Pub Date : 2019-03-01DOI: 10.1097/POC.0000000000000178
Irene J. Ventura, Amanullah Zadran, An V. D. Ho, Layma Zadran, D. T. Thuan, Tung T. Pham, G. Kost
Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.
{"title":"Rapid Diagnosis and Effective Monitoring of Diabetes Mellitus in Central Vietnam: Point-of-Care Needs, Improved Patient Access, and Spatial Care Paths for Enhanced Public Health","authors":"Irene J. Ventura, Amanullah Zadran, An V. D. Ho, Layma Zadran, D. T. Thuan, Tung T. Pham, G. Kost","doi":"10.1097/POC.0000000000000178","DOIUrl":"https://doi.org/10.1097/POC.0000000000000178","url":null,"abstract":"Goals Our primary objective was to describe needs for and availability of point-of-care testing for diabetes mellitus diagnosis/monitoring in Central Vietnam. Methods The field survey was designed to determine the status of point-of-care testing at 15 hospitals, comprising 1 provincial hospital (level 2), 7 district hospitals (level 3), and 7 community health centers (level 4) in Hue Province, Central Vietnam. Questions are related to diabetes and prediabetes, acute coronary syndromes, and infectious diseases. Spatial care paths for problem-solving were designed. Acute coronary syndrome results were reported open access elsewhere (see https://journals.lww.com/poctjournal/Pages/articleviewer.aspx?year=2018&issue=09000&article=00001&type=Fulltext). Results Blood glucose testing was limited. Two (28.6%) of 7 community health centers reported having glucose meters available, whereas overall, only 2 (13.3%) of 15 survey sites performed hemoglobin A1c (HbA1c) testing. Diabetes and prediabetes glucose screening cutoffs varied across levels, possibly generating erroneous/missing diagnoses. A diabetes screening program was not reported at the level 2 hospital; availability varied in levels 3 and 4. Glucose meters must be purchased at patients' expense. Microvascular and macrovascular complications, such as kidney failure, retinopathy, and neuropathy, are treated at Hue Central Hospital, the provincial hospital, and some district hospitals. Transfer depends on the extent of patient complications. Ambulance service is extremely limited. Helicopter rescue is not available. Conclusions We conclude the following: (a) diagnostic technologies should be improved; (b) HbA1c and blood glucose instruments must be supplied; (c) public health budgets should fund self-monitoring, glucose meters, and enhanced access; (d) healthcare leaders can create regional spatial care paths to improve outcomes; and (e) diagnostic cutoffs, especially HbA1c, should be harmonized after checking population differences.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87805204","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2019-03-01DOI: 10.1097/POC.0000000000000181
E. Dameron
B lood sampling has been an essential diagnostic tool for many years.Up to 70%of allmedical decisions are guided by diagnostic test results that include blood sample evaluations. Although traditional blood sampling techniques are still necessary, they are not always practical. For example, in remote areas that are a great distance frommedical facilities, access to sampling facilities may be limited. Bloodmicrosampling is a simplifiedmethod of blood sampling that even allows participants to draw their own specimens and mail them to the laboratory for analysis. Microsampling is a procedure for capturing and analyzing minute samples of blood for analysis. The samples collect 10 to 20 μL of blood volume. A conventional sample drawn by venipuncture may consist of sample volumes of up to 10mL, as much as 500 to 1000 times the size of microsamples. The sampling event requires a simple prick of the finger, allowing a drop of blood to rise to the skin surface. Using a device such as this one, the samples are captured in the absorbent tip of the collection devices. The samples are then folded into the attached protective case and can be mailed without refrigeration or special handling to the laboratory (Fig. 1).
{"title":"Invited Product Profile: The Mitra Microsampling Device","authors":"E. Dameron","doi":"10.1097/POC.0000000000000181","DOIUrl":"https://doi.org/10.1097/POC.0000000000000181","url":null,"abstract":"B lood sampling has been an essential diagnostic tool for many years.Up to 70%of allmedical decisions are guided by diagnostic test results that include blood sample evaluations. Although traditional blood sampling techniques are still necessary, they are not always practical. For example, in remote areas that are a great distance frommedical facilities, access to sampling facilities may be limited. Bloodmicrosampling is a simplifiedmethod of blood sampling that even allows participants to draw their own specimens and mail them to the laboratory for analysis. Microsampling is a procedure for capturing and analyzing minute samples of blood for analysis. The samples collect 10 to 20 μL of blood volume. A conventional sample drawn by venipuncture may consist of sample volumes of up to 10mL, as much as 500 to 1000 times the size of microsamples. The sampling event requires a simple prick of the finger, allowing a drop of blood to rise to the skin surface. Using a device such as this one, the samples are captured in the absorbent tip of the collection devices. The samples are then folded into the attached protective case and can be mailed without refrigeration or special handling to the laboratory (Fig. 1).","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2019-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84848017","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000174
Fred Delfino
{"title":"Invited Product Profile – Alere DDS2 Mobile Forensic Test System","authors":"Fred Delfino","doi":"10.1097/POC.0000000000000174","DOIUrl":"https://doi.org/10.1097/POC.0000000000000174","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91502261","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000171
Amarasinghe Arachchige Don Nalin Samandika Saparamadu, L. Lam, J. Lee
{"title":"An Approach to Pseudohyperglycemia in Point-of-Care-Testing Glucose Monitoring","authors":"Amarasinghe Arachchige Don Nalin Samandika Saparamadu, L. Lam, J. Lee","doi":"10.1097/POC.0000000000000171","DOIUrl":"https://doi.org/10.1097/POC.0000000000000171","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87551262","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000176
T. Richards
T he drive for health care providers to streamline workflow, improve efficiency, and reduce costs has never been greater. At the same time, the trend toward decentralized health care is accelerating, most notably within consumer-focused care across all settings. The result is an emerging demand for rapid, reliable blood collection and diagnostic capabilities both inside and outside traditional clinical settings to improve access to high-quality diagnostic information. So far, however, much of the transition has been slowed by the limitations inherent in phlebotomy and finger-stick sampling. Both require trained personnel, involve multiple steps, disrupt workflow, and are the primary source of preanalytical errors in diagnostic testing. Worse, these methods are inconvenient as well as create anxiety and discomfort for patients. It is estimated that at least 10% of the US population suffer from needle phobia, and the number is reported to be much greater as sufferers tend to avoid medical treatment altogether. This is a significant impediment to a patient's ability to access the health care system. To address the limitations of both venipuncture and fingerstick sampling, Seventh Sense Biosystems set out to create a blood collection device that can be easily self-administered and is a painless method for collecting blood both within and outside traditional health care settings. Seventh Sense's TAP platform is designed to address theworkflow and quality challenges; facilitate the shift to decentralized, self-administered blood collection; and most importantly expand the reach of blood-based diagnostics to those who need it.
医疗保健提供者精简工作流程、提高效率和降低成本的动力从未如此强烈。与此同时，分散医疗保健的趋势正在加速，最明显的是在所有环境中以消费者为中心的医疗保健。其结果是在传统临床环境内外都出现了对快速、可靠的血液采集和诊断能力的新需求，以改善获得高质量诊断信息的机会。然而，到目前为止，由于静脉切开术和手指棒取样固有的局限性，这种转变在很大程度上放慢了速度。两者都需要训练有素的人员，涉及多个步骤，扰乱工作流程，并且是诊断测试中分析前错误的主要来源。更糟糕的是，这些方法不仅不方便，而且会给患者带来焦虑和不适。据估计，至少有10%的美国人患有针头恐惧症，据报道，由于患者倾向于完全避免就医，这一数字要大得多。这对患者利用卫生保健系统的能力是一个重大障碍。为了解决静脉穿刺和手指穿刺取样的局限性，第七感生物系统公司(Seventh Sense Biosystems)着手制造一种采血装置，这种装置可以很容易地自我给药，是一种在传统医疗机构内外采集血液的无痛方法。第七感的TAP平台旨在解决工作流程和质量挑战;促进向分散、自我管理的采血转变;最重要的是，将基于血液的诊断扩大到那些需要它的人。
{"title":"The TAP Integrated Capillary Blood Collection System","authors":"T. Richards","doi":"10.1097/POC.0000000000000176","DOIUrl":"https://doi.org/10.1097/POC.0000000000000176","url":null,"abstract":"T he drive for health care providers to streamline workflow, improve efficiency, and reduce costs has never been greater. At the same time, the trend toward decentralized health care is accelerating, most notably within consumer-focused care across all settings. The result is an emerging demand for rapid, reliable blood collection and diagnostic capabilities both inside and outside traditional clinical settings to improve access to high-quality diagnostic information. So far, however, much of the transition has been slowed by the limitations inherent in phlebotomy and finger-stick sampling. Both require trained personnel, involve multiple steps, disrupt workflow, and are the primary source of preanalytical errors in diagnostic testing. Worse, these methods are inconvenient as well as create anxiety and discomfort for patients. It is estimated that at least 10% of the US population suffer from needle phobia, and the number is reported to be much greater as sufferers tend to avoid medical treatment altogether. This is a significant impediment to a patient's ability to access the health care system. To address the limitations of both venipuncture and fingerstick sampling, Seventh Sense Biosystems set out to create a blood collection device that can be easily self-administered and is a painless method for collecting blood both within and outside traditional health care settings. Seventh Sense's TAP platform is designed to address theworkflow and quality challenges; facilitate the shift to decentralized, self-administered blood collection; and most importantly expand the reach of blood-based diagnostics to those who need it.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89934447","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000172
Moshoeu Prisca Sekgaila, Desmond Kuupiel, T. Mashamba-Thompson
Abstract Evidence on the acceptability of home-based human immunodeficiency virus testing and counseling (HB-HTC) in low- and middle-income countries (LMICs) remains unclear. We aimed to map evidence on the acceptability of HB-HTC in LMICs. We searched PubMed, EBSCOhost, Google Scholar, Science Direct, World Health Organization library database, and UNAIDS databases from January 2013 to October 2017. Two independent reviewers screened the studies using the eligibility criteria both at abstract and full article screening stages as well as performing quality assessment of the included articles. Discrepancies at the abstract stage were resolved through discussions while a third reviewer was involved at the full article screening stage. The risk of bias of included studies was appraised using Mixed Methods Appraisal Tool version 2011. Thematic content analysis was performed to identify patterns of acceptability of HB-HTC. Of 620 studies identified from the data bases searched, 30 studies were included for data extraction. All included studies were published between 2013 and 2017. Most of the study participants from these included studies were aged between 18 months to 100 years comprising of males (59%) and females (41%). These included studies were conducted in diverse locations including South Africa, Kenya, Lesotho, Malawi, China, Zimbabwe, Zambia, Uganda, and Brazil. Most of the studies were conducted in South Africa (9) and Kenya (7). Evidence showed that HB-HTC was most accepted by the female population compared with males in LMICs. In conclusion, there is adequate evidence on acceptability of HB-HTC in LMICs and linkage to care. This study additionally demonstrates that HB-HTC approach was more acceptable compared with facility-based HTC.
{"title":"Acceptability of Home-Based Human Immunodeficiency Virus Testing and Counseling in Low- and Middle-Income Countries: A Systematic Scoping Review","authors":"Moshoeu Prisca Sekgaila, Desmond Kuupiel, T. Mashamba-Thompson","doi":"10.1097/POC.0000000000000172","DOIUrl":"https://doi.org/10.1097/POC.0000000000000172","url":null,"abstract":"Abstract Evidence on the acceptability of home-based human immunodeficiency virus testing and counseling (HB-HTC) in low- and middle-income countries (LMICs) remains unclear. We aimed to map evidence on the acceptability of HB-HTC in LMICs. We searched PubMed, EBSCOhost, Google Scholar, Science Direct, World Health Organization library database, and UNAIDS databases from January 2013 to October 2017. Two independent reviewers screened the studies using the eligibility criteria both at abstract and full article screening stages as well as performing quality assessment of the included articles. Discrepancies at the abstract stage were resolved through discussions while a third reviewer was involved at the full article screening stage. The risk of bias of included studies was appraised using Mixed Methods Appraisal Tool version 2011. Thematic content analysis was performed to identify patterns of acceptability of HB-HTC. Of 620 studies identified from the data bases searched, 30 studies were included for data extraction. All included studies were published between 2013 and 2017. Most of the study participants from these included studies were aged between 18 months to 100 years comprising of males (59%) and females (41%). These included studies were conducted in diverse locations including South Africa, Kenya, Lesotho, Malawi, China, Zimbabwe, Zambia, Uganda, and Brazil. Most of the studies were conducted in South Africa (9) and Kenya (7). Evidence showed that HB-HTC was most accepted by the female population compared with males in LMICs. In conclusion, there is adequate evidence on acceptability of HB-HTC in LMICs and linkage to care. This study additionally demonstrates that HB-HTC approach was more acceptable compared with facility-based HTC.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73552024","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000175
J. Phillips
R espiratory tract infections are a worldwide public health problem caused by ubiquitous organisms (viruses and bacteria). Several notable pathogens that can cause respiratory infections are influenza A/B, respiratory syncytial virus (RSV), and group A streptococcus (GAS). Influenza viruses cause annual epidemics typically between November andMarch in the northern hemisphere and are responsible for 3000 to 49,000 deaths in the United States each year. Respiratory syncytial virus is the most common cause of bronchiolitis and pneumonia, with most individuals recovering in a week or two. However, RSV can be serious in infants and older adults. The majority of patients seeking care for influenza and other respiratory viruses typically present to emergency departments or other urgent care settings, where rapid diagnosis is critical. Group A streptococcus is a pervasive human-specific pathogen responsible for more than 10 million infections each year in the United States, with typical human-to-human transmission occurring via respiratory droplets or skin contact. Without proper treatment, GAS can progress into acute rheumatic fever, rheumatic heart disease, and other potentially life-threatening conditions. A significant overlap exists in the clinical manifestations of the different types of respiratory infections, making it difficult for clinicians to properly diagnose on the basis of clinical symptoms alone. In addition, the treatments are markedly different. Thus, the need for an accurate in vitro diagnostic test that health care professionals can use at the point of care to differentiate the pathogens that cause respiratory infections is paramount.
{"title":"Invited Product Profile – Cobas Liat System: CLIA-Waived PCR Analyzer for Infectious Diseases","authors":"J. Phillips","doi":"10.1097/POC.0000000000000175","DOIUrl":"https://doi.org/10.1097/POC.0000000000000175","url":null,"abstract":"R espiratory tract infections are a worldwide public health problem caused by ubiquitous organisms (viruses and bacteria). Several notable pathogens that can cause respiratory infections are influenza A/B, respiratory syncytial virus (RSV), and group A streptococcus (GAS). Influenza viruses cause annual epidemics typically between November andMarch in the northern hemisphere and are responsible for 3000 to 49,000 deaths in the United States each year. Respiratory syncytial virus is the most common cause of bronchiolitis and pneumonia, with most individuals recovering in a week or two. However, RSV can be serious in infants and older adults. The majority of patients seeking care for influenza and other respiratory viruses typically present to emergency departments or other urgent care settings, where rapid diagnosis is critical. Group A streptococcus is a pervasive human-specific pathogen responsible for more than 10 million infections each year in the United States, with typical human-to-human transmission occurring via respiratory droplets or skin contact. Without proper treatment, GAS can progress into acute rheumatic fever, rheumatic heart disease, and other potentially life-threatening conditions. A significant overlap exists in the clinical manifestations of the different types of respiratory infections, making it difficult for clinicians to properly diagnose on the basis of clinical symptoms alone. In addition, the treatments are markedly different. Thus, the need for an accurate in vitro diagnostic test that health care professionals can use at the point of care to differentiate the pathogens that cause respiratory infections is paramount.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87942574","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/poc.0000000000000177
{"title":"Point-of-Care Diagnosis of Acute Myocardial Infarction in Central Vietnam: International Exchange, Needs Assessment, and Spatial Care Paths: Erratum","authors":"","doi":"10.1097/poc.0000000000000177","DOIUrl":"https://doi.org/10.1097/poc.0000000000000177","url":null,"abstract":"","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77174826","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2018-12-01DOI: 10.1097/POC.0000000000000170
A. Ramezani, Lars Eng, M. Turkina, A. Theodorsson, F. Nayeri
Background Pneumonia is a serious and widespread cause of morbidity and mortality. At an early stage, the symptoms are similar to other respiratory disorders, and there is no single criterion standard for diagnosis. Antibiotics are used too often as a precaution. Objectives The objective of this study was to perform an assessment and clinical evaluation of a rapid sputum screening test (index test) to rule out pneumonia. Methods Leftover sputum samples (467) collected at the Department of Microbiology from November 2016 to March 2017 were blindly analyzed within 72 hours with the index test. The clinical accuracy of the test was estimated for pneumonia by comparison with the established diagnosis by independent physicians (International Classification of Diseases, 10th Revision). Hepatocyte growth factor and calprotectin were measured on random samples (80), and layman volunteers (40) were asked to perform the test on artificial samples. Results Two of 73 cases of pneumonia (community-acquired and nosocomial) showed negative results by the sputum strip test (97% sensitivity and 94% negative predictive value). The test results were highly correlated to hepatocyte growth factor and calprotectin concentrations in samples (R2 = 67% respective 39%). Importantly, all of the volunteers were able to estimate the correct positive and negative results. Conclusions The novel rapid sputum test represents a feasible tool for screening and ruling out the overwhelming majority of nonsevere respiratory infections at primary care settings, at home or when properly equipped laboratories are not available.
{"title":"A Sputum Screening Test to Rule Out Pneumonia at an Early Stage With High Negative Predictive Value","authors":"A. Ramezani, Lars Eng, M. Turkina, A. Theodorsson, F. Nayeri","doi":"10.1097/POC.0000000000000170","DOIUrl":"https://doi.org/10.1097/POC.0000000000000170","url":null,"abstract":"Background Pneumonia is a serious and widespread cause of morbidity and mortality. At an early stage, the symptoms are similar to other respiratory disorders, and there is no single criterion standard for diagnosis. Antibiotics are used too often as a precaution. Objectives The objective of this study was to perform an assessment and clinical evaluation of a rapid sputum screening test (index test) to rule out pneumonia. Methods Leftover sputum samples (467) collected at the Department of Microbiology from November 2016 to March 2017 were blindly analyzed within 72 hours with the index test. The clinical accuracy of the test was estimated for pneumonia by comparison with the established diagnosis by independent physicians (International Classification of Diseases, 10th Revision). Hepatocyte growth factor and calprotectin were measured on random samples (80), and layman volunteers (40) were asked to perform the test on artificial samples. Results Two of 73 cases of pneumonia (community-acquired and nosocomial) showed negative results by the sputum strip test (97% sensitivity and 94% negative predictive value). The test results were highly correlated to hepatocyte growth factor and calprotectin concentrations in samples (R2 = 67% respective 39%). Importantly, all of the volunteers were able to estimate the correct positive and negative results. Conclusions The novel rapid sputum test represents a feasible tool for screening and ruling out the overwhelming majority of nonsevere respiratory infections at primary care settings, at home or when properly equipped laboratories are not available.","PeriodicalId":20262,"journal":{"name":"Point of Care: The Journal of Near-Patient Testing & Technology","volume":null,"pages":null},"PeriodicalIF":0.0,"publicationDate":"2018-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81147380","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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