{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:23:50Z","timestamp":1788269030646,"version":"build-2803163510"},"reference-count":13,"publisher":"American Society for Microbiology","issue":"9","license":[{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T00:00:00Z","timestamp":1788220800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.asm.org\/non-commercial-tdm-license"}],"content-domain":{"domain":["journals.asm.org"],"crossmark-restriction":true},"short-container-title":["Microbiol Spectr"],"published-print":{"date-parts":[[2026,9,1]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title\/>\n                    <jats:p>\n                      Rapid respiratory diagnostic tests are widely utilized but often do not change clinical management. We evaluated the effects of an intervention to de-implement widespread use of a multiplex respiratory pathogen PCR panel (RPP) in favor of a selective use strategy. This was a retrospective, quasi-experimental study conducted in a safety-net healthcare system. We compared RPP utilization during 2 years of unrestricted, widespread use (24 July 2022\u201323 July 2024) and 1 year after implementation of a selective use strategy (24 July 2024\u201323 July 2025). The primary outcome was change in weekly test volume as assessed by interrupted time-series analysis (ITS). During the widespread and selective use periods, 8,923 and 184 RPPs were performed, respectively. By ITS, test volume declined by 66 per week (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001) immediately after the intervention; this reduction was sustained over the subsequent year. Median weekly tests decreased from 83 (IQR 67\u2013103) to 3 (IQR 2\u20135) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001), a relative decline of 96.4%. The median age of patients tested decreased from 50 to 7 years (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). The proportion of positive tests was similar (32.1% vs 35.9%;\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      = 0.28); however, the pathogens detected differed. Annualized laboratory costs decreased from $741,446 to $30,623. Use of an influenza\/RSV\/SARS-CoV-2 PCR decreased from a weekly median of 331 (IQR 189\u2013586) to 118 (IQR 25\u2013390) (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      &lt; 0.001). An intervention to de-implement widespread use of an RPP in favor of selective use led to a greater than 95% reduction in tests that was sustained over 1 year.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>IMPORTANCE<\/jats:title>\n                    <jats:p>Use of rapid respiratory multiplex PCR panels (RPPs) is widespread but has not been shown to reduce antibiotic use or improve clinical outcomes. Reducing low-value use of these tests is therefore an important diagnostic stewardship target. To our knowledge, this is the first study describing a successful intervention to de-implement widespread use of this test among pediatric and adult patients and in ambulatory and inpatient care locations in favor of targeted use.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1128\/spectrum.00364-26","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T13:00:55Z","timestamp":1785243655000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":0,"title":["Effects of a diagnostic stewardship intervention to de-implement widespread use of a rapid respiratory multiplex PCR test"],"prefix":"10.1128","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1029-7085","authenticated-orcid":true,"given":"Timothy C.","family":"Jenkins","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Denver Health","place":["Denver, USA"]},{"name":"Division of Infectious Diseases, University of Colorado School of Medicine","place":["Aurora, USA"]},{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Services, Denver Health","place":["Denver, USA"]},{"name":"Department of Pathology, University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heather L.","family":"Young","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Denver Health","place":["Denver, USA"]},{"name":"Division of Infectious Diseases, University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David L.","family":"Wyles","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Division of Infectious Diseases, Denver Health","place":["Denver, USA"]},{"name":"Division of Infectious Diseases, University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0003-9375-680X","authenticated-orcid":true,"given":"Katherine C.","family":"Shihadeh","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pharmacy, Denver Health","place":["Denver, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison L.","family":"Sabel","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Patient Safety and Quality, Denver Health","place":["Denver, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Read G.","family":"Pierce","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Medicine, Denver Health","place":["Denver, USA"]},{"name":"Department of Medicine, Division of Hospital Medicine, University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Wilson","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01fbz6h17","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Pathology and Laboratory Services, Denver Health","place":["Denver, USA"]},{"name":"Department of Pathology, University of Colorado School of Medicine","place":["Aurora, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2025.0160"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMcp2117115"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciaa508"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1128\/JCM.01945-17"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofz481"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2021.11836"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2022.16162"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.cmi.2019.09.013"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1542\/hpeds.2020-000943"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/ofid\/ofae631.1321"},{"key":"e_1_3_2_12_2","unstructured":"Centers for Disease Control and Prevention. 2025. Preventing spread of respiratory viruses when you\u2019re sick. Available from: https:\/\/www.cdc.gov\/respiratory-viruses\/prevention\/precautions-when-sick.html?utm_source=chatgpt.com. Retrieved 10 Dec 2025."},{"key":"e_1_3_2_13_2","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7423a1"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1515\/dx-2024-0163"}],"container-title":["Microbiology Spectrum"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00364-26","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.asm.org\/doi\/pdf\/10.1128\/spectrum.00364-26","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:09:50Z","timestamp":1788268190000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.asm.org\/doi\/10.1128\/spectrum.00364-26"}},"subtitle":[],"editor":[{"given":"Tulip A.","family":"Jhaveri","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"editor"}]}],"short-title":[],"issued":{"date-parts":[[2026,9,1]]},"references-count":13,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2026,9,1]]}},"alternative-id":["10.1128\/spectrum.00364-26"],"URL":"https:\/\/doi.org\/10.1128\/spectrum.00364-26","relation":{},"ISSN":["2165-0497"],"issn-type":[{"value":"2165-0497","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,9,1]]},"assertion":[{"value":"2026-02-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-06-24","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-07-28","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e00364-26"}}