Comparing localized versus centralized rapid diagnostics in a UK district hospital

Reviewed by: S. Schaeffer Spires, MD, Duke University School of Medicine

Haigh and colleagues evaluated the test characteristics and turnaround times (TAT) for the rapid diagnostics for influenza, respiratory syncytial virus, Clostridioides difficile, and norovirus performed on site versus off site.  They found that the sensitivity for all the local tests were >95%, except for the RSV which was 66%.  Compared to centralized testing, the median turnaround time (TAT) difference for the local testing 19 hours for the respiratory samples and 17 hours for the stool samples.  They reported this improvement in time was “advantageous in making quicker patient-care decisions and offering infection prevention and control advice when compared with the batch non-random access PCR platforms.” They only measured the TAT and test characteristics, and no clinical outcomes, thus they could only speculate regarding the improvement in infection prevention measures or length of stay. As we see some healthcare systems in the US moving towards centralized laboratories, a typical complaint that arises is the test takes longer to get the results, de-valuing the “rapid-ness” of the rapid diagnostic.  

Reference:

Haigh J, Cutino-Moguel M-T, Wilks M, Welch CA, Melzer M. A service evaluation of simultaneous near-patient testing for influenza, respiratory syncytial virus, Clostridium difficile and norovirus in a UK district general hospital. Journal of Hospital Infection. 2019;103(4):441-446. DOI:10.1016/j.jhin.2019.08.022

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