Impact of Point-of-Care Diagnostics on Clinical Decision-making in Low- and Middle-Income Countries

Abstract

Background: Rapid tests have transformed the landscape of available tools for clinicians caring for patients who are critically ill. Their emergence as part of routine care increases the capacity for similar devices to reverse or minimize major epidemics and assist healthcare providers in their clinical decision-making. To assess how a point-of-care complete blood count (CBC) could change patterns in clinical decision-making, we presented low and middle income (LMIC) healthcare providers with hypothetical clinical scenarios to understand how such a device could impact the way they treat and refer patients. Methods: Our survey asked about current use of CBC results, and then presented three separate scenarios that occur in LMICs. Survey respondents were queried about how they might change hospitalization plans and/or mediations based on point-of-care CBC results. Results: In all three scenarios, a majority of clinicians were likely to modify the way they triage patients based on real-time results. Conclusion: Our survey demonstrates that a point-of-care CBC diagnostic could change the way providers in resource-limited settings treat and refer critically ill patients. All hypothetical clinical scenarios describe common, urgent case presentations that can occur at any level of a health system in resource-limited settings. Rapid, simple and accessible technology for basic lab tests like CBC could impact patient care in low and middle-income countries by providing health care workers with actionable data with the potential to affect patient-centered outcomes.