TABLE 1

Key diagnostic stewardship considerations for implementation of rapid infectious disease diagnostics

GoalKey questionKey considerations and potential strategies
Right testIs the test appropriate for the clinical setting?Sensitivity and specificity
Predictive values
Testing volumes
Diagnostic yield
Laboratory feasibility
Cost
Clinical impact
Right patientWill the clinical care of the patient be affected by the test result?Laboratory test utilization committee
Automatic laboratory reflex
CPOE decision support
Appropriate use criteria
Indication selection
Prior authorization
Benchmarking
Specimen rejection
Right timeWill the result be available in time to optimally affect care?Time to specimen receipt
Centralized vs point-of-care testing
On-demand vs batched testing
Specimen preparation time
Run time
Result reporting time