How To Test For Pneumonia In The Kandidat

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Christine Norris
3 years ago
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1 innovation

2 Nationaal POCT symposium Antwerpen 23 okt 2014 POCT Pearls and Pitfalls in Primary care Progressing towards better patient care. The Dutch experience Rogier Hopstaken MD PhD Ron Kusters PhD

3 Netherlands

4 POCT = history and physical exam? Nederland?

5 Smartest GP practice

6 How do youknowthati don thave cancer, doc?

7 Retired teacher

8 Point of patient testing

9 Dutch general practice

10 POCT in Dutch general practice

11 Innovation nothing new!

12 Huh, GPs and research? Jullie hebben geluk

13 Laennec

14 With or without stethoscope?

15 Clinical diagnosis pneumonia Are we bad doctors? Melbye 1990, Hopstaken 2003, van Vught 2013

16 Pneumonia on study book

17 Pneumonia in general practice

18 Prediction of pneumonia History/Exam auc 0.70 H/E + CRP auc 0.90 Hopstaken Brit J Gen Pract 2003 Hopstaken BJGP 2003

19 CRP: best predictor of pneumonia in general practice Van der Meer BMJ 2005 vd Meer BMJ 2005

20 Perfect test Receiver operating curve sensitivity Area under the curve 100% 1-specificity

21 No test is perfect fever CRP Hopstaken Brit J Gen Pract 2003 Hopstaken BJGP 2003

23 Secrets of the doctor Hoe kan dat nou?

24 Antibiotics

25 I ll pass you on to the nurse Change habits

26 CRP Usual Care + Communication - 23% 39% CRP + Comm. 33% 68% + - CRP Communication Cals BMJ 2009 Cals BMJ cost-effective

27 Talking and testing

29 1 h accredited Corresponds with Dutch guideline > 4000 GPs

31 Saltro 30y, GP founded

32 CRP POCT Best performance

34 Posters 16 and17 Analytical performance, agreement and user-friendliness of six urine test strip analysers in point of care test ing Marjolein JC Schot, Sanne van Delft, Antoinette MJ Kooijman-Buiting, Niek J de Wit, Rogier M Hopstaken Background: Urine analysis is a widely used diagnostic procedure in general practice, most commonly used for the diagnosis of urine tract infection (UTI). Point of Care testing (POCT) analysers for urine analysis are commercially available for use in general practice. The present study compares analytical performance, agreement and user-friendliness of six different urine strip POC analysers. Methods: The following six analysers were evaluated: Uryxxon Relax (Machery Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) Urilyzer (Analyticon). Results were compared to a laboratory reference standard urine analyser, the Urisys 2400 (Roche) and the Sedimax urine analyser (Menarini, Florence, Italy). Analytical performance and agreement with the laboratory standards were analyzed. Subsequently, analyser characteristics were compared and user-friendliness was evaluated. Clinitek Status (Siemens) Uryxxon Relax (Machery Nagel) Urisys 1100 (Roche) Aution micro (Menarini) Aution 11 (Menarini) Urilyzer (Analyticon) Nitrite (n=77) Leucocytes (n=77) Erythrocytes (n=77) Sensitivity Specificity Sensitivity Specificity Sensitivity Specificity 1 1 0,56 1 0, ,94 0,98 0,75 0, ,78 1 0, ,94 0,98 0, ,94 0,96 0, ,94 0,66 1 0,73 0,97 Results: Analytical performance was good for al six urine test strip POC analysers. Compared to laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. See table 1. First-time users found the different urine test Table 1: Sensitivity and specificity, Urisys 2400 as reference strip POC analysers easy to use. The Uryxxon standard Relax was found to be most user-friendly followed by the Urisys The susceptibility to flaws, either in preparation of the analyser, performing the analysis or reading the results was also considered lowest for these two analysers. First-time users were overall positive about the increase in productivity, effectiveness and accuracy by using a urine test strip POC analyser. Practice assistants performing user-friendliness tests Conclusions: The overall performance of all six commercially available urine test strip POC analysers was sufficient to justify routine use in suspected urinary tract infections in general practice. First-time users indicate that the analysers are easy to use and expect higher productivity and accuracy when using these analysers in daily practice. Obviously the next step is to determine if the use of urine test strip analysers in the primary care setting indeed has added value. A study on this subject is currently in progress.

Urinalysis Compliance Tools. POCC Webinar January 19, 2011 Dr. Susan Selgren

Urinalysis Compliance Tools. POCC Webinar January 19, 2011 Dr. Susan Selgren Urinalysis Compliance Tools POCC Webinar January 19, 2011 Dr. Susan Selgren Learning Objectives Be able to review and improve upon a laboratory plan for compliance including: Competency Documentation Proficiency