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TRIAGE TESTING


point-of-care (POC) triage test which can help prevent the spread of infection and reduce risk in clinical settings. The FebriDx product was shown to be highly accurate in rapid identification of SARS-CoV-2 infections and could be deployed as a front door triage tool in hospitals and urgent care centres, overcoming current issues of delayed diagnosis from reverse transcriptase- polymerase chain reaction (RT-PCR) testing – a methodology with varying turnaround times and sensitivity. FebriDx as a rapid triage tool that detects both influenza and SARS-CoV-2 is likely to be of utility in the coming winter months. FebriDx allows clinicians to identify viral patients in 10 minutes from a capillary whole blood sample; facilitate immediate patient isolation; ensure patients with bacterial infections are not missed; and rule out non-clinically- significant infection. Delays mean that infected and non-infected patients may come into unnecessary contact, resulting in those who are well becoming infected. The situation is compounded by the limited availability of single isolation units, meaning that patients are temporarily held in assessment areas or inpatient wards until results are available. The impact on patient flow and effective care puts additional pressure on already overwhelmed acute services. The use of FebriDx will allow clinicians to make an initial decision for each individual, while waiting for the result of a confirmatory test from the medical laboratory.


Combination testing improves clinical decision-making The use of FebriDx as a triage tool can help prevent the spread of infection, being the only rapid test able to differentiate viral from bacterial infection due to the detection of both C-reactive protein (CRP), an acute-phase inflammatory protein elevated in acute bacterial and viral infection, and myxovirus resistance protein A (MxA), an intracellular protein with a fast induction time of one to two hours that only becomes elevated in the presence of acute viral infection. By detecting both markers, the sensitivity and negative predictive value of the test is optimised. FebriDx has been demonstrated to be highly accurate in detecting SARS-CoV-2 infections rapidly, including identifying infections that have been missed by RT-PCR testing. Similarly, FebriDx will be important outside the hospital in community diagnostic hubs, care homes and GP practices, and could be deployed in any of the settings previously discussed.


It has also been shown that FebriDx is


ineffective, increasing morbidity and mortality across all territories.


The power to disrupt care pathways The term ‘game changer’ is used all too frequently, mainly as a political battering ram. The public are not easily convinced, as may have been the case historically. The power needs to be returned to the term, and multi-centre decentralised diagnostics have the potential to do this. The right test delivered at the right time, provided on a reliable platform, used by trained staff who can interpret and act on the results, has the power to disrupt the delivery of care as it is presently known. Might FebriDx be a true game changer? The test performance is compelling, the impact realised and presented in multiple studies.


How can the change be facilitated? National bodies in global territories need to be receptive to change in the first instance. No change is no longer an option. Leading clinicians need to influence the direction of travel. Diagnostics companies need to understand the problem to be solved. Together, an array of solutions to common and complex health conditions and diseases are possible.


Each of these solutions has the ability to positively impact on morbidity, mortality and long-term outcomes for patients from all backgrounds. Geographical, demographical or sociological implications must not figure when it comes to population health.


The FebriDx cartridge.


an effective tool in improving antibiotic stewardship and reducing antimicrobial resistance (AMR). It is estimated that 50% of antibiotics prescribed for acute respiratory infections (ARIs) are unnecessary, and this is the leading cause of AMR on a global scale. Rapid identification of patients who need antibiotics and avoiding unnecessary prescribing has a significant impact on the healthcare economy and improves the outcomes for patients requiring treatment. Antimicrobial resistance is a global


healthcare issue with the potential to render many therapies and medications


WWW.PATHOLOGYINPRACTICE.COM DECEMBER 2020


A standardised approach A standardised approach to the adoption of new tests is required. This starts with the verification work needed to confirm the performance characteristics stated by the provider. It concludes with the implementation of the solution at ground level where clinicians can have complete confidence in the tools adopted to inform their care decisions. Ultimately, the patient should benefit from the information provided by the test, but it should not be forgotten that inaccurate information offered by a diagnostic test can have widespread implications across society when viewed on a national and global level. This is where policy-makers must be single-minded in the intended outcome of their decisions. Where a positive outcome is expected, what are the relative risks? What might be the impact of adopting a test that could generate an inaccurate result? Is this fully understood? How is this communicated, reinforced and monitored following adoption? Clear information to clinicians on the limitations is key, where


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