A multiple criteria decision analysis to establish the use cases and candidate point of care tests to enter into a platform trial of multiple in vitro diagnostic point of care tests in the prehospital environment

Kirby, Kim; Coggins, Jessica; Gibson, Andy; Liddiard, Cathy; Moore, Theresa H.M.; Savović, Jelena; Mitchell, Kimberley; Thompson, Alexander; Benger, Jonathan; Body, Richard

Abstract

Background
There are increasing demands on Emergency Medical Services. More efficient treatment pathways are required to support conveyance decision making and patient referral in prehospital care. Point of Care testing is increasingly available and utilised across the NHS to support optimal ways of working. We aimed to design and conduct a Multiple Criteria Decision Analysis to prioritise in vitro point of care tests and use cases for inclusion in a platform trial of in vitro point of care testing in UK Emergency Medical Services.

Methods
We designed a Multiple Criteria Decision Analysis that included systematic scoping reviews stakeholder recruitment, two stakeholder surveys and two stakeholder workshops to scope the use cases, explore criteria and map use cases, evaluate the criteria and measure the use cases against the criteria.

Results
We recruited 32 stakeholders. We developed a scoring matrix with 4 criteria for scoring the use cases and 8 criteria for scoring the point of care tests and applied weighting determined from survey results. Use cases were scored by the stakeholders against 4 criteria. The 3 highest scoring use cases were point of care troponin testing in: possible Acute Myocardial Infarction, lactate testing in suspected sepsis and in trauma. We developed the process for scoring the point of care tests to be completed close to a proposed trial to allow for a changes in technology.

Conclusions
We successfully designed a Multiple Criteria Decision Analysis to identify use cases and candidate tests for inclusion in a future platform trial of in vitro point of care testing in UK Emergency Medical Services. We identified 3 use cases for evaluation in a platform trial of in vitro point of care testing: troponin testing in possible acute myocardial infarction, lactate testing in suspected sepsis and lactate testing to identify occult haemorrhage in trauma.

• Journal Article Type: Article
• Acceptance Date: Apr 29, 2024
• Online Publication Date: May 9, 2024
• Publication Date: May 9, 2024
• Deposit Date: May 13, 2024
• Publicly Available Date: May 15, 2024
• Journal: NIHR Open Research
• Print ISSN: 2633-4402
• Publisher: Taylor and Francis
• Peer Reviewed: Not Peer Reviewed
• Volume: 4
• Article Number: 29
• DOI: https://doi.org/10.3310/nihropenres.13580.1
• Public URL: https://uwe-repository.worktribe.com/output/11985912
• Additional Information: Referee status: Awaiting Peer Review; Grant Information: This project is funded by the National Institute for Health Research (NIHR) under its ‘Health Technology Assessment’ (Grant Reference Number NIHR156550). THM Moore’s, and J Savović’s time was supported by the NIHR Applied Research Collaboration West (NIHR ARC West). The views expressed are those of the author(s) and not necessarily those of the NIHR or the Department of Health and Social Care. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.; Copyright: 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.