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英国和爱尔兰儿科环境中的即时检测:一项横断面研究。

Point-of-care testing in Paediatric settings in the UK and Ireland: a cross-sectional study.

机构信息

Paediatric Emergency Medicine Leicester Academic (PEMLA) Group, Children's Emergency Department, Leicester Royal Infirmary, Leicester, UK.

Emergency Department, Bristol Royal Hospital for Children, Bristol, UK.

出版信息

BMC Emerg Med. 2022 Jan 11;22(1):6. doi: 10.1186/s12873-021-00556-7.

Abstract

BACKGROUND

Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation.

METHODS

A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland).

RESULTS

In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reactive Protein (CRP) (13/139; 9.4%), Procalcitonin (PCT) (2/139; 1.4%) and Group A Streptococcus (5/139; 3.6%) and was relatively low. Obstacles to the introduction of new POCT included resources and infrastructure to support test performance and quality assurance.

CONCLUSION

This survey demonstrates significant consensus in POCT practice in the UK and Ireland but highlights specific inequity in newer biomarkers, some which do not have support from national guidance. A clear strategy to overcome the key obstacles of funding, evidence base, and standardising variation will be essential if there is a drive toward increasing implementation of POCT.

摘要

背景

即时检验(POCT)是在患者所在地或附近进行的诊断检测。了解当前在这种情况下 POCT 的能力和范围对于响应新的研究证据至关重要,因为这些新证据可能导致广泛实施。

方法

2020 年 1 月 6 日至 2 月 2 日,代表英国和爱尔兰的两个儿科研究网络(英国和爱尔兰儿科急救研究网络和英国和爱尔兰普通和青少年儿科研究网络),对 POCT 使用情况进行了横断面在线调查研究。

结果

共有 91/109(83.5%)个站点做出回应,一些受访者根据网络成员身份为其站点的多个单位提供了详细信息(共有 139 个单位)。最常进行的 POCT 检测是血糖(137/139;98.6%)、尿液分析(134/139;96.4%)和血气分析(132/139;95%)。用于流感/呼吸道合胞病毒(RSV)(45/139;32.4%,41/139;29.5%)、C 反应蛋白(CRP)(13/139;9.4%)、降钙素原(PCT)(2/139;1.4%)和 A 组链球菌(5/139;3.6%)的 POCT 使用率相对较低。引入新的 POCT 的障碍包括支持测试性能和质量保证的资源和基础设施。

结论

这项调查表明,英国和爱尔兰的 POCT 实践具有显著的一致性,但突出了一些新生物标志物的特定不平等现象,其中一些标志物没有得到国家指南的支持。如果要推动增加 POCT 的实施,那么就需要制定一个明确的策略来克服资金、证据基础和标准化差异方面的关键障碍。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b7ac/8753865/b0723c06fd5b/12873_2021_556_Fig1_HTML.jpg

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