Systematic review of near patient test evaluations in primary care.
OBJECTIVE
To identify and qualitatively synthesise the findings from all studies that have examined the performance and effect of near patient tests in the primary care setting.


METHODS
Systematic review of published and unpublished research 1986-99.


METHODS
Test performance characteristics, measures of effect on clinical practice or patient outcome.


RESULTS
101 relevant publications were identified. The general quality of these papers was low, and consequently only 32 papers were assessed in detail. Although these papers gave some indication of the value of near patient testing in areas such as anticoagulation monitoring and group A beta haemolytic streptococcus testing, the research raised many more questions than it answered. Almost no reports were found of unbiased assessment of the effect of near patient tests in primary care on patient outcomes, organisational outcomes, or cost.


CONCLUSIONS
Available research provides little evidence to guide the expansion of use of near patient testing in primary care. Further research is needed in areas of clinical practice where near patient tests might be most beneficial.
Delaney
B C
BC
Department of Primary Care, University of Birmingham, Birmingham B15 2TT.
Hyde
C J
CJ
McManus
R J
RJ
Wilson
S
S
Fitzmaurice
D A
DA
Jowett
S
S
Tobias
R
R
Thorpe
G H
GH
Hobbs
F D
FD
D006801:Humans; D015337:Multicenter Studies as Topic; D019095:Point-of-Care Systems / Q000592:standards*; D011320:Primary Health Care / Q000592:standards*; D011787:Quality of Health Care; D016032:Randomized Controlled Trials as Topic; D016896:Treatment Outcome