Clinical yield of multiple testing with respiratory pathogen panels

Diagn Microbiol Infect Dis. 2022 Apr;102(4):115629. doi: 10.1016/j.diagmicrobio.2021.115629. Epub 2021 Dec 29.

Abstract

Though multiplex respiratory pathogen panels (RPP) have high sensitivity, multiple tests are occasionally performed simultaneously or in rapid succession in an attempt to increase the yield. The purpose of this study was to assess the impact of this practice.

Methods: "Multiple testing" was defined as >1 RPP performed within 12 hours on the same patient and specimen type. All cases of multiple testing for adults at two hospitals over a 5-year period were included. Chart review was performed to determine whether discordant results led to a clinical diagnosis or change in clinical management.

Results: Of 18,779 RPPs, 462 (2.5%) represented cases of multiple testing. Twenty-six of 462 cases (5.6%) produced discordant results. Five discordant results (1.1% of 462 multiple testing episodes) were associated with a clinical diagnosis, and 4 (0.9%) influenced clinical management.

Conclusion: Multiple RPP testing facilitates clinical management in <1% of cases. Medical centers may consider de-implementing this practice.

Keywords: diagnostic stewardship; duplicate testing; multiple testing; multiplex molecular panel testing; respiratory panels; syndromic panels.

MeSH terms

  • Adult
  • Humans
  • Molecular Diagnostic Techniques* / methods
  • Respiratory Tract Infections* / diagnosis