Point-of-care tests for influenza A and B viruses and RSV in emergency departments – indications, impact on patient management and possible gains by syndromic respiratory testing, Capital Region, Denmark, 2018

Schneider, Uffe Vest; Holm, Mona Katrine Alberthe; Bang, Didi; Petersen, Randi Føns; Mortensen, Shila; Trebbien, Ramona; Lisby, Jan Gorm

doi:10.2807/1560-7917.es.2020.25.44.1900430

Cited by 11 publications

(8 citation statements)

References 15 publications

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“…In addition, studies should control for selection bias and adjust for differences in settings where the RSV test was performed, seasonality, and staff utilization of RSV tests. The use of POC testing for influenza and RSV across four centers in Denmark resulted in a significant reduction in antibiotic prescription and median hospitalization time in adults (44.3 hours) and children (14.2 hours), there was also an increase in the use of antiviral treatment in adults only (18). These positive results indicate that further studies are warranted to explore the effects of testing for RSV on patient outcomes (43).…”

Section: Discussionmentioning

confidence: 99%

“…In one study based in the emergency department of a US hospital, patients aged 6–21 years old accounted for 8.7% of the total number of RSV positive tests, whereas patients aged 22–59 years old and those aged ≥ 60 years old accounted for 14.0% and 10.5%, respectively (17). Viral diagnostic testing in pediatric and adult populations helps tailor patient management and the implementation of hospital infection prevention policies, as well as reduce the inappropriate use of antibiotics (18).…”

Section: Introductionmentioning

confidence: 99%

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Diagnostic Accuracy of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

Bernstein¹,

Mejías

Rath

et al. 2022

Preprint

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Background: Non-pharmaceutical interventions to prevent the spread of coronavirus disease 2019 also decreased the spread of respiratory syncytial virus (RSV) and influenza. Viral diagnostic testing in patients with respiratory tract infections (RTI) is a necessary tool for patient management; therefore, sensitive and specific tests are required. This scoping literature review evaluated the analytical validity of commercially available sample-to-answer RSV diagnostic tests in different contexts. Content: PubMed and Embase were queried for studies reporting on the analytical validity of tests for RSV in patients with RTI (published January 2005–January 2021). Sensitivity and specificity of RSV tests and information on study design, patient, and setting characteristics were extracted from 77 studies that met predefined inclusion criteria. A literature gap was identified for studies of RSV tests conducted in adult-only populations (5.3% of total sub-records), and in outpatient (7.5%) or household (0.8%) settings. Overall, RSV tests with analytical time >30 min had higher sensitivity (62.5–100%) versus RSV tests with analytical time ≤30 min (25.7–100%), this sensitivity range could be partially attributed to the different modalities (antigen versus molecular) used. Molecular-based rapid RSV tests had higher sensitivity (66.7–100%) and specificity (94.3–100%) than antigen-based RSV tests (25.7–100% and 80.3–100%). Summary: Molecular-based RSV tests should be considered for first-line use when possible, given their high sensitivity and specificity and that adults with RTI typically have low viral load, necessitating a highly sensitive test. This review benefits healthcare professionals by summarizing the diagnostic accuracy data available for commercially available RSV tests.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Diagnostic Accuracy of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

Bernstein¹,

Mejías

Rath

et al. 2022

Preprint

View full text Add to dashboard Cite

show abstract

“…Local indications for each test need to be established as part of local guidelines for use. 24 Prior to introducing a new test, it may be necessary to establish a business case showing a positive technology assessment, an acceptable cost, expected performance characteristics and a description of benefits for patients, the end users and the community.…”

Section: Test Indicationsmentioning

confidence: 99%

Point of care testing for infectious disease: ownership and quality

Lisby

Schneider

2021

Journal of Antimicrobial Chemotherapy

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Traditionally, diagnosis of acute infections has been organism-growth based, which makes timely and actionable infection diagnosis a major challenge. In addition, traditional microbial detection methods, including direct microscopy, are not suited for outsourcing to clinical, non-laboratory-educated personnel. Optimal management of patients with known or suspected clinical infections, such as targeted (or no) antimicrobial treatment and correct use of single room contact isolation facilities, requires rapid identification of the causative infectious microorganism. We are now facing a new disruptive paradigm shift in diagnostic microbiology. The availability of small-footprint robust instruments with easy-to-use assay kits allows non-laboratory-trained nurses and physicians to perform high-quality molecular diagnostics in a near-patient setting with results available in <30 minutes. This technology is currently breaking the centralized laboratory monopoly on the delivery of gold-standard clinical microbiology diagnostics. There is clear potential for huge positive impacts on clinical patient management and antibiotic stewardship, especially in settings where access to timely laboratory test results is not possible, but there are also potentially huge risks. Moving diagnostic testing away from the controlled diagnostic laboratory environment will lead to risks such as increased risk of inappropriate use of the diagnostic tests, insufficient training of staff performing the tests, incorrect interpretation of the test results, lack of quality control procedures, failure to capture test results in electronic patient records and compromised local as well as national surveillance. To reap the upside and avoid the downside of point-of-care infectious disease testing, the diagnostic laboratory needs to maintain oversight, and each institution must have a clear strategy for implementation and execution. If we fail, the risks could outweigh the benefits.

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“…In one study based in the emergency department of a US hospital, patients aged 6 to 21 years old accounted for 8.7% of the total number of RSV-positive tests, whereas patients aged 22 to 59 years old, and those aged ≥60 years old accounted for 14.0% and 10.5%, respectively ( 15 ). Viral diagnostic testing in pediatric and adult populations helps to tailor patient management and the implementation of hospital infection prevention policies as well as reduce the inappropriate use of antibiotics ( 16 ).…”

Section: Introductionmentioning

confidence: 99%

Summarizing Study Characteristics and Diagnostic Performance of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

Bernstein

Mejías

Rath

et al. 2022

The Journal of Applied Laboratory Medicine

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Background Nonpharmaceutical interventions to prevent the spread of coronavirus disease 2019 also decreased the spread of respiratory syncytial virus (RSV) and influenza. Viral diagnostic testing in patients with respiratory tract infections (RTI) is a necessary tool for patient management; therefore, sensitive and specific tests are required. This scoping literature review aimed to summarize the study characteristics of commercially available sample-to-answer RSV tests. Content PubMed and Embase were queried for studies reporting on the diagnostic performance of tests for RSV in patients with RTI (published January 2005–January 2021). Information on study design, patient and setting characteristics, and published diagnostic performance of RSV tests were extracted from 77 studies that met predefined inclusion criteria. A literature gap was identified for studies of RSV tests conducted in adult-only populations (5.3% of total subrecords) and in outpatient (7.5%) or household (0.8%) settings. Overall, RSV tests with analytical time >30 min had higher published sensitivity (62.5%–100%) vs RSV tests with analytical time ≤30 min (25.7%–100%); this sensitivity range could be partially attributed to the different modalities (antigen vs molecular) used. Molecular-based rapid RSV tests had higher published sensitivity (66.7%–100%) and specificity (94.3%–100%) than antigen-based RSV tests (sensitivity: 25.7%–100%; specificity:80.3%–100%). Summary This scoping review reveals a paucity of literature on studies of RSV tests in specific populations and settings, highlighting the need for further assessments. Considering the implications of these results in the current pandemic landscape, the authors preliminarily suggest adopting molecular-based RSV tests for first-line use in these settings.

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Point-of-care tests for influenza A and B viruses and RSV in emergency departments – indications, impact on patient management and possible gains by syndromic respiratory testing, Capital Region, Denmark, 2018

Abstract: Point-of-care tests for influenza A and B viruses and RSV in emergency departments-indications, impact on patient management and possible gains by syndromic respiratory testing,

Cited by 11 publications

References 15 publications

Diagnostic Accuracy of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

Diagnostic Accuracy of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

Point of care testing for infectious disease: ownership and quality

Summarizing Study Characteristics and Diagnostic Performance of Commercially Available Tests for Respiratory Syncytial Virus: A Scoping Literature Review in the COVID-19 Era

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