Systematic review of near patient test evaluations in primary care

Objective To identify and qualitatively synthesise the findings from all st udies that have examined the performance and effect of near patient tests i n the primary care setting. Design systematic review of published and unpublished research 1986-99. Main outcome measures Test performance characteristics, measures of effect on clinical practice or patient outcome. Results 101 relevant publications were identified. The general quality of t hese papers was low,and consequently only 32 papers were assessed in detail . Although these papers gave some indication of the value of near patient t esting in areas such as anticoagulation monitoring and group A beta haemoly tic 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 expans ion of use of near patient testing in primary care. Further research is nee ded in areas of clinical practice where near patient tests might be most be neficial.