{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,25]],"date-time":"2026-10-25T00:18:22Z","timestamp":1792887502197,"version":"4.5.0"},"reference-count":15,"publisher":"Oxford University Press (OUP)","license":[{"start":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T00:00:00Z","timestamp":1787702400000},"content-version":"am","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>Efficacy of antifungal therapy in invasive aspergillosis relies primarily on mortality, overlooking critical measures of treatment response. We used the Mycoses Study Group Education &amp; Research Consortium (MSG) Desirability of Outcome Ranking (DOOR) framework to assess efficacy of antifungal therapies by integrating mortality, treatment failure, and severe adverse events. Voriconazole achieved better overall outcomes than amphotericin B using the DOOR approach.<\/jats:p>","DOI":"10.1093\/cid\/ciag457","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:16:05Z","timestamp":1785237365000},"source":"Crossref","is-referenced-by-count":1,"title":["Reanalyzing a Randomized Controlled Trial of Invasive Aspergillosis Using a Desirability of Outcome Ranking Approach: Voriconazole Versus Amphotericin B Deoxycholate"],"prefix":"10.1093","author":[{"given":"Julio C","family":"Zuniga-Moya","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1368-2226","authenticated-orcid":false,"given":"Marcela","family":"Araujo de Oliveira Santana","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4784-7589","authenticated-orcid":false,"given":"Luis","family":"Ostrosky-Zeichner","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, McGovern Medical School , Houston, Texas ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8518-5750","authenticated-orcid":false,"suffix":"III","given":"George R","family":"Thompson","sequence":"additional","affiliation":[{"name":"Department of Medicine, Division of Infectious Diseases, and the Department of Medical Microbiology and Immunology, University of California , Davis, Sacramento ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas J","family":"Walsh","sequence":"additional","affiliation":[{"name":"Departments of Medicine and Microbiology & Immunology, University of Maryland School of Medicine , Baltimore, Maryland ,","place":["USA"]},{"name":"Center for Innovative Therapeutics and Diagnostics , Richmond, Virginia ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7612-4710","authenticated-orcid":false,"given":"Andrej","family":"Spec","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Washington University in St Louis School of Medicine , St Louis, Missouri ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,8,26]]},"reference":[{"key":"2026082609013353800_ciag457-B1","doi-asserted-by":"crossref","first-page":"e428","DOI":"10.1016\/S1473-3099(23)00692-8","article-title":"Global incidence and mortality of severe fungal disease","volume":"24","author":"Denning","year":"2024","journal-title":"Lancet Infect Dis"},{"key":"2026082609013353800_ciag457-B2","doi-asserted-by":"crossref","first-page":"760","DOI":"10.1016\/S0140-6736(15)01159-9","article-title":"Isavuconazole versus voriconazole for primary treatment of invasive mould disease caused by Aspergillus and other filamentous fungi (SECURE): a phase 3, randomised-controlled, non-inferiority trial","volume":"387","author":"Maertens","year":"2016","journal-title":"Lancet"},{"key":"2026082609013353800_ciag457-B3","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1056\/NEJMoa020191","article-title":"Voriconazole versus amphotericin B for primary therapy of invasive aspergillosis","volume":"347","author":"Herbrecht","year":"2002","journal-title":"N Engl J Med"},{"key":"2026082609013353800_ciag457-B4","doi-asserted-by":"crossref","first-page":"499","DOI":"10.1016\/S0140-6736(21)00219-1","article-title":"Posaconazole versus voriconazole for primary treatment of invasive aspergillosis: a phase 3, randomised, controlled, non-inferiority trial","volume":"397","author":"Maertens","year":"2021","journal-title":"Lancet"},{"key":"2026082609013353800_ciag457-B5","doi-asserted-by":"crossref","first-page":"2309","DOI":"10.1002\/cncr.23441","article-title":"Changes in causes of death overtime after treatment for invasive aspergillosis","volume":"112","author":"Wingard","year":"2008","journal-title":"Cancer"},{"key":"2026082609013353800_ciag457-B6","doi-asserted-by":"crossref","first-page":"649","DOI":"10.1093\/cid\/ciad239","article-title":"Exploration of a potential desirability of outcome ranking endpoint for complicated intra-abdominal infections using 9 registrational trials for antibacterial drugs","volume":"77","author":"Kinamon","year":"2023","journal-title":"Clin Infect Dis"},{"key":"2026082609013353800_ciag457-B7","doi-asserted-by":"crossref","first-page":"112","DOI":"10.1093\/cid\/ciaf719","article-title":"Evaluating desirability of outcome ranking (DOOR) and win ratio for hierarchical composite endpoints in cryptococcal meningitis trials","volume":"83","author":"Dai","year":"2026","journal-title":"Clin Infect Dis"},{"key":"2026082609013353800_ciag457-B8","doi-asserted-by":"crossref","first-page":"ofag012","DOI":"10.1093\/ofid\/ofag012","article-title":"Development framework of desirability of outcome ranking endpoints for use in clinical trials of invasive fungal diseases","volume":"13","author":"Portugal Gonzales","year":"2026","journal-title":"Open Forum Infect Dis"},{"key":"2026082609013353800_ciag457-B9","doi-asserted-by":"crossref","first-page":"674","DOI":"10.1086\/590566","article-title":"Defining responses to therapy and study outcomes in clinical trials of invasive fungal diseases: mycoses study group and European organization for research and treatment of cancer consensus criteria","volume":"47","author":"Segal","year":"2008","journal-title":"Clin Infect Dis"},{"key":"2026082609013353800_ciag457-B10","doi-asserted-by":"crossref","first-page":"800","DOI":"10.1093\/cid\/civ495","article-title":"Desirability of Outcome Ranking (DOOR) and Response Adjusted for Duration of Antibiotic Risk (RADAR)","volume":"61","author":"Evans","year":"2015","journal-title":"Clin Infect Dis"},{"key":"2026082609013353800_ciag457-B11","doi-asserted-by":"crossref","first-page":"1024","DOI":"10.1016\/j.cmi.2023.05.003","article-title":"Unlocking the DOOR-how to design, apply, analyse, and interpret desirability of outcome ranking endpoints in infectious diseases clinical trials","volume":"29","author":"Ong","year":"2023","journal-title":"Clin Microbiol Infect"},{"key":"2026082609013353800_ciag457-B12","doi-asserted-by":"publisher","author":"Yijie He","DOI":"10.32614\/CRAN.package.door"},{"key":"2026082609013353800_ciag457-B13","doi-asserted-by":"crossref","first-page":"225","DOI":"10.1056\/NEJM200201243460403","article-title":"Voriconazole compared with liposomal amphotericin B for empirical antifungal therapy in patients with neutropenia and persistent fever","volume":"346","author":"Walsh","year":"2002","journal-title":"N Engl J Med"},{"key":"2026082609013353800_ciag457-B14","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1086\/514341","article-title":"Liposomal amphotericin B as initial therapy for invasive mold infection: a randomized trial comparing a high-loading dose regimen with standard dosing (AmBiLoad trial)","volume":"44","author":"Cornely","year":"2007","journal-title":"Clin Infect Dis"},{"key":"2026082609013353800_ciag457-B15","doi-asserted-by":"crossref","first-page":"dkaf473","DOI":"10.1093\/jac\/dkaf473","article-title":"Liposomal amphotericin B and renal safety: review of the evidence and clinical considerations","volume":"81","author":"Maertens","year":"2026","journal-title":"J Antimicrob Chemother"}],"container-title":["Clinical Infectious Diseases"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag457\/70769389\/ciag457.pdf","content-type":"application\/pdf","content-version":"am","intended-application":"syndication"},{"URL":"https:\/\/academic.oup.com\/cid\/advance-article-pdf\/doi\/10.1093\/cid\/ciag457\/70769389\/ciag457.pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,8,26]],"date-time":"2026-08-26T13:01:37Z","timestamp":1787749297000},"score":1,"resource":{"primary":{"URL":"https:\/\/academic.oup.com\/cid\/advance-article\/doi\/10.1093\/cid\/ciag457\/8769325"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,26]]},"references-count":15,"URL":"https:\/\/doi.org\/10.1093\/cid\/ciag457","relation":{},"ISSN":["1058-4838","1537-6591"],"issn-type":[{"value":"1058-4838","type":"print"},{"value":"1537-6591","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,8,26]]},"article-number":"ciag457"}}