Evaluating multi-bug point-of-care tests for sexually transmitted infections

We were a collaborator on a recent Innovate UK-funded SBRI project with Atlas Genetics and the Applied Diagnostic Research and Evaluation Unit at St George’s University of London. In this project, our team compared the overall costs, patient benefits and cost-effectiveness of three different multi-pathogen point-of-care testing strategies with the current strategy of microscopy and lab-based testing.

This work was presented at the STI and HIV World Congress which takes place July 9-12 in Rio de Janeiro. The poster can be seen here.

Point-of-care tests allow rapid diagnosis of infections – which previously took days or even weeks to diagnose in the lab. Patients benefit from reduced waiting time for results and  quickly receiving the most appropriate treatment.

Some sexual health clinics have already started using point-of-care testing for the more common infections such as chlamydia, gonorrhoea and HIV. Busy clinics benefit because fewer patients need to return for follow-up,  increasing the clinics’ capacity to see more patients.  At the same time, many sites do not currently have access to testing for the less common infections such as M. genitalium or are limited to less accurate tests like microscopy for diagnosing trichomoniasis.

New point-of-care tests are being developed which simultaneously test for multiple infections. Clinics need to decide which testing strategy provides the most benefit to their patients and represents the best value for their service.

To help clinics, we assessed different point-of-care testing strategies. These strategies were a dual test for chlamydia and gonorrhoea, a triple test which also tested for M. genitalium, and a quadruple test which also tested for trichomoniasis. Our model showed that the point-of-care strategies provided more benefits to patients but may cost more than the strategy currently used. The quadruple point-of-care test offered the most benefit to patients and was the cheapest point-of-care strategy relative to standard care – with an incremental cost-effectiveness ratio (ICER) of £36,585 per quality adjusted life years (QALY) gained.

This is one of many projects Aquarius has been involved in that assesses the economic impact of point-of-care testing. You can find more information about our previous projects on the Case Studies page of our website. If you would like to find out how you can work with us on a project please get in touch.

Susie Huntington