European Physicians Prioritise Rapid Fever Tests for Immunocompromised Patients and Unclear Presentations
A survey of 265 hospital doctors across 30 European countries identified febrile immunocompromised patients, fever without a focus, and young infants as top priorities for new rapid diagnostic test development. Notably, 92% would find even a generic bacterial vs. non-bacterial test useful, suggesting that relatively simple point-of-care tools could fill significant clinical gaps in fever workup.
The original study
Priorities for the development of a new rapid diagnostic test for patients with fever: a cross-sectional online survey among hospital physicians across Europe.
- Authors
- Bonnet G, Nielsen MJ, Foss AM, Lewin A, Nijman RG, Fitchett E, et al.
- Journal
- BMJ open
- PMID
- 41876150
Original abstract
OBJECTIVE: This study aimed to understand hospital doctors' priorities (target use cases and aetiologies) for the development of a new rapid diagnostic test for patients with fever. DESIGN: A cross-sectional online survey. SETTING: Europe-wide. PARTICIPANTS: Secondary and tertiary care doctors involved in patient assessment and diagnosis across Europe. INTERVENTION: Online survey from April to September 2024. MAIN OUTCOME MEASURES: Importance of developing a new test on a scale of 1-10 for up to 19 'use cases' (types of febrile presentations in specific demographic groups): use case scores and ranks and differences across subgroups of respondents, with free text to capture additional suggestions; respondents' preferences (multiple choice) regarding which aetiologies should be included in a new test. RESULTS: 265 respondents from 30 European countries (out of 270 starting the survey) were included in the analysis. Top priorities included febrile immunocompromised patients and fever without a focus for both paediatric and adult use cases, and 1-3 months old febrile infants. Rankings were similar across clinician subgroups despite some differences in average scores. 92% (243/263), 95% CI 89% to 95%, of respondents would find a 'generic' test for bacterial aetiology useful, even if it does not differentiate between Gram-positive and Gram-negative aetiologies. 54% (63/116), 95% CI 45% to 63%, of respondents would find a 'generic' test for inflammatory aetiology useful when seeking to diagnose children for whom Kawasaki's disease (KD) is on the differential, even in the absence of any KD-specific test, 83% (96/116), 95% CI 75% to 89%, would find such a 'generic' test useful if they could use it alongside a KD test when desired. CONCLUSION: Clinicians prioritise the most vulnerable patients (because of age or comorbidities) and unclear presentations (fever without a focus) for the development of a new fever diagnostic test. Even relatively simple (eg, bacterial, inflammatory) tests could provide added value to most clinicians.