), NPV 100% (95% CI: 56.6–100%), and overall accuracy 90.0% (95% CI: 73.5–97.9%).

Conclusion

The rMAT-CAP is a valid, reliable, and contextually relevant tool for evaluating therapeutic appropriateness in CAP management. Its structured approach supports antimicrobial stewardship initiatives and facilitates standardized audit and feedback in UAE hospitals.

Trial registration

Clinical trial number: not applicable.