Diagnostic point-of-care tests in resource-limited settings.
Diagnostic point-of-care tests in resource-limited settings.
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DOI：
10.1016/s1473-3099(13)70250-0
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发表时间：
2014-03
影响因子：
56.3
通讯作者：
Bassett, Ingrid V.
中科院分区：
文献类型：
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作者：
Drain, Paul K.;Hyle, Emily P.;Noubary, Farzad;Freedberg, Kenneth A.;Wilson, Douglas;Bishai, William R.;Rodriguez, William;Bassett, Ingrid V.
诊断床旁（POC）测试旨在最大限度地减少获得测试结果的时间，从而使临床医生和患者能够迅速做出临床决策。随着POC测试扩展到资源有限的环境（RLS），收益必须超过成本。为了优化RLS中的POC测试，诊断性POC测试需要严格的评估，重点是相关的临床结果和运营成本，这与传统诊断测试的评估不同。在这里，我们回顾了已发表的关于RLS中POC检测的研究，发现POC检测的临床实用性没有明确定义的指标。因此，我们提出了一个评估POC测试的框架，并建议和定义术语“测试功效”来描述诊断测试的能力，以支持其操作范围内的临床决策。我们还提出了在资源有限的环境中进行理想诊断POC测试的修订标准。通过系统评估，集中诊断检测和新型POC技术之间的比较可以更加正式，卫生官员可以更好地确定哪些POC技术代表了其临床项目的有价值的补充。
Diagnostic point-of-care (POC) testing is intended to minimize the time to obtain a test result, thereby allowing clinicians and patients to make an expeditious clinical decision. As POC tests expand into resource-limited settings (RLS), the benefits must outweigh the costs. To optimize POC testing in RLS, diagnostic POC tests need rigorous evaluations focused on relevant clinical outcomes and operational costs, which differ from evaluations of conventional diagnostic tests. Here, we reviewed published studies on POC testing in RLS, and found no clearly defined metric for the clinical utility of POC testing. Therefore, we propose a framework for evaluating POC tests, and suggest and define the term “test efficacy” to describe a diagnostic test’s capacity to support a clinical decision within its operational context. We also proposed revised criteria for an ideal diagnostic POC test in resource-limited settings. Through systematic evaluations, comparisons between centralized diagnostic testing and novel POC technologies can be more formalized, and health officials can better determine which POC technologies represent valuable additions to their clinical programs.