Implementation of the cobas Liat influenza point-of-care test into an emergency department during a high-incidence season: a retrospective evaluation following real-world implementation

Youngs, Jonathan; Iqbal, Yasser; Riley, Peter; Pope, Cassie F.; Planche, Timothy; Carrington, David

doi:10.1016/j.jhin.2018.12.008

Cited by 15 publications

(21 citation statements)

References 8 publications

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“…Two studies compared assays from the cobas Liat system performed in the emergency department to Cepheid“s GeneXpert Xpert Flu assays (rapid central testing) during the 2017–2018 flu season. [32,33] The sensitivity and specificity of the cobas Liat system ranged from 0.85 to 0.99 and 0.96 to 0.99, respectively. The study that reported the lower sensitivity might have been subject to bias because only negative results were systematically centrally controlled, thus increasing the likelihood of false positives.…”

Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

et al. 2019

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Study objective To investigate the performance of a rapid RT-PCR assay to detect influenza A/B at emergency department admission. Methods This single-center prospective study recruited adult patients attending the emergency department for influenza-like illness. Triage nurses performed nasopharyngeal swab samples and ran rapid RT-PCR assays using a dedicated device (cobas Liat, Roche Diagnostics, Meylan, France) located at triage. The same swab sample was also analyzed in the department of virology using conventional RT-PCR techniques. Patients were included 24 hours-a-day, 7 days-a-week. The primary outcome was the diagnostic accuracy of the rapid RT-PCR assay performed at triage. Results A total of 187 patients were included over 11 days in January 2018. Median age was 70 years (interquartile range 44 to 84) and 95 (51%) were male. Nine (5%) assays had to be repeated due to failure of the first assay. The sensitivity of the rapid RT-PCR assay performed at triage was 0.98 (95% confidence interval (CI): 0.91–1.00) and the specificity was 0.99 (95% CI: 0.94–1.00). A total of 92 (49%) assays were performed at night-time or during the weekend. The median time from patient entry to rapid RT-PCR assay results was 46 [interquartile range 36–55] minutes. Conclusion Rapid RT-PCR assay performed by nurses at triage to detect influenza A/B is feasible and highly accurate.

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Section: Discussionmentioning

confidence: 99%

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

et al. 2019

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“…Several studies [ 30 , [32] , [33] , [34] , [35] , [36] , [37] , [38] ] have assessed and compared the reliability of the Roche Cobas Liat against similar competing devices and concur on its fast and easy-to-use aspects. Adults tested in a “real-world” clinical setting [ 37 ] yielded the lowest values of sensitivity (influenza A: 83.0%, influenza B: 84.6%, RSV: 77.8%) in the literature. Other reports in more classical diagnostic settings generally reported high sensitivity (influenza A: 96.2%–100%, influenza B: 94.4%–100%, and RSV: 96.8%–100%).…”

Section: Today’s Commercial Tools Do Not Combat Pandemicsmentioning

confidence: 99%

A critical review of point-of-care diagnostic technologies to combat viral pandemics

Everitt

Tillery

David

et al. 2021

Analytica Chimica Acta

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The COVID-19 global pandemic of 2019–2020 pointedly revealed the lack of diagnostic solutions that are able to keep pace with the rapid spread of the virus. Despite the promise of decades of lab-on-a-chip research, no commercial products were available to deliver rapid results or enable testing in the field at the onset of the pandemic. In this critical review, we assess the current state of progress on the development of point-of-care technologies for the diagnosis of viral diseases that cause pandemics. While many previous reviews have reported on progress in various lab-on-a-chip technologies, here we address the literature from the perspective of the testing needs of a rapidly expanding pandemic. First, we recommend a set of requirements to heed when designing point-of-care diagnostic technologies to address the testing needs of a pandemic. We then review the current state of assay technologies with a focus on isothermal amplification and lateral-flow immunoassays. Though there is much progress on assay development, we argue that the largest roadblock to deployment exists in sample preparation. We summarize current approaches to automate sample preparation and discuss both the progress and shortcomings of these developments. Finally, we provide our recommendations to the field of specific challenges to address in order to prepare for the next pandemic.

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“…The high sensitivity and specificity for influenza A, influenza B and RSV found in our study was comparable to previous findings, with better diagnostic accuracy than other routinely available point-of-care devices. [14][15][16][17][18][20][21][22][23][24][25][26][27][28][29][30] The diagnostic accuracy of POCTs for influenza has been examined in individual studies and several systematic reviews. [31][32][33] Although the impact of the cobas® Liat® POCT on clinical decision making during visits to the emergency department has been established, [34] the effect on patient-relevant clinical outcomes still has to be determined.…”

Section: Comparison With Previous Studiesmentioning

confidence: 99%

Performance and ease of use of a molecular point-of-care test for influenza A/B and RSV in patients presenting to primary care

Verbakel

Matheeussen

Loens

et al. 2020

Eur J Clin Microbiol Infect Dis

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Annual influenza epidemics cause substantial morbidity and mortality, and the majority of patients with influenza-like illness present to primary care. Point-of-care influenza tests could support treatment decisions. It is critical to establish analytic performance of these platforms in real-life patient samples before uptake can be considered. We aimed to assess the analytical performance and ease of use of the cobas® Liat® PCR POCT in detecting influenza A/B and RSV in samples collected from patients with influenza-like illness in primary care. Sensitivity and specificity of the cobas® Liat® POCT are calculated in comparison with a commercial laboratory-based PCR test (Fast-Track Respiratory Pathogens 21 Plus kit (Fast-Track Diagnostics)). Samples with discordant results were analysed additionally by the RespiFinder 2Smart (PathoFinder) using an Extended Gold Standard (EGS). Acceptability was scored on a five-point Likert scale as well as a failure mode analysis of the cobas® Liat® POCT was performed. Nasal and oropharyngeal swabs were obtained from 140 children and nasopharyngeal swabs from 604 adults (744 patients). The cobas® Liat® POCT had a sensitivity and specificity of 100% (95% CI 99-100%) and 98.1% (95%CI 96.3-99%) for influenza A, 100% (95% CI 97.7-100%) and 99.7% (95%CI 98.7-99.9%) for influenza B and 100% (95% CI 87.1-100%) and 99.4% (95%CI 98.6-99.8%) for RSV, respectively. According to trained lab technicians, the cobas® Liat® POCT was considered easy-to-use, with a fast turnaround time. Cobas® Liat® POCT is a promising decentralised test platform for influenza A/B and RSV in primary care as it provides fairly rapid results with excellent analytic performance. Point-of-care influenza tests could support treatment decisions in primary care. Cobas® Liat® POCT is a promising decentralised test platform for influenza A/B and RSV in primary care as it provides fairly rapid results with excellent analytic performance. Keywords Influenza. Point-of-care. Primary care. Ease-of-use. PCR BACKGROUND Annual influenza epidemics cause substantial morbidity and mortality and the 2009 H1N1 influenza outbreak was defined as a pandemic by the World Health Organisation (WHO). [1, 2] About 50% of patients presenting to primary care with influenza-like illness (ILI) during a period of high influenza incidence, with some variation by country, usually have laboratory-confirmed influenza infection. [3] Unlike in Japan for example, [4] in European primary care, point-of-care testing for influenza is not routine practice, making it difficult for clinicians to distinguish influenza from other viral infections that cause ILI at the point of care with a high degree of certainty. [5] It is common practice throughout Europe to base treatment or advice to patients with ILI on signs and symptoms alone, given that point-of-care tests (POCTs) may neither be feasible nor perform adequately, and that antiviral Electronic supplementary material The online version of this article (

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Implementation of the cobas Liat influenza point-of-care test into an emergency department during a high-incidence season: a retrospective evaluation following real-world implementation

Cited by 15 publications

References 8 publications

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

Diagnostic accuracy of a rapid RT-PCR assay for point-of-care detection of influenza A/B virus at emergency department admission: A prospective evaluation during the 2017/2018 influenza season

A critical review of point-of-care diagnostic technologies to combat viral pandemics

Performance and ease of use of a molecular point-of-care test for influenza A/B and RSV in patients presenting to primary care

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