Recommended point-of-care tests in out-of-hours primary care: A modified Delphi study.

Current evidence shows that point-of-care tests (POCTs) are used to improve diagnostic accuracy in limited-resource settings. However, there is no unified guidance on which POCTs should be available in out-of-hours primary care. Prior research has shown variability in POCT use across regions. That uncertainty drove the need for a consensus-based approach. No prior work had resolved the lack of standardized recommendations. This gap motivated the use of a modified Delphi study. The study aimed to address the absence of clear guidelines for POCT prioritization. Establishing such guidelines could help streamline diagnostic processes in urgent care settings.

The aim was to identify which POCTs should be considered essential or optional in European out-of-hours primary care. The study focused on resolving the lack of consensus among clinicians and researchers. The researchers proposed to use a structured consensus method to guide POCT availability. The primary goal was to inform policy and practice in urgent care diagnostics. The study aimed to address variability in POCT use across countries. The researchers proposed to involve experts from diverse clinical backgrounds. The study aimed to support diagnostic efficiency in limited-resource settings. The purpose was to provide a framework for POCT implementation in OOH services.

The study used a modified Delphi process with three rounds of expert consultation. In the first round, participants provided data on current POCT availability. In the second round, 28 POCTs were rated as essential, optional, or unnecessary. The third round included an in-person workshop followed by anonymous voting. Consensus was defined as ≥66.6% agreement among participants. The panel included experts from 20 European countries with varied clinical experience. The process combined quantitative ratings with qualitative discussion. The method ensured transparency and structured decision-making.

Six POCTs reached consensus as essential: blood glucose, urine dipstick, CRP, pregnancy testing, ECG, and haemoglobin. Twelve tests were classified as optional, and ten were deemed unnecessary. The essential tests were selected based on high agreement and clinical relevance. Blood glucose testing was prioritized for its diagnostic and management value. Urine dipstick was included for rapid detection of urinary tract infections. CRP was rated essential for assessing inflammation in acute conditions. Pregnancy testing was included for timely diagnosis in urgent care settings. ECG was recommended for evaluating cardiac symptoms in OOH settings.

The study provides the first European consensus on POCT prioritization in out-of-hours primary care. The authors propose that implementing essential POCTs could improve diagnostic efficiency. The authors suggest that training and governance are needed to support POCT use. The authors propose that optional tests should be adapted to local service needs. The authors suggest that inappropriate use of POCTs remains a concern. The authors propose that clinician confidence varies and should be addressed. The authors suggest that patient-driven demand influences POCT use. The authors propose that governance structures should be developed to manage POCT implementation.