PMD117 - POINT-OF-CARE TESTING IN PRIMARY CARE: A SYSTEMATIC REVIEW OF TEST EVALUATIONS AND AVAILABLE EVIDENCE

Abstract

There are numerous point-of-care tests (POCTs) available on the market, but many of these are not used by general practitioners (GPs). This study reviewed literature pertaining to the evaluation/usage of POCTs in primary care, to investigate whether the reported outcomes reflect aspects previously demonstrated to be important for 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 (e.g. trials, simulations, observational studies) and qualitative studies (e.g. interviews, surveys). Data was extracted from the included studies, such as the type of study, the extent to which manufacturers were involved with the study, and the biomarker/assay measured by the test(s). Studies were evaluated to summarize 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 1,547 publications, of which 131 met the inclusion criteria. From these studies, more than 40 POCTs across several disease areas (including cardiovascular disease, venous thromboembolism and respiratory-tract-infections) were identified. There was a clear inconsistency between what is reported on in the identified evaluations and what GPs consider important. GPs perceive clinical utility as the most important aspect, yet this was rarely included 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 tests still fail to report on aspects that GPs find important. To ensure that an evaluation of a test 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.