A-307 Potential Impact of Flexible Respiratory Testing: Clinical and Economical Benefit

Background Respiratory pathogens pose a significant public health threat, contributing to high rates of morbidity and mortality. Recent outbreaks caused by human metapneumovirus highlight the critical need to adapt diagnostic testing to current circulating pathogens. Flexible testing, defined as an easily customizable respiratory pathogen panel that can be altered based on seasonal or pandemic pathogen prevalence, could assist physicians to avoid the pitfalls associated with traditional diagnostic methods. For example, traditional small, fixed panels cover a very limited number of pathogens and leave doctors and patients without an answer. In contrast, traditional syndromic panel tests employ an all or nothing approach which leads to laboratory inefficiency, unnecessary costs, and the pointless testing of every patient for rare pathogens that are unlikely to be the cause of illness. The aim of this analysis is to examine the epidemiology of respiratory pathogens in the University of Louisville Health patient population and model the potential impact of flexible testing solutions. Methods Prevalence rates for traditional syndromic respiratory testing performed on adult patients in 2024 were analyzed. The frequency of each pathogen detected was summarized. We used prevalence data to model a flexible testing approach to determine what cost benefits could have been by testing for only the top seven targets Results In 2024, 4,346 respiratory panels were performed. The mean overall positivity rate was 18.4% (N = 799). The top seven most prevalent pathogens represented 94% of all positive tests for the year. Human metapneumovirus was in the top seven targets during the Spring and Summer, accounting for 48 positive tests (6%). Based on a market average of $139.00 per test for syndromic panels, a 94% reduction in usage of the full syndromic panel could have been realized with associated reduction in costs, with only 6% of cases requiring additional testing. Conclusion This analysis suggests there are both clinical and economic benefits to implementing a flexible testing solution. Flexible testing allows clinicians to quickly adjust the targets they test for as needed, such as seasonality or in response to circulating pathogens.