Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved]
Background PROTECT (Platform Randomised evaluation of clinical Outcomes using novel TEChnologies to optimise antimicrobial Therapy) has brought together a team of researchers to design a platform trial to rapidly evaluate and adopt into care multiple diagnostic technologies, bringing immediate benef...
Saved in:
| Main Authors: | , , , , , , |
|---|---|
| Format: | Article |
| Language: | English |
| Published: |
F1000 Research Ltd
2025-01-01
|
| Series: | NIHR Open Research |
| Subjects: | |
| Online Access: | https://openresearch.nihr.ac.uk/articles/4-35/v2 |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| _version_ | 1832591167700598784 |
|---|---|
| author | Raasti Naseem Sara Pretorius Nicola Howe Clare Lendrem Cameron Williams Enitan D Carrol Philip Pallmann |
| author_facet | Raasti Naseem Sara Pretorius Nicola Howe Clare Lendrem Cameron Williams Enitan D Carrol Philip Pallmann |
| author_sort | Raasti Naseem |
| collection | DOAJ |
| description | Background PROTECT (Platform Randomised evaluation of clinical Outcomes using novel TEChnologies to optimise antimicrobial Therapy) has brought together a team of researchers to design a platform trial to rapidly evaluate and adopt into care multiple diagnostic technologies, bringing immediate benefit to patients. Rapid diagnostic tests will be used to identify patients at risk of deterioration from severe infection, before they become critically unwell. The platform will assess their comparative clinical effectiveness and cost-effectiveness relative to current standard of care. Preliminary work, conducted under a Health Technology Assessment Application Acceleration Award, provided key evidence to optimise the design of the PROTECT platform. Methods Qualitative methods which involved consulting key stakeholders in the field of serious infection addressed the key priorities. A high-level care pathway analysis focusing on serious infection in secondary care, captured the points of contact, actions, decisions, and potential outcomes associated with a patient’s care. Results Two use cases of rapid diagnostic tests for serious infection were identified; (1) in acute emergency medicine to decide on antimicrobial initiation and/or escalation of care, and (2) in hospitalised patients to monitor treatment response. The “ideal” test should be rapid, point-of-care, cheap to procure, have capacity for high usability, and ability to be performed and interpreted by all staff. Facilitators to the adoption of infection diagnostic tests is their clinical need, and the main potential barrier is poor change management and behavioural change. Conclusions Any new test should provide robust evidence of its clinical effectiveness and have the potential to accelerate ruling in or out serious infection which benefits the clinical pathway for patients, clinicians, and hospitals as a whole, to be considered for adoption as a new standard of care. |
| format | Article |
| id | doaj-art-6c5ed23079d6409088a6386eda886566 |
| institution | Kabale University |
| issn | 2633-4402 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | F1000 Research Ltd |
| record_format | Article |
| series | NIHR Open Research |
| spelling | doaj-art-6c5ed23079d6409088a6386eda8865662025-01-23T01:00:00ZengF1000 Research LtdNIHR Open Research2633-44022025-01-01415085Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved]Raasti Naseem0https://orcid.org/0000-0003-1978-4370Sara Pretorius1https://orcid.org/0000-0001-8277-711XNicola Howe2https://orcid.org/0000-0001-9446-8314Clare Lendrem3Cameron Williams4Enitan D Carrol5https://orcid.org/0000-0001-8357-7726Philip Pallmann6https://orcid.org/0000-0001-8274-9696Health Innovation North East and North Cumbria, England, NE4 5PL, UKNIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, England, NE2 4HH, UKNIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, England, NE2 4HH, UKNIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, England, NE2 4HH, UKNIHR Newcastle In Vitro Diagnostics Co-operative, Newcastle University, Newcastle upon Tyne, England, NE2 4HH, UKInstitute of Infection, Veterinary and Ecological Sciences, University of Liverpool, Liverpool, England, L69 7BE, UKCentre for Trials Research, Cardiff University, Cardiff, Wales, CF14 4YS, UKBackground PROTECT (Platform Randomised evaluation of clinical Outcomes using novel TEChnologies to optimise antimicrobial Therapy) has brought together a team of researchers to design a platform trial to rapidly evaluate and adopt into care multiple diagnostic technologies, bringing immediate benefit to patients. Rapid diagnostic tests will be used to identify patients at risk of deterioration from severe infection, before they become critically unwell. The platform will assess their comparative clinical effectiveness and cost-effectiveness relative to current standard of care. Preliminary work, conducted under a Health Technology Assessment Application Acceleration Award, provided key evidence to optimise the design of the PROTECT platform. Methods Qualitative methods which involved consulting key stakeholders in the field of serious infection addressed the key priorities. A high-level care pathway analysis focusing on serious infection in secondary care, captured the points of contact, actions, decisions, and potential outcomes associated with a patient’s care. Results Two use cases of rapid diagnostic tests for serious infection were identified; (1) in acute emergency medicine to decide on antimicrobial initiation and/or escalation of care, and (2) in hospitalised patients to monitor treatment response. The “ideal” test should be rapid, point-of-care, cheap to procure, have capacity for high usability, and ability to be performed and interpreted by all staff. Facilitators to the adoption of infection diagnostic tests is their clinical need, and the main potential barrier is poor change management and behavioural change. Conclusions Any new test should provide robust evidence of its clinical effectiveness and have the potential to accelerate ruling in or out serious infection which benefits the clinical pathway for patients, clinicians, and hospitals as a whole, to be considered for adoption as a new standard of care.https://openresearch.nihr.ac.uk/articles/4-35/v2Antimicrobial resistance care pathway analysis platform trial adaptive design bacterial infection implementationeng |
| spellingShingle | Raasti Naseem Sara Pretorius Nicola Howe Clare Lendrem Cameron Williams Enitan D Carrol Philip Pallmann Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] NIHR Open Research Antimicrobial resistance care pathway analysis platform trial adaptive design bacterial infection implementation eng |
| title | Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] |
| title_full | Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] |
| title_fullStr | Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] |
| title_full_unstemmed | Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] |
| title_short | Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection [version 2; peer review: 2 approved] |
| title_sort | mapping decision making pathways determination of intervention entry points for diagnostic tests in suspected serious infection version 2 peer review 2 approved |
| topic | Antimicrobial resistance care pathway analysis platform trial adaptive design bacterial infection implementation eng |
| url | https://openresearch.nihr.ac.uk/articles/4-35/v2 |
| work_keys_str_mv | AT raastinaseem mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT sarapretorius mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT nicolahowe mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT clarelendrem mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT cameronwilliams mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT enitandcarrol mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved AT philippallmann mappingdecisionmakingpathwaysdeterminationofinterventionentrypointsfordiagnostictestsinsuspectedseriousinfectionversion2peerreview2approved |