Diagnostic point-of-care tests in resource-limited settings
Paul K Drain, Emily P Hyle, Farzad Noubary, Kenneth A Freedberg, Douglas Wilson, William R Bishai, William Rodriguez, Ingrid V Bassett, Paul K Drain, Emily P Hyle, Farzad Noubary, Kenneth A Freedberg, Douglas Wilson, William R Bishai, William Rodriguez, Ingrid V Bassett
Abstract
The aim of diagnostic point-of-care testing is to minimise the time to obtain a test result, thereby allowing clinicians and patients to make a quick clinical decision. Because point-of-care tests are used in resource-limited settings, the benefits need to outweigh the costs. To optimise point-of-care testing in resource-limited settings, diagnostic tests need rigorous assessments focused on relevant clinical outcomes and operational costs, which differ from assessments of conventional diagnostic tests. We reviewed published studies on point-of-care testing in resource-limited settings, and found no clearly defined metric for the clinical usefulness of point-of-care testing. Therefore, we propose a framework for the assessment of point-of-care tests, and suggest and define the term test efficacy to describe the ability of a diagnostic test to support a clinical decision within its operational context. We also propose revised criteria for an ideal diagnostic point-of-care test in resource-limited settings. Through systematic assessments, comparisons between centralised testing and novel point-of-care technologies can be more formalised, and health officials can better establish which point-of-care technologies represent valuable additions to their clinical programmes.
Conflict of interest statement
Conflicts of Interest
WR is CEO of Daktari Diagnostics, which develops point-of-care test for use in resource-limited settings. All other authors declare no conflicts of interest.
Copyright © 2014 Elsevier Ltd. All rights reserved.
Source: PubMed