Diagnostic Stewardship: Opportunity for a Laboratory–Infectious Diseases Partnership
Open accessAbstract
Recent advances in microbial diagnostics are providing clinicians with information about microbes causing infections and their resistance to antimicrobial agents more rapidly than ever before. Diagnostic stewardship refers to the appropriate use of laboratory testing to guide patient management, including treatment, in order to optimize clinical outcomes and limit the spread of antimicrobial resistance. Fulfilling the promise of diagnostic stewardship requires a seamless partnership between clinical laboratories, pharmacists, and infectious diseases clinicians, so that appropriate tests are ordered and diagnostic information is translated into appropriate management in real time.
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Diagnostic stewardship and development of a diagnostic decision rule with a stepwise approach may improve appropriate use of the ME panel.
“Several studies showed that diagnostic stewardship and the development of a diagnostic decision rule with a stepwise approach may improve the appropriate use of the ME Panel (12–14).”
From Utilization of a Meningitis/Encephalitis PCR panel at the University Hospital Basel – a retrospective study to develop a diagnostic decision rule (2024) · cites this paper as [13]
The discussion of multiplex tests says infectious diseases clinicians can establish criteria for their appropriate use, supporting the diagnostic-stewardship principle. It does not describe a stepwise diagnostic decision rule or show that such a rule improves appropriate use of the meningitis/encephalitis (ME) panel specifically. (LLM, conf=0.84)
Experimental — accuracy not yet measuredThis raises concerns about overutilization of the assay, emphasizing the need to rationalize testing algorithms and employ diagnostic stewardship practices.
“This raises concerns about overutilization of the assay (20), emphasizing the need to rationalize testing algorithms and employ diagnostic stewardship practices (21).”
The authors of the latter study advise against potential overreliance on test results and suggest restriction strategies within the scope of diagnostic stewardship programs.
“The authors advice against potential overreliance of test results and suggest restriction strategies within the scope of diagnostic stewardship programs [49].”
From Implementation of the FilmArray ME panel in laboratory routine using a simple sample selection strategy for diagnosis of meningitis and encephalitis (2020) · cites this paper as [49]
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Is diagnostic stewardship possible in solid organ transplantation?
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- Authors
- Patel, R., & Fang, F. C.
- Affiliations
- Mayo Clinic (US)
- University of Washington (US)
- Corresponding author
- Patel, Robin
- Venue
- Clinical Infectious Diseases
- Publisher
- Oxford University Press (OUP)
- Published
- 2018-03-14
- Volume
- 67
- Issue
- 5
- Pages
- 799-801
- ISSN
- 1058-4838 (ISSN-L)
- 1537-6591
- PMC
- PMC6093996
- OpenAlex
- W2794388430
- Cited by
- 127
- References
- 37
- Citations by year
- 2026: 13 · 2025: 13 · 2024: 14 · 2023: 17 · 2022: 16 · 2021: 21 · 2020: 20 · 2019: 11 · 2018: 2
- FWCI
- 8.30
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- academic.oup.com/journals/pages/open_access/funder_policies/chorus/standard_publication_model (vor)
- Locations
- Clinical Infectious Diseases (publishedVersion)
- Europe PMC (PubMed Central) (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases
- National Institutes of Health (UM1 AI104681, R01 AR056647, R21 AI125870)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (R01 AR056647)
- Topics
- Life Sciences › Immunology and Microbiology › Applied Microbiology and Biotechnology › Antibiotic Use and Resistance
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Clinical Biochemistry › Bacterial Identification and Susceptibility Testing
- Health Sciences › Medicine › Physiology › Clinical Laboratory Practices and Quality Control
- Keywords
- diagnostic stewardship, antimicrobial resistance, clinical laboratory, pharmacists, antimicrobial susceptibility testing, clinical management
- MeSH terms
- Antimicrobial Stewardship, Anti-Infective Agents, Communicable Diseases, Drug Utilization, Humans, Microbial Sensitivity Tests, Patients, Clinical Laboratory Techniques, Molecular Diagnostic Techniques
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