Reliability and feasibility of a near patient test for C-reactive protein in primary care.

摘要: BACKGROUND: The applications of new diagnostic technologies such as near patient tests are relevant to the further development and potential primary care. Through their use, doctors in community may increase accuracy diagnoses improve ability monitor disease. A reliable indicator disease activity various clinical conditions is C-reactive protein (CRP) a test for this now available, although there little information on its use outside hospitals. AIM: study was set up evaluate feasibility using novel CRP care validate results against laboratory "gold standard9 (Beckman Array) compare with usual inflammation used general practice. METHOD: Prospective recording an "intention investigate9 basis, validation Beckman Array system hospital erythrocyte sedimentation rate results, six medical practices Birmingham. Main outcome measures were change local usage, characteristics patients chosen testing, quality control, comparison readings from same sample sent independent laboratory. RESULTS: Tests levels rarely requested before undertaken. During 3-month period, 181 carried out, 146 (81%) establish diagnosis remainder monitoring. Out tests, 67% performed by practitioners, mostly during consultation itself. Using cut-off level 10 mg I-1, gave which agreed 84% cases. sensitivity specificity 97 79%, respectively. predictive value positive result 59% that negative 99%. Cohen9s Kappa 62% overall mean bias range 6.11 I-1 (SE = 3.07 I-1). Each took 6 min average perform, including all preparations, blood letting, performing averaging time control estimations. cost per averaged pounds 1.72, rising 4.17 labour, capital costs, controls consumables (general practitioner assay at frequency found study). CONCLUSIONS: Measurement awareness could be raised. This proved feasible practitioners practice nurses. Its reliability compared satisfactory overall, excellent adequate operator technique.