OBJECTIVE Evaluate impact of MeMed BV (MMBV) host-protein test on clinical decision-making for children with acute infection in urgent care centers (UCCs). METHODS Pragmatic study examining real-world use of MMBV by physicians trained to order the test when facing diagnostic uncertainty in suspected pediatric infections. Study assessed MMBV’s impact on 2 decisions: whether to refer to the emergency department (ED), and, for discharged patients, whether to prescribe antibiotics. MMBV scores from 65 to 100 indicated a bacterial infection (or coinfection) and from 0 to 35 indicated viral/nonbacterial. Physicians filled pre- and post-test questionnaires. The outcomes included ED referrals, alignment between prescription and MMBV results, and 7-day post-UCC hospitalizations and antibiotic prescriptions. RESULTS The MMBV was ordered for 2171 patients. According to post-test questionnaires (n = 1677), MMBV results encouraged referral in 3.9% and discouraged referral in 26.0% of cases. Hospitalization rates were similar when the MMBV result did not impact vs when it discouraged referral (5.5% vs 4.6%; P = .53). Among 1713 nonreferred patients, the prescription aligned with MMBV results in 80.5%. Physicians reported that MMBV results changed or supported prescription decisions in 82.0% of cases. When physicians were undecided pretest, 80.6% of bacterial MMBV and 15.9% of viral MMBV cases were managed. When physicians were likely to prescribe but MMBV results were viral, 61.7% of patients were not treated. Post-UCC hospitalizations (3.3% vs 1.5%; P = .49) and prescriptions (14.7% vs 16%; P = .74) were comparable between not treated vs treated. When unlikely to prescribe but the MMBV results were bacterial, 77.1% of patients were treated. Post-UCC prescriptions were higher among cases not managed at a UCC (33.3% vs 13.2%; P = .02). CONCLUSIONS MMBV aided safe clinical decision-making for pediatric acute infections in UCCs.
Kalmovich et al. (Fri,) studied this question.