Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis
Objectives This article summarises all the available evidence on the impact of introducing blood-based point-of-care panel testing (POCT) in ambulatory care on patient outcomes and healthcare processes. Design Systematic review and meta-analysis of randomised-controlled trials and before-after stud...
| Main Authors: | , , , , , , , |
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| Format: | Journal article |
| Language: | English |
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BMJ
2020
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| _version_ | 1797100196473077760 |
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| author | Goyder, C Tan, PS Verbakel, J Ananthakumar, T Lee, JJ Hayward, G Turner, PJ Bruel, AVD |
| author_facet | Goyder, C Tan, PS Verbakel, J Ananthakumar, T Lee, JJ Hayward, G Turner, PJ Bruel, AVD |
| author_sort | Goyder, C |
| collection | OXFORD |
| description | Objectives This article summarises all the available evidence on the impact of introducing blood-based point-of-care panel testing (POCT) in ambulatory care on patient outcomes and healthcare processes.
Design Systematic review and meta-analysis of randomised-controlled trials and before-after studies.
Data sources Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, Database of Abstracts of Reviews and Effects, Science Citation Index from inception to 22 October 2019.
Eligibility criteria for selecting studies Included studies were based in ambulatory care and compared POCT with laboratory testing. The primary outcome was the time to decision regarding disposition that is, admission/referral termed disposition decision (DD) time. Secondary outcomes included length of stay (LOS) at the ambulatory care unit/practice and mortality.
Results 19 562 patients from nine studies were included in the review, eight of these were randomised-controlled trials, and one was a before-after study. All the studies were based in either emergency departments or the ambulance service; no studies were from primary care settings. General panel tests performed at the POCT resulted in DDs being made 40 min faster (95% CI −42.2 to −36.6, I2=0%) compared with the group receiving usual care, including central laboratory testing. This in turn resulted in a reduction in LOS for patients who were subsequently discharged by 34 min (95% CI −63.7 to −5.16). No significant difference in mortality was reported.
Discussion Although statistical and clinical heterogeneity is evident and only a small number of studies were included in the meta-analysis, our results suggest that POCTs might lead to faster discharge decisions. Future research should be performed in primary care and identify how POCTs can contribute meaningful changes to patient care rather than focusing on healthcare processes. |
| first_indexed | 2024-03-07T05:34:19Z |
| format | Journal article |
| id | oxford-uuid:e35d2480-b661-4840-b59d-fa3644186a9e |
| institution | University of Oxford |
| language | English |
| last_indexed | 2024-03-07T05:34:19Z |
| publishDate | 2020 |
| publisher | BMJ |
| record_format | dspace |
| spelling | oxford-uuid:e35d2480-b661-4840-b59d-fa3644186a9e2022-03-27T10:08:35ZImpact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysisJournal articlehttp://purl.org/coar/resource_type/c_dcae04bcuuid:e35d2480-b661-4840-b59d-fa3644186a9eEnglishSymplectic ElementsBMJ2020Goyder, CTan, PSVerbakel, JAnanthakumar, TLee, JJHayward, GTurner, PJBruel, AVDObjectives This article summarises all the available evidence on the impact of introducing blood-based point-of-care panel testing (POCT) in ambulatory care on patient outcomes and healthcare processes. Design Systematic review and meta-analysis of randomised-controlled trials and before-after studies. Data sources Ovid Medline, Embase, Cochrane Database of Systematic Reviews, Cochrane CENTRAL, Database of Abstracts of Reviews and Effects, Science Citation Index from inception to 22 October 2019. Eligibility criteria for selecting studies Included studies were based in ambulatory care and compared POCT with laboratory testing. The primary outcome was the time to decision regarding disposition that is, admission/referral termed disposition decision (DD) time. Secondary outcomes included length of stay (LOS) at the ambulatory care unit/practice and mortality. Results 19 562 patients from nine studies were included in the review, eight of these were randomised-controlled trials, and one was a before-after study. All the studies were based in either emergency departments or the ambulance service; no studies were from primary care settings. General panel tests performed at the POCT resulted in DDs being made 40 min faster (95% CI −42.2 to −36.6, I2=0%) compared with the group receiving usual care, including central laboratory testing. This in turn resulted in a reduction in LOS for patients who were subsequently discharged by 34 min (95% CI −63.7 to −5.16). No significant difference in mortality was reported. Discussion Although statistical and clinical heterogeneity is evident and only a small number of studies were included in the meta-analysis, our results suggest that POCTs might lead to faster discharge decisions. Future research should be performed in primary care and identify how POCTs can contribute meaningful changes to patient care rather than focusing on healthcare processes. |
| spellingShingle | Goyder, C Tan, PS Verbakel, J Ananthakumar, T Lee, JJ Hayward, G Turner, PJ Bruel, AVD Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title | Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title_full | Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title_fullStr | Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title_full_unstemmed | Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title_short | Impact of point-of-care panel tests in ambulatory care: a systematic review and meta-analysis |
| title_sort | impact of point of care panel tests in ambulatory care a systematic review and meta analysis |
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