Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection

Naseem, Raasti, Howe, Nicola, Pretorius, Sara, Williams, Cameron, Lendrem, Clare, Pallmann, Philip ORCID: https://orcid.org/0000-0001-8274-9696 and Carrol, Enitan D. 2025. Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection. NIHR Open Research 4 , 35. 10.3310/nihropenres.13568.2

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Abstract

Antibiotic resistance, where antibiotics no longer work against infections caused by bacteria, threatens the lives of millions of people globally. To prevent resistance, antibiotics should only be used when absolutely necessary. When patients present to emergency care with a suspected infection, it is difficult for healthcare professionals to know if it is caused by bacteria (which could need treating with antibiotics) or a virus (which cannot be treated with antibiotics), or something else. There is no reliable rapid test which can confirm bacterial infection, and current laboratory tests take too long to give results. Newly developed diagnostic tests may help healthcare professionals make rapid decisions about whether to start antibiotics for severe infection, and to identify which patients need admission to hospital. These tests have not yet been thoroughly evaluated to see if they are useful in the NHS. The PROTECT trial uses a platform design to evaluate several infection diagnostic tests rapidly to determine whether these improve care and patient outcomes, are safe, reduce the use of unnecessary antibiotics, and are value for money for the NHS. This research describes initial work carried out with experts in serious infection to find out which kinds of tests would be most useful to healthcare professionals in hospitals, and which type of tests should be included in the platform trial. We also explored with the experts what barriers there might be to introducing new tests into hospitals or emergency departments. The PROTECT trial will have a diverse PPI group with lived experience of severe infection and/or lived experience of being part of a marginalised minority ethnic community. The PPI group have already influenced the study’s design by advising on the acceptability of new tests, the platform trial design, consent methods, communication of information and outcomes that matter to patients and their families.

Item Type:	Article
Date Type:	Published Online
Status:	Published
Schools:	Schools > Medicine Research Institutes & Centres > Centre for Trials Research (CNTRR)
Publisher:	Taylor and Francis
ISSN:	2633-4402
Date of First Compliant Deposit:	10 February 2025
Date of Acceptance:	23 April 2023
Last Modified:	20 Feb 2025 10:30
URI:	https://orca.cardiff.ac.uk/id/eprint/176065

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