2635. Introduction of point-of-care testing for respiratory viruses in congregate living facilities
Bibliographic record
Abstract
Abstract Background Timely diagnosis of viral respiratory infection is critical to control respiratory viral transmission in congregate care facilities. We conducted a quality improvement study to assess whether a point-of-care (POC) testing for detection of respiratory viruses could improve time to outbreak measures in congregate living facilities. Methods We implemented a POC cartridge based nucleic acid amplification test platform, which detects SARS-CoV-2, influenza A, and respiratory syncytial virus, at one long-term care home and three retirement homes between December 1, 2022 and April 15, 2023. Residents with respiratory symptoms underwent paired testing, whereby nasopharyngeal swabs were tested first on POC, then on multiplex respiratory virus panel (MRVP) polymerase chain reaction at an external laboratory. We determined difference in turn-around time (TAT), as well as sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV), using MRVP as the reference standard. We also compared time to outbreak declaration (from MRVP result) to five other congregate care facilities without access to POC testing. Results A total of 189 tests were performed using POC testing, of which 39.7% (75/189) were positive. SARS-CoV-2 was the most common virus identified (90.7%, 68/75). Median difference in TAT between POC and MRVP was 34.0 hours (IQR 21.8–43.5 hours). Sensitivity, specificity, PPV and NPV of POC were 0.88, 0.87, 0.83 and 0.90, respectively. There were six outbreaks during the study period (all SARS-CoV-2), of which two were declared based on POC result alone, before MRVP was resulted. Median time to outbreak declaration from MRVP result for the remaining four outbreaks was 6.6 hours (IQR 4.6–9.2 hours). In comparison, there were nine outbreaks at the non-POC comparator facilities; median time to outbreak declaration was 15.2 hours (IQR 5.5–26.0 hours). Conclusion We demonstrated the feasibility of implementing a POC platform in congregate living facilities for identification of respiratory viral infection. The improved TAT resulted in more expedited detection and declaration of outbreaks. Disclosures Jerome A. Leis, MD MSc FRCPC, Ontario Hospital Association, Ministry of Attorney General of Ontario, Seneca College: Expert Testimony
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.003 | 0.008 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.009 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".