title: Evidence-based point-of-care tests and device designs for disaster preparedness.
abstract: OBJECTIVE
  To define pathogen tests and device specifications needed for emerging point-of-care (POC) technologies used in disasters.
  
  
  METHODS
  Surveys included multiple-choice and ranking questions. Multiple-choice questions were analyzed with the chi2 test for goodness-of-fit and the binomial distribution test. Rankings were scored and compared using analysis of variance and Tukey's multiple comparison test.
  
  
  METHODS
  Disaster care experts on the editorial boards of the American Journal of Disaster Medicine and the Disaster Medicine and Public Health Preparedness, and the readers of the POC Journal.
  
  
  RESULTS
  Vibrio cholera and Staphylococcus aureus were top-ranked pathogens for testing in disaster settings. Respondents felt that disaster response teams should be equipped with pandemic infectious disease tests for novel 2009 H1N1 and avian H5N1 influenza (disaster care, p < 0.05; POC, p < 0.01). In disaster settings, respondents preferred self-contained test cassettes (disaster care, p < 0.05; POC, p < 0.001) for direct blood sampling (POC, p < 0.01) and disposal of biological waste (disaster care, p < 0.05; POC, p < 0.001). Multiplex testing performed at the POC was preferred in urgent care and emergency room settings.
  
  
  CONCLUSIONS
  Evidence-based needs assessment identifies pathogen detection priorities in disaster care scenarios, in which Vibrio cholera, methicillin-sensitive and methicillin-resistant Staphylococcus aureus, and Escherichia coli ranked the highest. POC testing should incorporate setting-specific design criteria such as safe disposable cassettes and direct blood sampling at the site of care.
authors.affiliation: UC Davis-LLNL Point-of-Care Technologies Center, Department of Pathology and Laboratory Medicine, School of Medicine, University of California, Davis, USA.
authors.forename: T Keith
authors.initials: TK
authors.lastname: Brock
authors.forename: Daniel M
authors.initials: DM
authors.lastname: Mecozzi
authors.forename: Stephanie
authors.initials: S
authors.lastname: Sumner
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Kost
mesh_terms: D000704:Analysis of Variance; D016009:Chi-Square Distribution; D002771:Cholera / Q000175:diagnosis; D019411:Clinical Laboratory Techniques / Q000295:instrumentation; D003141:Communicable Diseases / Q000175:diagnosis*; D054597:Disaster Medicine / Q000295:instrumentation / Q000379:methods*; D004189:Disaster Planning; D004927:Escherichia coli Infections / Q000175:diagnosis; D019317:Evidence-Based Medicine; D006801:Humans; D057221:Influenza A Virus, H1N2 Subtype / Q000302:isolation & purification; D007251:Influenza, Human / Q000175:diagnosis; D017744:Medical Waste Disposal / Q000295:instrumentation; D019095:Point-of-Care Systems; D013203:Staphylococcal Infections / Q000175:diagnosis; D018709:Statistics, Nonparametric; D011795:Surveys and Questionnaires
chemical_list: D017744:Medical Waste Disposal