Positive Impact of a Point-of-Care Molecular Influenza Test in the Emergency Department During the 2017–2018 Seasonal Influenza Epidemic

Martinot, M.; Greigert, Valentin; Gravier, Simon; Klein, Stéphane; Eyriey, Magali; Pachart, Anne; Kaiser, J.; Zadeh, M. Mohseni; Briel, D. De; Gottwalles, Y.; Thibaud, E.

doi:10.1093/ofid/ofz312

Cited by 13 publications

(9 citation statements)

References 14 publications

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“…With respect to ED-LOS, the systematic reviews noted no overall decrease in ED-LOS. However, in the viral influenza group, 7 studies 3,4,11,14,19,20,22 showed a significant decrease in ED-LOS, with 4 showing no significant change in ED-LOS. 6,12,18,21 The remaining 10 studies 5,[7][8][9][10]13,[15][16][17]23 did not report any findings related to ED-LOS.…”

Section: Resultsmentioning

confidence: 87%

“…As indicated in Tables 1 through 3, a variety of additional significant findings were identified on a case-by-case basis, but it was not clear if they actually improved patient outcomes. Of note, several studies did show decreased admissions 4,7,11,[13][14][15]19 and decreased hospital stays, § which could a priori reflect improved outcomes. However, inpatient LOS is not a typical reason for requesting ED-POCT.…”

Section: Resultsmentioning

confidence: 99%

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Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence

Alter

2021

Archives of Pathology &Amp; Laboratory Medicine

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Context.— Point-of-care test (POCT) instruments produce lab results with rapid turnaround times. Based on that fact, emergency department (ED) POCT requests are predicated on the belief that rapid test turnaround times lead to improved care, typically a decreased ED length of stay (LOS). Objective.— To compile the available peer-reviewed data regarding use of POCT in the ED with an emphasis on ED-LOS. Data Sources.— An English-language PubMed search using the following free text terms: (“EMERGENCY” AND “POINT OF CARE”) NOT ULTRASOUND as well as “RAPID INFECTIOUS DISEASE TESTING.” In addition, the PubMed “similar articles” functionality was used to identify related articles that were not identified on the initial search. Conclusions.— Seventy-four references were identified that studied POCT ED use to determine if they resulted in significant changes in ED processes, especially ED-LOS. They were divided into 3 groups: viral-influenza (n = 24), viral-respiratory not otherwise specified (n = 8), and nonviral (n = 42). The nonviral group was further divided into the following groups: chemistry, cardiac, bacterial/strep, C-reactive protein, D-dimer, drugs of abuse, lactate, and pregnancy. Across all groups there was a trend toward a significantly decreased ED-LOS; however, a number of studies showed no change, and a third group was not assessed for ED-LOS. For POCT to improve ED-LOS it has to be integrated into existing ED processes such that a rapid test result will allow the patient to have a shorter LOS, whether it is to discharge or admission.

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Section: Resultsmentioning

confidence: 87%

Section: Resultsmentioning

confidence: 99%

Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence

Alter

2021

Archives of Pathology &Amp; Laboratory Medicine

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“…Prior studies on the effectiveness of rapid testing for respiratory viruses have primarily focused on influenza and have evaluated impacts on therapeutic decision-making and reductions in ED and hospital lengths of stay. [ 9 , 10 , 16 ] To our knowledge, this study is unique in that it is the first to evaluate the clinical effectiveness of rapid testing for SARS-CoV-2 and because it focuses on both infection risk exposure time and resource savings. Our demonstration that a relatively small number of rapid tests, if properly targeted, can be used to drive large decreases in time that patients spend under investigation for infectious disease in the hospital setting is novel.…”

Section: Discussionmentioning

confidence: 99%

“…Previous studies on the effectiveness of rapid testing for respiratory viruses have primarily focused on influenza, and have evaluated impacts on therapeutic decision-making and reductions in ED and hospital lengths of stay [9,10,16]. To the authors' knowledge, this study is unique in that it is the first to evaluate the clinical effectiveness of rapid testing for SARS-CoV-2, and because it focuses on both risk exposure time and resource savings.…”

Section: Discussionmentioning

confidence: 99%

“…Analytical performance of approved nucleic acid amplification tests (NAATs) for SARS-CoV-2 is universally high, but processing times are variable. [ 7 ] While rapid (<1hr) NAATs for influenza and other respiratory viruses have had positive effects on patient throughput and appropriateness of antiviral and antibiotic prescribing by physicians,[ [8] , [9] , [10] , [11] ] the benefits of rapid testing for COVID-19 is not well-understood.…”

Section: Introductionmentioning

confidence: 99%

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Targeted rapid testing for SARS-CoV-2 in the emergency department is associated with large reductions in uninfected patient exposure time

Hinson

Rothman

Carroll

et al. 2021

Journal of Hospital Infection

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Opportunity exists to decrease healthcare-related exposure to SARS-CoV-2, preserve infection control resources and increase care capacity by reducing the time to diagnosis of COVID-19. We performed a retrospective cohort analysis to measure the effect of targeted rapid molecular testing for SARS-CoV-2 on these outcomes. In comparison to standard-platform testing, rapid testing was associated with a 65.6% reduction (12.6 hours) in median time to removal from isolation cohort for patients with negative diagnostic results. This translated to an increase in COVID-19 treatment capacity of 3,028 bed hours and 7,500 less patient interactions that required consumption of personal protective equipment per week.

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Appropriate Use and Future Directions of Molecular Diagnostic Testing

Graf

Pancholi

2020

Curr Infect Dis Rep

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Purpose of Review Major technologic advances in two main areas of molecular infectious disease diagnostics have resulted in accelerated adoption or ordering, outpacing implementation, and clinical utility studies. Physicians must understand the limitations to and appropriate utilization of these technologies in order to provide cost-effective and well-informed care for their patients. Recent Findings Rapid molecular testing and, to a lesser degree, clinical metagenomics are now being routinely used in clinical practice. While these tests allow for a breadth of interrogation not possible with conventional microbiology, they pose new challenges for diagnostic and antimicrobial stewardship programs. This review will summarize the most recent literature on these two categories of technologic advances and discuss the few studies that have looked at utilization and stewardship approaches. This review also highlights the future directions for both of these technologies. Summary The appropriate utilization of rapid molecular testing and clinical metagenomics has not been well established. More studies are needed to assess their prospective impacts on patient management and antimicrobial stewardship efforts as the future state of infectious disease diagnostics will see continued expansion of these technologic advances.

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Positive Impact of a Point-of-Care Molecular Influenza Test in the Emergency Department During the 2017–2018 Seasonal Influenza Epidemic

Cited by 13 publications

References 14 publications

Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence

Point-of-Care Testing for the Emergency Department Patient: Quantity and Quality of the Available Evidence

Targeted rapid testing for SARS-CoV-2 in the emergency department is associated with large reductions in uninfected patient exposure time

Appropriate Use and Future Directions of Molecular Diagnostic Testing

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