Clinical yield of multiple testing with respiratory pathogen panels.

Area of Science:

• Clinical Microbiology
• Diagnostic Testing
• Infectious Disease

Background:

• Multiplex respiratory pathogen panels (RPP) are highly sensitive diagnostic tools.
• Simultaneous or sequential RPP testing is sometimes employed to maximize diagnostic yield.

Purpose of the Study:

• To evaluate the clinical impact of performing multiple respiratory pathogen panels (RPP) on the same patient within a short timeframe.
• To determine if redundant RPP testing leads to improved clinical diagnosis or management.

Main Methods:

• Defined "multiple testing" as more than one RPP performed within 12 hours on the same patient and specimen type.
• Reviewed adult cases of multiple RPP testing at two hospitals over a 5-year period.
• Assessed chart data to identify if discordant results influenced clinical diagnosis or management.

Main Results:

• Out of 18,779 RPPs, 462 (2.5%) involved multiple testing.
• Discordant results occurred in 26 of 462 multiple testing cases (5.6%).
• Only 5 discordant results (1.1%) were linked to a clinical diagnosis, and 4 (0.9%) influenced clinical management.

Conclusions:

• Multiple RPP testing infrequently leads to changes in clinical diagnosis or management.
• The practice of performing multiple RPP tests may be considered for de-implementation in medical centers.
• Current evidence suggests limited clinical utility for redundant respiratory pathogen panel testing.