Speed and Convenience Aren't Everything with Diagnostics

doi:10.1371/journal.pmed.1001113

Abstract

Highlights

In an age when we can sequence an entire genome within a day, we expect to be able to gather and access accurate information at a pace
Since speed and convenience come at a cost, is that cost worthwhile? In a recent PLoS Medicine essay, David Dowdy and colleagues highlighted the challenges of determining the cost-effectiveness of rapid TB diagnostics, including the danger of draining resources from other TB-specific interventions and the need to take into account the cost of treating false-positive diagnoses [4]
The kits may be both rapid and convenient, but as a meta-analysis by Karen Steingart and colleagues in PLoS Medicine has shown, they fail in their primary purpose since they are neither accurate nor consistent enough to replace sputum smear microscopy as a test for TB [6]

Summary

Introduction

In an age when we can sequence an entire genome within a day, we expect to be able to gather and access accurate information at a pace. Reducing the lag time between testing and diagnosis has obvious advantages for the patient by ensuring timely receipt of care, and this should in turn benefit others by reducing the probability of transmission. In December last year the World Health Organization (WHO) endorsed the use of a new automated PCR-based test for tuberculosis (TB), known as Xpert, which can rapidly confirm infection and detect resistance to rifampicin [1,2].

Results

Conclusion