TY - JOUR
T1 - Availability and use of rapid diagnostic tests for the management of acute childhood infections in Europe
T2 - A cross-sectional survey of paediatricians
AU - Dewez, Juan Emmanuel
AU - Pembrey, Lucy
AU - Nijman, Ruud G.
AU - del Torso, Stefano
AU - Grossman, Zachi
AU - Hadjipanayis, Adamos
AU - Van Esso, Diego
AU - Lim, Emma
AU - Emonts, Marieke
AU - Burns, James
AU - Gras-LeGuen, Christèle
AU - Kohlfuerst, Daniela
AU - Dornbusch, Hans Jürgen
AU - Brengel-Pesce, Karen
AU - Mallet, Francois
AU - von Both, Ulrich
AU - Tsolia, Maria
AU - Eleftheriou, Irini
AU - Zavadska, Dace
AU - de Groot, Ronald
AU - van der Flier, Michiel
AU - Moll, Henriëtte
AU - Hagedoorn, Nienke
AU - Borensztajn, Dorine
AU - Oostenbrink, Rianne
AU - Kuijpers, Taco
AU - Pokorn, Marko
AU - Vincek, Katarina
AU - Martinó n-Torres, Federico
AU - Rivero, Irene
AU - Agyeman, Philipp
AU - Carrol, Enitan D.
AU - Paulus, Stéphane
AU - Cunnington, Aubrey
AU - Herberg, Jethro
AU - Levin, Michael
AU - Mujkić, Aida
AU - Geitmann, Karin
AU - Da Dalt, Liviana
AU - Valiulis, Arunas
AU - Lapatto, Risto
AU - Syridou, Garyfallia
AU - Altorjai, Péter
AU - Torpiano, Paul
AU - Størdal, Ketil
AU - Illy, Károly
AU - Mazur, Artur
AU - Spreitzer, Mateja Vintar
AU - Rios, Joana
AU - Wyder, Corinne
AU - Romankevych, Ivanna
AU - Basmaci, Romain
AU - Ibanez-Mico, Salvador
AU - Yeung, Shunmay
N1 - Publisher Copyright:
© 2022 Dewez et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
PY - 2022/12/20
Y1 - 2022/12/20
N2 - Background Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability. Methods and findings A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks. Questions focused on the availability and use of currently available POCTs. Data were analysed descriptively and using Median Odds Ratio (MOR) to measure variation between countries. Multilevel regression modelling using changes in the area under the receiver operating characteristic curve of models were used to assess the contribution of individual or workplace versus country level factors, to the observed variation. The commonest POCT was urine dipsticks (UD) which were available to >80% of primary care and hospital paediatricians in 68% (13/19) and 79% (23/29) countries, respectively. Availability of all POCTs varied between countries. In primary care, the country (MOR) varied from 1.61 (95%CI: 1.04-2.58) for lactate to 7.28 (95%CI: 3.04-24.35) for UD. In hospitals, the country MOR varied from 1.37 (95%CI:1.04-1.80) for lactate to 11.93 (95% CI:3.35-72.23) for UD. Most paediatricians in primary care (69%, 795/1154) and hospital (81%, 962/1188) would use a diagnostic test in the case scenario of an infant with undifferentiated fever. Multilevel regression modelling showed that the country of work was more important in predicting both the availability and use of POCTs than individual or workplace characteristics. Conclusion There is substantial variability in the adoption of POCTs for the management of acute infections in children across Europe. To inform future implementation of both existing and innovative tests, further research is needed to understand what drives the variation between countries, the needs of frontline clinicians, and the role of diagnostic tests in the management of acute childhood infections.
AB - Background Point-of-care-tests (POCTs) have been advocated to optimise care in patients with infections but their actual use varies. This study aimed to estimate the variability in the adoption of current POCTs by paediatricians across Europe, and to explore the determinants of variability. Methods and findings A cross-sectional survey was conducted of hospital and primary care paediatricians, recruited through professional networks. Questions focused on the availability and use of currently available POCTs. Data were analysed descriptively and using Median Odds Ratio (MOR) to measure variation between countries. Multilevel regression modelling using changes in the area under the receiver operating characteristic curve of models were used to assess the contribution of individual or workplace versus country level factors, to the observed variation. The commonest POCT was urine dipsticks (UD) which were available to >80% of primary care and hospital paediatricians in 68% (13/19) and 79% (23/29) countries, respectively. Availability of all POCTs varied between countries. In primary care, the country (MOR) varied from 1.61 (95%CI: 1.04-2.58) for lactate to 7.28 (95%CI: 3.04-24.35) for UD. In hospitals, the country MOR varied from 1.37 (95%CI:1.04-1.80) for lactate to 11.93 (95% CI:3.35-72.23) for UD. Most paediatricians in primary care (69%, 795/1154) and hospital (81%, 962/1188) would use a diagnostic test in the case scenario of an infant with undifferentiated fever. Multilevel regression modelling showed that the country of work was more important in predicting both the availability and use of POCTs than individual or workplace characteristics. Conclusion There is substantial variability in the adoption of POCTs for the management of acute infections in children across Europe. To inform future implementation of both existing and innovative tests, further research is needed to understand what drives the variation between countries, the needs of frontline clinicians, and the role of diagnostic tests in the management of acute childhood infections.
UR - http://www.scopus.com/inward/record.url?scp=85144588983&partnerID=8YFLogxK
U2 - 10.1371/journal.pone.0275336
DO - 10.1371/journal.pone.0275336
M3 - Article
C2 - 36538525
AN - SCOPUS:85144588983
VL - 17
JO - PLoS ONE
JF - PLoS ONE
SN - 1932-6203
IS - 12 December
M1 - e0275336
ER -