Since the COVID-19 pandemic, diagnostic tests such as PCR and rapid tests have become part of the public lexicon. Rapid diagnosis also plays a crucial role in identifying and treating microbial infections, and in slowing down antimicrobial resistance (AMR).
Rapid advances in medical, biological, technological and digital knowledge are prompting the in vitro diagnostics industry to invest more than ever in the development of innovative solutions. New diagnostic tests are being made available to laboratories and technical platforms to support better antimicrobial prescribing throughout the care pathway.
This translates as:
- In general practice, with tests carried out in the presence of and close to the patient during the consultation with the doctor (Point of Care Testing POCT). For example, in the case of respiratory infections, rapid and simplified identification of pathogens is possible using syndromic panels, rapid tests, or tests carried out in centralised technical platforms in biological laboratories.
- In hospitals, with tests relocated to emergency departments close to patients (Near Patient Testing, NPT), and in central laboratories where syndromic panels, microbiological identification tests and antibiograms can be performed. These laboratories are increasingly benefiting from information aggregation software (Clinical Decision Support Systems, CDSS), which facilitates the analysis of results.
Regardless of where diagnostic tests are performed, digitising results plays a key role in ensuring traceability and linking them to patient records and care pathways. The aim is to offer greater speed and accuracy at the lowest possible cost and as close as possible to patients and healthcare professionals, without compromising the quality of diagnostic services.
New diagnostic tests, used appropriately by healthcare and multidisciplinary teams (e.g. antibiotic stewardship committees, hygienists), contribute to better use of antibiotics; reduce the risk of antibiotic resistance; improve the quality of care (e.g. acute respiratory infections1, bacteraemia 2, 3, use of CDSS4); and increase the efficiency of healthcare facilities. Rapid and accurate diagnosis makes it possible to avoid or reduce unnecessary medical procedures and longer, more expensive tests that have become obsolete, while freeing up medical time and promoting the autonomy of healthcare staff (e.g. NPT in emergency departments). Beyond that, the entire management of community-acquired and hospital-acquired infections benefits from this diagnostic innovation.
The benefits of improved care extend to society as a whole once patients leave hospital: fewer readmissions, the ability to return to work or school quickly, and fewer short- and long-term complications. It is these societal impacts that should be properly valued.
In a context of heightened budgetary and organisational constraints on healthcare systems, there are opportunities for efficiency in terms of medico-economic value that can be exploited. The impact of recent diagnostic developments must be assessed in all their dimensions, both in private practice and in hospitals, for patients, healthcare professionals and society.
This is why the strategic committee for the healthcare sector on ‘antibiotic resistance’ has decided to make this a collaborative focus, involving government authorities, academic research organisations, health economists, and pharmaceutical and in vitro diagnostics manufacturers.
What better commitment to the common good could there be?
References
1Subramony 2016. Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogens on Healthcare Resource Utilization for Pediatric Inpatients. J Pediatr http://dx.doi.org/10.1016/j.jpeds.2016.02.050
1 Subramony 2016. Impact of Multiplex Polymerase Chain Reaction Testing for Respiratory Pathogens on Healthcare Resource Utilization for Pediatric Inpatients. J Pediatr http://dx.doi.org/10.1016/j.jpeds.2016.02.050
2 Timbrook, 2017. The Effect of Molecular Rapid Diagnostic Testing on Clinical Outcomes in Bloodstream Infections: A Systematic Review and Meta-analysis. Clin. Infec. Dis. 64(1):15-23
3 Pliakos 2018. The Cost-Effectiveness of Rapid Diagnostic Testing for the Diagnosis of Bloodstream Infections with or without Antimicrobial Stewardship Clin. Microbiol. Rev. 2018:31(3):E00095-17
4 Laka 2020. Can Evidence-Based Decision Support Tools Transform Antibiotic Management? A Systematic Review and Meta-Analyses. J. Antimicrobial. Chem. 75(5):1099-1111
5 Clark 2020. Clinical impact of a routine, molecular, point-of-care, testand-treat strategy for influenza in adults admitted tohospital (FluPOC): a multicentre, open-label, randomized controlled trial. Lancet Respir Med; 9: 419–29
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