Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis

Abstract Background The increasing number of available point-of-care (POC) tests challenges clinicians regarding decisions on which tests to use, how to efficiently use them, and how to interpret the results. Although POC tests may offer benefits in terms of low turn-around-time, improved patient’s satisfaction, and health outcomes, only few are actually used in clinical practice. Therefore, this study aims to identify which criteria are, in general, important in the decision to implement a POC test, and to determine their weight. Two POC tests available for use in Dutch general practices (i.e... Mehr ...

Verfasser: Michelle M. A. Kip
J. Marjan Hummel
Elra B. Eppink
Hendrik Koffijberg
Rogier M. Hopstaken
Maarten J. IJzerman
Ron Kusters
Dokumenttyp: Artikel
Erscheinungsdatum: 2019
Reihe/Periodikum: BMC Family Practice, Vol 20, Iss 1, Pp 1-10 (2019)
Verlag/Hrsg.: BMC
Schlagwörter: Analytic hierarchy process / Health technology assessment / Adoption / Multi-criteria decision analysis / Point-of-care tests / Preference elicitation / Medicine (General) / R5-920
Sprache: Englisch
Permalink: https://search.fid-benelux.de/Record/base-27405740
Datenquelle: BASE; Originalkatalog
Powered By: BASE
Link(s) : https://doi.org/10.1186/s12875-018-0893-4

Abstract Background The increasing number of available point-of-care (POC) tests challenges clinicians regarding decisions on which tests to use, how to efficiently use them, and how to interpret the results. Although POC tests may offer benefits in terms of low turn-around-time, improved patient’s satisfaction, and health outcomes, only few are actually used in clinical practice. Therefore, this study aims to identify which criteria are, in general, important in the decision to implement a POC test, and to determine their weight. Two POC tests available for use in Dutch general practices (i.e. the C-reactive protein (CRP) test and the glycated haemoglobin (HbA1c) test) serve as case studies. The information obtained from this study can be used to guide POC test development and their introduction in clinical practice. Methods Relevant criteria were identified based on a literature review and semi-structured interviews with twelve experts in the field. Subsequently, the criteria were clustered in four groups (i.e. user, organization, clinical value, and socio-political context) and the relative importance of each criterion was determined by calculating geometric means as implemented in the Analytic Hierarchy Process. Of these twelve experts, ten participated in a facilitated group session, in which their priorities regarding both POC tests (compared to central laboratory testing) were elicited. Results Of 20 criteria in four clusters, the test’s clinical utility, its technical performance, and risks (associated with the treatment decision based on the test result) were considered most important for using a POC test, with relative weights of 22.2, 12.6 and 8.5%, respectively. Overall, the experts preferred the POC CRP test over its laboratory equivalent, whereas they did not prefer the POC HbA1c test. This difference was mainly explained by their strong preference for the POC CRP test with regard to the subcriterion ‘clinical utility’. Conclusions The list of identified criteria, and the insights in their relative ...