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

Research output: Contribution to journalReview articlepeer-review

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.

Original languageEnglish (US)
Pages (from-to)239-249
Number of pages11
JournalThe Lancet Infectious Diseases
Volume14
Issue number3
DOIs
StatePublished - Mar 2014

ASJC Scopus subject areas

  • Infectious Diseases

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