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Use of a Host-Protein Test for Pediatric Acute Infections at Urgent Care Centers
Boaz Kalmovich1, Ilan Yehoshua1,2, Sara Kivity1
1Division of Health, Maccabi Healthcare Services, Tel Aviv, Israel.
Objective:
Evaluate impact of MeMed BV (MMBV) host-protein test on clinical decision-making for children with acute infection in urgent care centers (UCCs).
Methods:
Pragmatic study examining real-world use of MMBV by physicians trained to order the test when facing diagnostic uncertainty in suspected pediatric infections. Study assessed MMBV's impact on 2 decisions: whether to refer to the emergency department (ED), and, for discharged patients, whether to prescribe antibiotics. MMBV scores from 65 to 100 indicated a bacterial infection (or coinfection) and from 0 to 35 indicated viral/nonbacterial. Physicians filled pre- and post-test questionnaires. The outcomes included ED referrals, alignment between prescription and MMBV results, and 7-day post-UCC hospitalizations and antibiotic prescriptions.
Results:
The MMBV was ordered for 2171 patients. According to post-test questionnaires (n = 1677), MMBV results encouraged referral in 3.9% and discouraged referral in 26.0% of cases. Hospitalization rates were similar when the MMBV result did not impact vs when it discouraged referral (5.5% vs 4.6%; P = .53). Among 1713 nonreferred patients, the prescription aligned with MMBV results in 80.5%. Physicians reported that MMBV results changed or supported prescription decisions in 82.0% of cases. When physicians were undecided pretest, 80.6% of bacterial MMBV and 15.9% of viral MMBV cases were managed. When physicians were likely to prescribe but MMBV results were viral, 61.7% of patients were not treated. Post-UCC hospitalizations (3.3% vs 1.5%; P = .49) and prescriptions (14.7% vs 16%; P = .74) were comparable between not treated vs treated. When unlikely to prescribe but the MMBV results were bacterial, 77.1% of patients were treated. Post-UCC prescriptions were higher among cases not managed at a UCC (33.3% vs 13.2%; P = .02).
Conclusions:
MMBV aided safe clinical decision-making for pediatric acute infections in UCCs.
Insights
The MeMed BV (MMBV) host-protein test improved clinical decisions for children with acute infections in urgent care centers (UCCs). This test helped physicians safely manage pediatric infections, reducing unnecessary antibiotic prescriptions.
Area of Science:
- Infectious Diseases
- Clinical Diagnostics
- Pediatrics
Background:
- Urgent care centers (UCCs) manage numerous pediatric acute infections.
- Accurate diagnosis is crucial for appropriate treatment and resource allocation.
- The MeMed BV (MMBV) host-protein test offers a novel approach to differentiate bacterial from viral infections.
Purpose of the Study:
- To evaluate the impact of the MeMed BV (MMBV) host-protein test on clinical decision-making for children with acute infections in UCCs.
- To assess how MMBV test results influence physician decisions regarding emergency department (ED) referrals and antibiotic prescriptions.
- To determine the safety and effectiveness of MMBV in real-world pediatric urgent care settings.
Main Methods:
- A pragmatic study involving physicians trained to use the MMBV test in cases of diagnostic uncertainty for suspected pediatric infections.
- Assessed MMBV's impact on ED referral decisions and antibiotic prescription for discharged patients.
- Collected data via pre- and post-test physician questionnaires, including MMBV scores, referral rates, prescription alignment, and 7-day post-UCC outcomes (hospitalizations, antibiotic prescriptions).
Main Results:
- MMBV testing was performed on 2171 patients; results influenced referral decisions in 29.9% of cases (3.9% encouraged, 26.0% discouraged referral).
- Among non-referred patients, antibiotic prescription aligned with MMBV results in 80.5% of cases, with physicians reporting MMBV changed or supported decisions in 82.0%.
- When MMBV results guided management (e.g., avoiding antibiotics for viral infections), post-UCC hospitalizations and prescriptions remained comparable, indicating safe decision-making.
Conclusions:
- The MeMed BV (MMBV) host-protein test significantly aids clinical decision-making for pediatric acute infections in urgent care settings.
- MMBV facilitates appropriate management, potentially reducing unnecessary antibiotic use while ensuring necessary care.
- The test supports safe and effective clinical practice in urgent care environments for pediatric patients.
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