{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,21]],"date-time":"2026-08-21T12:21:24Z","timestamp":1787314884524,"version":"build-2736575974"},"update-to":[{"DOI":"10.3310\/nihropenres.13568.1","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000}}],"reference-count":16,"publisher":"National Institute for Health and Care Research","license":[{"start":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T00:00:00Z","timestamp":1737072000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100000664","name":"Health Technology Assessment Programme","doi-asserted-by":"publisher","award":["NIHR156664"],"award-info":[{"award-number":["NIHR156664"]}],"id":[{"id":"10.13039\/501100000664","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["openresearch.nihr.ac.uk"],"crossmark-restriction":false},"short-container-title":["NIHR Open Res"],"abstract":"<ns3:p>Background PROTECT (Platform Randomised evaluation of clinical Outcomes using novel TEChnologies to optimise antimicrobial Therapy) has brought together a team of researchers to design a platform trial to rapidly evaluate and adopt into care multiple diagnostic technologies, bringing immediate benefit to patients. Rapid diagnostic tests will be used to identify patients at risk of deterioration from severe infection, before they become critically unwell. The platform will assess their comparative clinical effectiveness and cost-effectiveness relative to current standard of care. Preliminary work, conducted under a Health Technology Assessment Application Acceleration Award, provided key evidence to optimise the design of the PROTECT platform. Methods Qualitative methods which involved consulting key stakeholders in the field of serious infection addressed the key priorities. A high-level care pathway analysis focusing on serious infection in secondary care, captured the points of contact, actions, decisions, and potential outcomes associated with a patient\u2019s care. Results Two use cases of rapid diagnostic tests for serious infection were identified; (1) in acute emergency medicine to decide on antimicrobial initiation and\/or escalation of care, and (2) in hospitalised patients to monitor treatment response. The \u201cideal\u201d test should be rapid, point-of-care, cheap to procure, have capacity for high usability, and ability to be performed and interpreted by all staff. Facilitators to the adoption of infection diagnostic tests is their clinical need, and the main potential barrier is poor change management and behavioural change. Conclusions Any new test should provide robust evidence of its clinical effectiveness and have the potential to accelerate ruling in or out serious infection which benefits the clinical pathway for patients, clinicians, and hospitals as a whole, to be considered for adoption as a new standard of care.<\/ns3:p>","DOI":"10.3310\/nihropenres.13568.2","type":"journal-article","created":{"date-parts":[[2025,1,17]],"date-time":"2025-01-17T09:40:06Z","timestamp":1737106806000},"page":"35","update-policy":"https:\/\/doi.org\/10.3310\/nihropenres.crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["Mapping decision-making pathways: Determination of intervention entry points for diagnostic tests in suspected serious infection"],"prefix":"10.3310","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-1978-4370","authenticated-orcid":false,"given":"Raasti","family":"Naseem","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9446-8314","authenticated-orcid":false,"given":"Nicola","family":"Howe","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8277-711X","authenticated-orcid":false,"given":"Sara","family":"Pretorius","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cameron","family":"Williams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Clare","family":"Lendrem","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8274-9696","authenticated-orcid":false,"given":"Philip","family":"Pallmann","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8357-7726","authenticated-orcid":false,"given":"Enitan D","family":"Carrol","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"PROTECT study team","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"6221","published-online":{"date-parts":[[2025,1,17]]},"reference":[{"key":"ref-1","doi-asserted-by":"publisher","first-page":"49","DOI":"10.3390\/antibiotics8020049","article-title":"Measuring appropriate antibiotic prescribing in acute hospitals: development of a national audit tool through a delphi consensus.","volume":"8","author":"G Hood","year":"2019","journal-title":"Antibiotics (Basel)."},{"key":"ref-2","doi-asserted-by":"publisher","first-page":"516","DOI":"10.3390\/antibiotics10050516","article-title":"Use of procalcitonin during the first wave of COVID-19 in the acute NHS hospitals: a retrospective observational study.","volume":"10","author":"N Powell","year":"2021","journal-title":"Antibiotics 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status","group":{"name":"current-referee-status","label":"Current Referee Status"}},{"value":"10.3310\/nihropenres.15085.r34496, Yasaman Fatemi, Pediatric Infectious Diseases, University of Washington School of medicine, Seattle, Washington, 22 Jan 2025, version 2, indexed","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-35\/v2#referee-response-34496","order":0,"name":"referee-response-34496","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"10.3310\/nihropenres.14728.r32377, Juan Pericas, Vall d'Hebron University Hospital, Barcelona, Catalonia, 16 Sep 2024, version 1, 1 approved, 1 approved with reservations","URL":"https:\/\/openresearch.nihr.ac.uk\/articles\/4-35\/v1#referee-response-32377","order":1,"name":"referee-response-32377","label":"Referee Report","group":{"name":"article-reports","label":"Article Reports"}},{"value":"This project is funded by the National Institute of Health and Care Research (NIHR) under its Health Technology Assessment (HTA) programme (Grant Reference Number NIHR156664). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care.\r\nThe Centre for Trials Research at Cardiff University receives infrastructure funding from Health and Care Research Wales. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.","order":2,"name":"grant-information","label":"Grant Information"},{"value":"This is an open access article distributed under the terms of the Creative Commons Attribution Licence, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.","order":0,"name":"copyright-info","label":"Copyright"}]}}