scholarly journals Using Point of Care Testing to estimate influenza vaccine effectiveness in the English primary care sentinel surveillance network

PLoS ONE ◽  
2021 ◽  
Vol 16 (3) ◽  
pp. e0248123
Author(s):  
Simon de Lusignan ◽  
Uy Hoang ◽  
Harshana Liyanage ◽  
Manasa Tripathy ◽  
Julian Sherlock ◽  
...  
Keyword(s):  
Primary Care ◽  
Influenza Vaccine ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Clinical Decision ◽  
Vaccine Effectiveness ◽  
Sentinel Surveillance ◽  
Point Of Care Testing ◽  
Surveillance Network ◽  
Negative Case

Introduction Rapid Point of Care Testing (POCT) for influenza could be used to provide information on influenza vaccine effectiveness (IVE) as well as influencing clinical decision-making in primary care. Methods We undertook a test negative case control study to estimate the overall and age-specific (6 months-17 years, 18–64 years, ≥65 years old) IVE against medically attended POCT-confirmed influenza. The study took place over the winter of 2019–2020 and was nested within twelve general practices that are part of the Oxford-Royal College of General Practitioners (RCGP) Research and Surveillance Centre (RSC), the English sentinel surveillance network. Results 648 POCT were conducted. 193 (29.7%) of those who were swabbed had received the seasonal influenza vaccine. The crude unadjusted overall IVE was 46.1% (95% CI: 13.9–66.3). After adjusting for confounders the overall IVE was 26.0% (95% CI: 0–65.5). In total 211 patients were prescribed an antimicrobial after swab testing. Given a positive influenza POCT result, the odds ratio (OR) of receiving an antiviral was 21.1 (95%CI: 2.4–182.2, p = <0.01) and the OR of being prescribed an antibiotic was 0.6 (95%CI: 0.4–0.9, p = <0.01). Discussion Using influenza POCT in a primary care sentinel surveillance network to estimate IVE is feasible and provides comparable results to published IVE estimates. A further advantage is that near patient testing of influenza is associated with improvements in appropriate antiviral and antibiotic use. Larger, randomised studies are needed in primary care to see if these trends are still present and to explore their impact on outcomes.

scholarly journals Feasibility of Point-of-Care Testing for Influenza Within a National Primary Care Sentinel Surveillance Network in England: Protocol for a Mixed Methods Study (Preprint)

2019 ◽  
Author(s):  
Simon de Lusignan ◽  
Uy Hoang ◽  
Harshana Liyanage ◽  
Ivelina Yonova ◽  
Filipa Ferreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Sample Size ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Sentinel Surveillance ◽  
Mixed Methods Study ◽  
Point Of Care Testing ◽  
Surveillance Network ◽  
Expected Sample Size

BACKGROUND Point-of-care testing (POCT) for influenza promises to provide real-time information to influence clinical decision making and improve patient outcomes. Public Health England has published a toolkit to assist implementation of these tests in the UK National Health Service. OBJECTIVE A feasibility study will be undertaken to assess the implementation of influenza POCT in primary care as part of a sentinel surveillance network. METHODS We will conduct a mixed methods study to compare the sampling rates in practices using POCT and current virology swabbing practices not using POCT, and to understand the issues and barriers to implementation of influenza POCT in primary care workflows. The study will take place between March and May 2019. It will be nested in general practices that are part of the English national sentinel surveillance network run by the Royal College of General Practitioners Research and Surveillance Centre. The primary outcome is the number of valid influenza swabs taken and tested by the practices involved in the study using the new POCT. RESULTS A total of 6 practices were recruited, and data collection commenced on March 11, 2019. Moreover, 312 swab samples had been collected at the time of submission of the protocol, which was 32.5% (312/960) of the expected sample size. In addition, 68 samples were positive for influenza, which was 20.1% (68/338) of the expected sample size. CONCLUSIONS To the best of our knowledge, this is the first time an evaluation study has been undertaken on POCT for influenza in general practice in the United Kingdom. This proposed study promises to shed light on the feasibility of implementation of POCT in primary care and on the views of practitioners about the use of influenza POCT in primary care, including its impact on primary care workflows. INTERNATIONAL REGISTERED REPORT DERR1-10.2196/14186

scholarly journals Feasibility of Point-of-Care Testing for Influenza Within a National Primary Care Sentinel Surveillance Network in England: Protocol for a Mixed Methods Study

10.2196/14186 ◽  
2019 ◽  
Vol 8 (11) ◽  
pp. e14186 ◽  
Author(s):  
Simon de Lusignan ◽  
Uy Hoang ◽  
Harshana Liyanage ◽  
Ivelina Yonova ◽  
Filipa Ferreira ◽  
...  
Keyword(s):  
Primary Care ◽  
Mixed Methods ◽  
Sample Size ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Sentinel Surveillance ◽  
Mixed Methods Study ◽  
Point Of Care Testing ◽  
Surveillance Network ◽  
Expected Sample Size

Background Point-of-care testing (POCT) for influenza promises to provide real-time information to influence clinical decision making and improve patient outcomes. Public Health England has published a toolkit to assist implementation of these tests in the UK National Health Service. Objective A feasibility study will be undertaken to assess the implementation of influenza POCT in primary care as part of a sentinel surveillance network. Methods We will conduct a mixed methods study to compare the sampling rates in practices using POCT and current virology swabbing practices not using POCT, and to understand the issues and barriers to implementation of influenza POCT in primary care workflows. The study will take place between March and May 2019. It will be nested in general practices that are part of the English national sentinel surveillance network run by the Royal College of General Practitioners Research and Surveillance Centre. The primary outcome is the number of valid influenza swabs taken and tested by the practices involved in the study using the new POCT. Results A total of 6 practices were recruited, and data collection commenced on March 11, 2019. Moreover, 312 swab samples had been collected at the time of submission of the protocol, which was 32.5% (312/960) of the expected sample size. In addition, 68 samples were positive for influenza, which was 20.1% (68/338) of the expected sample size. Conclusions To the best of our knowledge, this is the first time an evaluation study has been undertaken on POCT for influenza in general practice in the United Kingdom. This proposed study promises to shed light on the feasibility of implementation of POCT in primary care and on the views of practitioners about the use of influenza POCT in primary care, including its impact on primary care workflows. International Registered Report Identifier (IRRID) DERR1-10.2196/14186

scholarly journals Point-of-Care Testing-the Key in the Battle against SARS-CoV-2 Pandemic

Micromachines ◽  
2021 ◽  
Vol 12 (12) ◽  
pp. 1464
Author(s):  
Florina Silvia Iliescu ◽  
Ana Maria Ionescu ◽  
Larisa Gogianu ◽  
Monica Simion ◽  
Violeta Dediu ◽  
...  
Keyword(s):  
Clinical Decision Making ◽  
Point Of Care ◽  
Low Cost ◽  
Diagnostic Testing ◽  
Clinical Decision ◽  
Rapid Screening ◽  
Diagnostic Tools ◽  
Point Of Care Testing ◽  
Qrt Pcr ◽  
User Friendly

The deleterious effects of the coronavirus disease 2019 (COVID-19) pandemic urged the development of diagnostic tools to manage the spread of disease. Currently, the “gold standard” involves the use of quantitative real-time polymerase chain reaction (qRT-PCR) for SARS-CoV-2 detection. Even though it is sensitive, specific and applicable for large batches of samples, qRT-PCR is labour-intensive, time-consuming, requires trained personnel and is not available in remote settings. This review summarizes and compares the available strategies for COVID-19: serological testing, Point-of-Care Testing, nanotechnology-based approaches and biosensors. Last but not least, we address the advantages and limitations of these methods as well as perspectives in COVID-19 diagnostics. The effort is constantly focused on understanding the quickly changing landscape of available diagnostic testing of COVID-19 at the clinical levels and introducing reliable and rapid screening point of care testing. The last approach is key to aid the clinical decision-making process for infection control, enhancing an appropriate treatment strategy and prompt isolation of asymptomatic/mild cases. As a viable alternative, Point-of-Care Testing (POCT) is typically low-cost and user-friendly, hence harbouring tremendous potential for rapid COVID-19 diagnosis.

scholarly journals Accuracy, user-friendliness and usefulness of the Cobas h232 point-of-care test for NT-proBNP in primary care

2017 ◽  
Vol 71 (6) ◽  
pp. 539-545 ◽  
Author(s):  
Chiel Hex ◽  
Miek Smeets ◽  
Joris Penders ◽  
Viviane Van Hoof ◽  
Jan Verbakel ◽  
...  
Keyword(s):  
Heart Failure ◽  
Primary Care ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Linear Regression Analysis ◽  
Clinical Decision ◽  
User Friendliness ◽  
Point Of Care Test ◽  
Percentage Difference ◽  
Difference Plot

AimsN-terminal pro-B-type natriuretic peptide (NT-proBNP) has been shown to be useful for ruling out heart failure in primary care. In this study, we examined the accuracy of the Cobas h232 point-of-care (POC) instrument in primary care compared with an in-hospital measurement. Furthermore, we investigated the user-friendliness and usefulness of the POC device.MethodsFive general practitioner (GP) groups were asked to evaluate adult patients who were suspected of having heart failure and to test NT-proBNP with the Cobas h232. The samples were subsequently delivered to and analysed at a central hospital laboratory by the Cobas e602 using conventional transport and storage. Difference between the paired measurements was analysed using a percentage difference plot, and correlation was assessed using Passing-Bablok linear regression analysis. User-friendliness and usefulness were assessed using semistructured questionnaires.ResultsNineteen GPs studied 94 patients. Passing-Bablok analysis showed a slope of 1.05 (95% CI 1.00 to 1.11) (R2=0.97). The percentage difference plot showed a mean difference of 15.7% (95% CI −46.0% to –77.4%). User-friendliness and usefulness had median scores of 4 or 5 on a five-point Likert scale. Eighteen out of 19 GPs confirmed that the device influenced their clinical practice. During the study, GPs’ confidence in using NT-proBNP increased significantly from a mean score of 4.4 (95% CI 3.2 to 5.6) to 7.6 out of 10 (95% CI 7.1 to 8.2).ConclusionsThe Cobas h232 NT-proBNP POC test proved to be an accurate, user-friendly and useful test in primary care. Nearly all participating GPs were convinced that the test could benefit clinical decision making.

scholarly journals Assessment of influenza vaccine effectiveness in a sentinel surveillance network 2010–13, United States

Vaccine ◽  
2016 ◽  
Vol 34 (1) ◽  
pp. 61-66 ◽  
Author(s):  
Benjamin J. Cowling ◽  
Shuo Feng ◽  
Lyn Finelli ◽  
Andrea Steffens ◽  
Ashley Fowlkes
Keyword(s):  
United States ◽  
Influenza Vaccine ◽  
Vaccine Effectiveness ◽  
Sentinel Surveillance ◽  
Surveillance Network

Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) – does it leverage any advantage in clinical decision making?

2017 ◽  
Vol 54 (7-8) ◽  
pp. 471-494 ◽  
Author(s):  
Christopher Florkowski ◽  
Andrew Don-Wauchope ◽  
Nuria Gimenez ◽  
Karina Rodriguez-Capote ◽  
Julien Wils ◽  
...  
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Clinical Decision ◽  
Laboratory Medicine ◽  
Evidence Based ◽  
Point Of Care Testing

Point-of-Care Testing (DRAFT)

2018 ◽  
Author(s):  
Douglas E. Morgan
Keyword(s):  
Decision Making ◽  
Clinical Decision Making ◽  
Driving Forces ◽  
Clinical Laboratory ◽  
Point Of Care ◽  
Diagnostic Testing ◽  
Clinical Decision ◽  
Care Process ◽  
Point Of Care Testing ◽  
Subsequent Decrease

Point-of-care testing (POCT) is defined as medical diagnostic testing performed outside the clinical laboratory in close proximity to where the patient is receiving care. POCT is typically performed by non-laboratory personnel and the results are used for clinical decision making. When used appropriately, point-of-care testing (POCT) is a valuable resource during the rapid response system (RRS) activation. Advantages include shortened time between acquiring a sample from the patient and analysis of that sample and a subsequent decrease in time to clinical decision making. Disadvantages revolve largely around the cost of POCT. Driving forces behind the movement towards POCT include care process optimization, improvement of patient outcomes, changing regulatory requirements, and changes in the face of the workforce.

scholarly journals Interim estimates of influenza vaccine effectiveness in 2012/13 from Canada’s sentinel surveillance network, January 2013

2013 ◽  
Vol 18 (5) ◽  
Author(s):  
D M Skowronski ◽  
N Z Janjua ◽  
G De Serres ◽  
J A Dickinson ◽  
A-L Winter ◽  
...  
Keyword(s):  
Influenza Vaccine ◽  
Vaccine Effectiveness ◽  
Sentinel Surveillance ◽  
Surveillance Network ◽  
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scholarly journals Point-of-Care Testing in Rural and Remote Settings to Improve Access and Improve Outcomes

2020 ◽  
Author(s):  
Geoffrey C. E. Herd ◽  
Samarina M. A. Musaad
Keyword(s):  
New Zealand ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Special Section ◽  
Clinical Decision ◽  
Rural And Remote ◽  
Point Of Care Testing ◽  
Pathology Laboratory ◽  
Remote Locations ◽  
Sexual Health Clinics

Context.— Three key guiding principles of rural and remote clinical services are to improve health access, improve outcomes, and reduce inequity. In New Zealand as in other countries, point-of-care testing and technologies can assist in clinical decision-making for acute and chronic conditions and can help to achieve these key health principles for people living in rural and remote locations. This report is a companion article to the other point-of-care testing topics in this special section in this journal. Objective.— To provide readers with insights into where and how point-of-care testing devices and tests can be implemented to improve outcomes in New Zealand settings without on-site pathology laboratory support. The settings in which point-of-care testing devices and the success stories associated with these initiatives include general practices, pharmacies, workplaces, rural hospitals, and sexual health clinics. Data Sources.— The information is extracted from published literature and also first-hand experience in remote and rural New Zealand settings. This report also outlines the regulatory and accreditation challenges relating to point-of-care testing devices in New Zealand and includes advice on the selection of devices, training, and ongoing quality assurance for this type of medical testing in remote locations. Conclusions.— Point-of-care testing in rural remote settings without laboratory support can be challenging and rewarding for clinicians. It is now, and will be in the future, an even more important component of the health system to improve outcomes and reduce inequity.

scholarly journals Microfluidic-based point-of-care testing for disease diagnosis

2019 ◽  
Vol 131 ◽  
pp. 01004 ◽  
Author(s):  
Ruixuan Wen
Keyword(s):  
Decision Making ◽  
Medical Diagnosis ◽  
Clinical Decision Making ◽  
Point Of Care ◽  
Clinical Decision ◽  
Disease Diagnosis ◽  
Rapid Diagnosis ◽  
Design Strategies ◽  
Point Of Care Testing ◽  
Precision Testing

The early detection of diseases is important to optimize clinical treatment. To meet the increasing requirement of rapid medical diagnosis, point-of-care testing (POCT) has drawn scientists’ great attention for its outstanding advantages including simple, efficient, inexpensive and instrument-independent. Recent advantages of microfluidic-based diagnosis have played an important role in the significant technological process of POCT, which can achieve rapid diagnosis and provide high precision testing results for correct clinical decision making. This review focuses on design strategies, detection targets and sensing mechanisms of recent microfluidic-based POCT for disease diagnosis. Further, we provide a perspective of the next generation of POCT devices and their future opportunities.

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