An analysis of clinical data revealing the frequency of blood test requests from primary care providers indicates the potential utility of diagnostic platforms that combine several commonly requested tests onto multiplex panels, which could move blood testing from laboratory settings into the community.
Of more than 500 different blood tests analyzed, the data suggested the need for a variety of common community-requested test combinations, including tests of general health as well as tests to investigate anemia, fatigue, hormone levels, renal and liver function, and serum iron and vitamin levels.
For the diagnosis of acute disease and the management of chronic conditions, the availability of and demand for point-of-care (POC) diagnostic tests in primary care has been gradually increasing. Many general practitioners are keen to incorporate POC tests directly into their practice to inform immediate decisionmaking.
Thomas Fanshawe, PhD, University of Oxford.
Multiplex technologies have the potential to combine different biochemical and hematological tests, which can be carried out in a relatively short time from a single blood sample. Yet it remains unclear which tests should be included in such panels, particularly where patients present with a variety of conditions.
To spotlight the frequency and combination of test requests in community settings, a research team from the University of Oxford’s Nuffield department of primary care health sciences, and the University of Leuven, analyzed data from 11,763,473 laboratory blood tests requested by primary care practices in Oxfordshire, covering more than 413,000 patients.1
The study was funded by the UK’s National Institute for Health Research (NIHR) Community Healthcare Medtech and In Vitro Diagnostics Cooperative, an Oxford-based group hosted by Oxford Health NHS Foundation Trust, which advances the development and evaluation of diagnostic tests to transform community healthcare.
“There’s extremely high demand for laboratory blood tests from community settings in the UK, and our analysis suggests an important role in the future for multiplex devices that would enable health professionals to carry out their own tests at the point of care, greatly benefiting patients and speeding up their decisionmaking,” says lead researcher Thomas Fanshawe, PhD, a senior medical statistician at the University of Oxford. “Replicating laboratory testing with panels of tests in combination is technologically feasible, although should such tests be developed, we would need to understand more about how they’re used by practitioners to avoid situations where patients are tested unnecessarily.”
Philip Turner, PhD, NIHR community healthcare MIC.
“The NIHR community healthcare MIC instigated this project in response to questions from the IVD industry about what to include on multiplex point-of-care platforms,” adds Philip Turner, PhD, NIHR community healthcare MIC manager. “Combined with insights from our survey of general practitioners, this data-driven approach provides further evidence of where demand lies for diagnostic tests in community settings, although we would caution that the clinical utility of rapid point-of-care tests is contingent on a complex array of factors beyond demand.”
Oxford University’s medical sciences division is one of the largest biomedical research centers in Europe, with over 2,500 people involved in research and more than 2,800 students. The university is rated the best in the world for medicine and life sciences, and it is home to the UK’s top-ranked medical school. It has one of the largest clinical trial portfolios in the UK and great expertise in taking discoveries from the lab into the clinic. Partnerships with the local NHS Trusts enable patients to benefit from close links between medical research and healthcare delivery.
Within the division, the Nuffield department of primary care health sciences undertakes internationally acclaimed teaching and research to help general practitioners deliver better care in the community.
To learn more, visit the Nuffield department of primary care health sciences at the University of Oxford.
Reference
- Fanshawe TR, Ordóñez-Mena JM, Turner PJ, Van den Bruel A, Shine B, Hayward GN. Frequencies and patterns of laboratory test requests from general practice: a service evaluation to inform point-of-care testing. J Clin Pathol. Epub ahead of print, September 18, 2018; doi: 10.1136/jclinpath-2018-205242.
Headshots by Nasir Hamid courtesy University of Oxford.
