Health Technology and Services Research Department, Technical Medical Centre, University of Twente, Enschede, The Netherlands.
Laboratory for Clinical Chemistry and Haematology, Jeroen Bosch Hospital, Enschede, The Netherlands.
Int J Clin Pract. 2019 Oct;73(10):e13392. doi: 10.1111/ijcp.13392. Epub 2019 Aug 19.
There are numerous point-of-care tests (POCTs) available on the market, but many of these are not used. This study reviewed literature pertaining to the evaluation/usage of POCTs in primary care, to investigate whether outcomes being reported reflect aspects previously demonstrated to be important for general practitioners (GPs) in the decision to implement a POCT in practice.
Scopus and Medline were searched to identify studies that evaluated a POCT in primary care. We identified abstracts and full-texts consisting of applied studies (eg trials, simulations, observational studies) and qualitative studies (eg interviews, surveys). Data were extracted from the included studies, such as the type of study, the extent to which manufacturers were involved in the study, and the biomarker/assay measured by the test(s). Studies were evaluated to summarise the extent to which they reported on, amongst others, clinical utility, user-friendliness, turnaround-time and technical performance (aspects previously identified as important).
The initial search resulted in 1398 publications, of which 125 met the inclusion criteria. From these studies, 83 POCTs across several disease areas (including cardiovascular disease, venous thromboembolism and respiratory-tract-infections) were identified. There was an inconsistency between what is reported in the studies and what GPs consider important. GPs perceive clinical utility as the most important aspect, yet this was rarely included explicitly in test evaluations in the literature, with only 8% of evaluations incorporating it in their analysis/discussion.
This review showed that, despite the growing market and development of new POCTs, studies evaluating such tests fail to report on aspects that GPs find important. To ensure that an evaluation of a POCT is useful to primary care clinicians, future evaluations should not only focus on the technical performance aspects of a test, but also report on the aspects relating to the clinical utility and risks.
市场上有许多即时检测（POCT），但很多并未得到使用。本研究回顾了初级保健中 POCT 的评估/使用文献，以调查报告的结果是否反映了先前证明对全科医生（GP）在实践中实施 POCT 决策很重要的方面。
在 Scopus 和 Medline 上搜索评估初级保健中 POCT 的研究。我们确定了包含应用研究（如试验、模拟、观察性研究）和定性研究（如访谈、调查）的摘要和全文。从纳入的研究中提取数据，例如研究类型、制造商参与研究的程度以及测试（测试）测量的生物标志物/分析物。对研究进行评估，以总结它们在报告临床实用性、易用性、周转时间和技术性能（先前确定为重要的方面）等方面的程度。
最初的搜索产生了 1398 篇出版物，其中 125 篇符合纳入标准。从这些研究中，确定了 83 种针对多个疾病领域（包括心血管疾病、静脉血栓栓塞和呼吸道感染）的 POCT。研究报告的内容与 GP 认为重要的内容之间存在不一致。GP 将临床实用性视为最重要的方面，但文献中的测试评估很少明确包含这一点，只有 8%的评估将其纳入分析/讨论。
本综述表明，尽管即时检测市场不断增长且新 POCT 不断发展，但评估此类测试的研究未能报告 GP 认为重要的方面。为了确保对 POCT 的评估对初级保健临床医生有用，未来的评估不仅应侧重于测试的技术性能方面，还应报告与临床实用性和风险相关的方面。
