How are rapid diagnostic tests for infectious diseases used in clinical practice: a global survey by the International Society of Antimicrobial Chemotherapy (ISAC)

Stephen Poole,Heiman Wertheim,Mario Plebani,Stephen P Kidd,Juan González Del Castillo,Jennifer Townsend,Philipp Schuetz,Tobias Welte,Jens-Ulrik Stæhr Jensen,Albertus Beishuizen,Charles-Edouard Luyt,Kordo Saeed

doi:10.1007/s10096-020-04031-2

Abstract

Novel rapid diagnostic tests (RDTs) offer huge potential to optimise clinical care and improve patient outcomes. In this study, we aim to assess the current patterns of use around the world, identify issues for successful implementation and suggest best practice advice on how to introduce new tests. An electronic survey was devised by the International Society of Antimicrobial Chemotherapy (ISAC) Rapid Diagnostics and Biomarkers working group focussing on the availability, structure and impact of RDTs around the world. It was circulated to ISAC members in December 2019. Results were collated according to the UN human development index (HDI). 81 responses were gathered from 31 different countries. 84% of institutions reported the availability of any test 24/7. In more developed countries, this was more for respiratory viruses, whereas in high and medium/low developed countries, it was for HIV and viral hepatitis. Only 37% of those carrying out rapid tests measured the impact. There is no ‘one-size fits all’ solution to RDTs: the requirements must be tailored to the healthcare setting in which they are deployed and there are many factors that should be considered prior to this.

Highlights

Rapid diagnostic tests (RDTs) are increasingly used in clinical practice to provide actionable information for patient care in a timely manner, ideally at the time and location of the patient’s interaction with health care systems
The last decade has seen a boom in rapid diagnostic products, with many developed and approved by healthcare authorities around the world [1] for a variety of different infections including gastroenteritis [2], bloodstream infections [3], pneumonia [4] and respiratory viruses [5]
The survey included 9 questions about the experience of RDTs: 1) What RDTs are available in your setting 24/7? 2) Any others not listed? 3) If you do not have RDTs, what are the barriers to getting them in your institution? 4) Who performs the RDTs? 5) How are results communicated? 6) Do you measure the impact of the tests? 7) How are these measured? 8) Who is responsible for governance related issues and quality controls of RDTs and results? 9) Do you have any recommendations for when and what rapid diagnostic test should be available in your setting? Or do you want to share any impact on your rapid diagnostics tests?

Summary

Introduction

Rapid diagnostic tests (RDTs) are increasingly used in clinical practice to provide actionable information for patient care in a timely manner, ideally at the time and location of the patient’s interaction with health care systems. The last decade has seen a boom in rapid diagnostic products, with many developed and approved by healthcare authorities around the world [1] for a variety of different infections including gastroenteritis [2], bloodstream infections [3], pneumonia [4] and respiratory viruses [5]. Formats of these tests include lateral flow assays and polymerase chain reaction (PCR)

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