Practical considerations of Syndromic testing

In the previous step, we learned about the different syndromic testing panels used in clinical microbiology. Here, a summary of the cost-effectiveness of syndromic testing is considered.

The revolutionary nature of multiplex PCR tests means that current guidelines may not provide detailed guidance of their use, interpretation, or integration in clinical practice. Additionally, there are a range of tests available, and different manufacturers offering these tests. Practical considerations must therefore be taken into account when using such tests, and cost-effectiveness carefully considered to ensure that they are used appropriately and effectively.

Cost-effectiveness analysis

The cost of syndromic panels is typically higher than conventional methods, but their use may impact downstream costs associated with patient management as presented below.

A study investigating the clinical impact of using a gastrointestinal (GI) syndromic testing panel observed the following costs in the GI panel cohort (n=241) and control cohort (n=594; tested the year prior using conventional laboratory methods):

Taken from Beal et al. (2017)

If you require a text version of the above image, this is available as a PDF.

Although in-lab expenses were higher in the GI panel group, they showed lower healthcare costs (saving $293.61 per patient).

If multiple different routine tests are required, a single syndromic testing panel may be cost-effective as it tests for multiple targets. Additionally, as seen here and throughout the course, evidence exists for its ability to reduce hospital costs by shortening LOS, for example.

Syndromic testing is unlikely to replace routine laboratory methods, however it can be advantageous providing it is used appropriately and integrated into practice thoughtfully through diagnostic stewardship.