272 Chapter 11 Systematic reviews are required of the impacts of delays in appropriate therapy for patients with sepsis. The ultimate goal is to develop evidence to help physicians for identifying the patients in their clinical practices and guide their treatment decisions, so that they will have improved chance of providing appropriate therapy without delay (without affecting diagnostic tests or inducing ecological adverse events). Bioinformaticians should collaborate with clinicians in developing big data analyses in sepsis. It is important to identify critical variables that can be easily obtained from clinical records and which can be combined with endotypes, and genetic and immunologic information. This is crucial to identify rare associations and subgroups suitable for different therapeutic interventions. Novel statistical methods, including machine learning, latent class analyses and principal components analyses will be needed. Development of resource-limited setting, specific recommendations for treatment of sepsis are required, whereas global sepsis registries are needed to capture sepsis causes and their associated mortality in LMIC.
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