Diagnostic performance and clinical feasibility of a point-of-care test for respiratory viral infections in primary health care
| Autor: | Andrea H. L. Bruning, Dasja Pajkrt, Wilhelmina B. de Kruijf, Menno D. de Jong, Henk van Weert, Wim L M Willems, Katja C. Wolthers |
|---|---|
| Přispěvatelé: | Medical Microbiology and Infection Prevention, APH - Quality of Care, APH - Personalized Medicine, General practice, Amsterdam Cardiovascular Sciences, AII - Infectious diseases, Amsterdam institute for Infection and Immunity, Paediatric Infectious Diseases / Rheumatology / Immunology, Amsterdam Reproduction & Development (AR&D), ACS - Heart failure & arrhythmias |
| Jazyk: | angličtina |
| Rok vydání: | 2017 |
| Předmět: |
0301 basic medicine
Adult Male medicine.medical_specialty medicine.drug_class Point-of-care testing Point-of-Care Systems respiratory tract infection 030106 microbiology Antibiotics Inappropriate Prescribing medicine.disease_cause Sensitivity and Specificity 03 medical and health sciences 0302 clinical medicine Internal medicine Surveys and Questionnaires Influenza Human medicine Influenza A virus Humans 030212 general & internal medicine Prospective Studies Medical prescription Intensive care medicine Respiratory Tract Infections Netherlands Respiratory tract infections Primary Health Care business.industry Influenzavirus B 3. Good health rapid testing respiratory virus Influenza B virus Respiratory virus Feasibility Studies Female Seasons Health Services Research Family Practice business Viral load |
| Zdroj: | Family practice, 34(5), 558-563. Oxford University Press Family Practice |
| ISSN: | 0263-2136 |
| Popis: | Background Inappropriately high levels of antibiotics are still prescribed in primary health care for respiratory tract infections (RTIs). Access to diagnostic point-of-care tests (POCTs) for RTIs might reduce this over-prescription. Objective The purpose of our study was to determine the diagnostic performance and clinical feasibility of a recently developed diagnostic POCT for respiratory viruses, the mariPOC®, in a Dutch primary healthcare setting. Methods In patients with RTI symptoms presenting to a family practice during the 2015–2016 winter season, we determined the test’s sensitivity and specificity relative to polymerase chain reaction (PCR) testing performed in a laboratory. The clinical feasibility of the POCT was evaluated by interviewing general practitioners (GPs). Results One or more respiratory viruses were detected in 54.9% of the patients (n = 204). For influenza A virus (n = 24), sensitivity of the POCT was 54.2% and specificity was 98.9%; for influenza B virus (n = 18), sensitivity was 72.2% and specificity 99.5%; and for respiratory syncytial virus (RSV) (n = 12), sensitivity was 50.0% and specificity 100%. In samples with higher viral load, sensitivity was 85.7% for influenza A, 78.6% for influenza B and 85.7% for RSV. The availability of a diagnostic test for respiratory viruses was appreciated by both patients and GPs. Conclusions Our study shows that diagnostic POCTs for respiratory viruses might contribute to a precise and evidence-based diagnosis of RTIs and could positively influence prescription of antibiotics by GPs. However, before implementation in primary healthcare, diagnostic accuracy of the POCT needs improvement and it is impact on clinical decision making should be further assessed. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|