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Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis
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 satisfac...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327588/ https://www.ncbi.nlm.nih.gov/pubmed/30630430 http://dx.doi.org/10.1186/s12875-018-0893-4 |
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author | Kip, Michelle M. A. Hummel, J. Marjan Eppink, Elra B. Koffijberg, Hendrik Hopstaken, Rogier M. IJzerman, Maarten J. Kusters, Ron |
author_facet | Kip, Michelle M. A. Hummel, J. Marjan Eppink, Elra B. Koffijberg, Hendrik Hopstaken, Rogier M. IJzerman, Maarten J. Kusters, Ron |
author_sort | Kip, Michelle M. A. |
collection | PubMed |
description | 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 (HbA(1c)) 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 HbA(1c) 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 impact on successful implementation of POC tests, may facilitate implementation and use of existing POC tests in clinical practice. In addition, having experts score new POC tests on these criteria, provides developers with specific recommendations on how to increase the probability of successful implementation and use. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-018-0893-4) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6327588 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63275882019-01-15 Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis Kip, Michelle M. A. Hummel, J. Marjan Eppink, Elra B. Koffijberg, Hendrik Hopstaken, Rogier M. IJzerman, Maarten J. Kusters, Ron BMC Fam Pract Research Article 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 (HbA(1c)) 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 HbA(1c) 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 impact on successful implementation of POC tests, may facilitate implementation and use of existing POC tests in clinical practice. In addition, having experts score new POC tests on these criteria, provides developers with specific recommendations on how to increase the probability of successful implementation and use. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12875-018-0893-4) contains supplementary material, which is available to authorized users. BioMed Central 2019-01-10 /pmc/articles/PMC6327588/ /pubmed/30630430 http://dx.doi.org/10.1186/s12875-018-0893-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Kip, Michelle M. A. Hummel, J. Marjan Eppink, Elra B. Koffijberg, Hendrik Hopstaken, Rogier M. IJzerman, Maarten J. Kusters, Ron Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title | Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title_full | Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title_fullStr | Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title_full_unstemmed | Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title_short | Understanding the adoption and use of point-of-care tests in Dutch general practices using multi-criteria decision analysis |
title_sort | understanding the adoption and use of point-of-care tests in dutch general practices using multi-criteria decision analysis |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6327588/ https://www.ncbi.nlm.nih.gov/pubmed/30630430 http://dx.doi.org/10.1186/s12875-018-0893-4 |
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