In short, truly pragmatic studies within this context are desperately needed to fully address the impact of rapid respiratory NATs when implemented in a health care system. In contrast to research settings, the implementation of patient testing occurs in the confines of accredited laboratory or health care systems with testing performed by clinical laboratory staff or health care providers. Collection and testing were either performed by research staff with qualifications frequently not mentioned, or the collector and test performer omitted. Īn important limitation to the majority of prior RCTs of rapid respiratory NATs is their processes do not meet laboratory “best practice” thereby limiting translation of their results outside the research environment. Most published studies are observational studies comparing outcomes pre and post-implementation, therefore more randomized controlled trials (RCTs) are needed. The American Academy of Pediatrics (AAP) also endorses the use of rapid influenza tests for similar reasons. The Infectious Disease Society of America states that rapid NATs have the “potential to reduce unnecessary antibiotic use, improve antiviral prescribing, limit additional ancillary testing, shorten hospital or emergency department (ED) lengths of stay, and optimize infection-control practices”.
Biofire flu test trial#
One randomized trial has also demonstrated decreased duration of hospitalization. Two of the most consistent findings are decreased TAT and improved oseltamivir utilization demonstrated by reduced time to first dose and/or increased or reduced prescription in influenza positive or negative patients, respectively. Reviews of the literature conclude that the clinical impact of rapid respiratory virus NATs is variable, reflecting the heterogeneity in quality and study design of previously reported studies. In contrast, standard NAT done within the laboratory (often at centralized off-site laboratories) have longer turnaround times (TAT) partly due to logistical considerations including specimen transport. Some rapid NAT platforms can also be performed at the point-of-care or near to the patient. These tests have the capacity to be rapid, which is loosely defined as being able to provide results within 2 h. The recommended method to diagnose influenza and other respiratory virus infections is by nucleic acid tests (NATs) because of their superior analytical performance compared to antigen-based tests or culture. Diagnosis of these pathogens remains important to guide clinical management, to detect and manage outbreaks, for public health surveillance, and for pandemic preparedness. Prior to SARS-CoV-2, influenza virus and respiratory syncytial virus (RSV) were the respiratory pathogens most commonly responsible for severe disease causing hospitalization.
Globally, respiratory viral disease causes substantial morbidity and mortality with significant economic impact.
The LOS at ACH was not significantly different between the ROST and standard arms. ROST also reduced the median turnaround time by > 24 h (ACH and PLC). ROST also significantly reduced oseltamivir use at ACH, reduced chest radiographs (ACH), and laboratory test ordering (PLC), but not antibiotic prescriptions. The rate of oseltamivir prescription and number of doses given was reduced in PLC inpatients negative for influenza in the ROST arm compared to standard arm. 422 patient encounters were included at PLC 200 assigned to ROST (157 inpatients) and 222 to the standard arm (175 inpatients). The Creative Commons Public Domain Dedication waiver ( ) applies to the data made available in this article, unless otherwise stated in a credit line to the data.ħ06 patient encounters were included at ACH 322 assigned to ROST (181 inpatients) and 384 to the standard arm (194 inpatients). If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made.
0 kommentar(er)
