RT Journal Article
SR Electronic
T1 Diagnostic and economic evaluation of a point-of-care test for respiratory syncytial virus
JF ERJ Open Research
JO erjor
FD European Respiratory Society
SP 00018-2020
DO 10.1183/23120541.00018-2020
VO 6
IS 3
A1 A. Joy Allen
A1 Andrea Gonzalez-Ciscar
A1 Clare Lendrem
A1 Jana Suklan
A1 Karen Allen
A1 Ashley Bell
A1 Frances Baxter
A1 Stephen Crulley
A1 Louise Fairlie
A1 Danielle Hardy
A1 Louise Johnston
A1 Joanne McKenna
A1 Nicole Richards
A1 Gavin Shovlin
A1 Clare Simmister
A1 Sheila Waugh
A1 Philip Woodsford
A1 Sara Graziadio
A1 Michael Power
A1 A. John Simpson
A1 Prashant Kumar
A1 Katherine Eastham
A1 Malcolm Brodlie
YR 2020
UL http://openres.ersjournals.com/content/6/3/00018-2020.abstract
AB Respiratory syncytial virus is a common cause of bronchiolitis. Historically, point-of-care tests have involved antigen detection technology with limited sensitivity. The aim of this study was to prospectively evaluate the diagnostic accuracy and model the economic impact of the Roche cobas® Liat® point-of-care influenza A/B and respiratory syncytial virus test.The “DEC-RSV” study was a multi-centre, prospective, observational study in children under 2 years presenting with viral respiratory symptoms. A nasopharyngeal aspirate sample was tested using the point-of-care test and standard laboratory-based procedures. The primary outcome was accuracy of respiratory syncytial virus detection. The cost implications of adopting a point-of-care test were modelled using study data.A total of 186 participants were recruited, with both tests performed on 177 samples. The point-of-care test was invalid for 16 samples (diagnostic yield 91%) leaving 161 available for primary analysis. After resolving discrepancies, the cobas® Liat® respiratory syncytial virus test had 100.00% (95% CI 96.07%–100.00%) sensitivity and 98.53% (95% CI 92.08%–99.96%) specificity. Median time to result was 0.6 h (interquartile range (IQR) 0.5–1) for point-of-care testing and 28.9 h (IQR 26.3–48.1) for standard laboratory testing. Estimated non-diagnostic cost savings for 1000 patients, based on isolation decision-making on point-of-care test result, were £57 010, which would increase to £94 847 when cohort nursing is used.In young children the cobas® Liat® point-of-care respiratory syncytial virus test has high diagnostic accuracy using nasopharyngeal aspirates (currently an off-licence sample type). Time to result is clinically important and was favourable compared to laboratory-based testing. The potential exists for cost savings when adopting the point-of-care test.This prospective evaluation of the cobas Liat point-of-care RSV test in children demonstrated high diagnostic accuracy using nasopharyngeal aspirate samples, with favourable time to result compared to usual laboratory-based testing procedures https://bit.ly/2yKKmUB