{"id":3167,"date":"2016-12-20T15:33:32","date_gmt":"2016-12-20T02:33:32","guid":{"rendered":"http:\/\/microbiologymatters.com\/?p=3167"},"modified":"2016-12-20T15:33:32","modified_gmt":"2016-12-20T02:33:32","slug":"quality-not-quantity","status":"publish","type":"post","link":"https:\/\/microbiologymatters.com\/?p=3167","title":{"rendered":"“Quality, not quantity…”"},"content":{"rendered":"

\"\"<\/span><\/p>\n

Whenever I am thinking about a new test Y, which is superior to the old (incumbent)\u00a0one X, but costs more money, then the first thing I do is calculate the “disease budget”. i.e. I will find out the cost of our current test to diagnose that condition\u00a0(and any other related tests)\u00a0and multiply it by the number of tests we do to get\u00a0the total amount of money spent on that specific\u00a0disease\/infection.<\/span><\/p>\n

I can then work out how many tests we can perform with new test Y, and consider implementing selective<\/span> testing criteria<\/span> in order to focus testing on those patients that most require it.<\/span><\/p>\n

Short of getting more money from lab funders for the “disease budget”, which is occasionally necessary, but very\u00a0difficult to achieve , this is one of the few\u00a0ways that we can introduce\u00a0better (but more expensive)\u00a0tests into our armoury. (Another possible route is utilising other disease budgets which have become redundant, i.e. rotavirus testing dramatically decreased due to childhood vaccination, so the money used for rotavirus testing could be used to fund the diagnosis of another faecal pathogen.)<\/em><\/span><\/p>\n

We know that a combination of poor sensitivity and long turnaround times\u00a0affects a\u00a0lot of the traditional tests that we currently use in the microbiology department.<\/span><\/p>\n

But it is not good enough to simply say, “These new tests are just\u00a0too expensive for our budget”.<\/span><\/p>\n

We owe it to our patients to play the system and work out ways of getting better, albeit<\/span> more expensive tests on to the menu.<\/span><\/p>\n

I prefer to use good tests well, on the right patients, and where real-time <\/a><\/span>results can make real-time differences to patient management.<\/span><\/p>\n

When strict clinical “qualifying” criteria are set up for certain tests, there will always be a few\u00a0grumbles from requestors\u00a0“Why can’t my patient get test Y”. This is when the 3Es,\u00a0empathy, education, and explanation of the criteria are required. Even then, you can be sure that you\u00a0will never keep everybody happy…<\/span><\/p>\n

It is very rarely that we, in the microbiology department, audit how often the hundreds of results that we\u00a0report out actually make a real time difference to the patients.<\/span><\/p>\n

I suspect we\u00a0shy away from this type of audit\u00a0because the results would probably\u00a0scare the living daylights out of\u00a0us, and our funders…<\/span><\/p>\n

Quality, not quantity.<\/span><\/p>\n

Michael<\/em><\/p>\n

 <\/p>\n","protected":false},"excerpt":{"rendered":"

Whenever I am thinking about a new test Y, which is superior to the old (incumbent)\u00a0one X, but costs more money, then the first thing I do is calculate the “disease budget”. i.e. I will find out the cost of our current test to diagnose that condition\u00a0(and any other related tests)\u00a0and multiply it by the … Continue reading “Quality, not quantity…”<\/span> →<\/span><\/a><\/p>\n","protected":false},"author":1,"featured_media":0,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"jetpack_post_was_ever_published":false,"_jetpack_newsletter_access":"","_jetpack_dont_email_post_to_subs":false,"_jetpack_newsletter_tier_id":0,"footnotes":"","jetpack_publicize_message":"","jetpack_publicize_feature_enabled":true,"jetpack_social_post_already_shared":true,"jetpack_social_options":{"image_generator_settings":{"template":"highway","enabled":false}}},"categories":[3,4],"tags":[408,493],"jetpack_publicize_connections":[],"jetpack_featured_media_url":"","jetpack_sharing_enabled":true,"jetpack_shortlink":"https:\/\/wp.me\/p37jIp-P5","jetpack-related-posts":[{"id":3327,"url":"https:\/\/microbiologymatters.com\/?p=3327","url_meta":{"origin":3167,"position":0},"title":"“Reflex Testing: A Hot Potato”","author":"michael","date":"February 14, 2017","format":false,"excerpt":"A reflex test in the laboratory setting is most simply defined as a test that the laboratory automatically adds on based on the result of the initial requested test, in order to optimise the diagnostic process. Sounds like a no-brainer... For example one might add a Hepatitis C viral load\u2026","rel":"","context":"In "The Science of Microbiology"","block_context":{"text":"The Science of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=4"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":2695,"url":"https:\/\/microbiologymatters.com\/?p=2695","url_meta":{"origin":3167,"position":1},"title":"“Cutting off the fat whilst keeping the flesh”","author":"michael","date":"January 11, 2016","format":false,"excerpt":"Reducing inappropriate or unnecessary\u00a0testing is\u00a0generally a good idea. Not only does it free up finances which can then be used on other more useful tests, it also improves the positive predictive value of the test in question\u00a0by increasing the prevalence in the tested population. But how exactly do you reduce\u2026","rel":"","context":"In \"consultation\"","block_context":{"text":"consultation","link":"https:\/\/microbiologymatters.com\/?tag=consultation"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2016\/01\/RawBacon-300x214.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":3930,"url":"https:\/\/microbiologymatters.com\/?p=3930","url_meta":{"origin":3167,"position":2},"title":"“Taking the crap out of enteric microbiology”","author":"michael","date":"August 20, 2019","format":false,"excerpt":"Just because a stool sample turns up at your microbiology laboratory, it doesn't mean you have to test it... This is old style microbiology reasoning, testing for everything in the hope that you will find something! There are many different microbiology tests that one can do on a stool sample.\u2026","rel":"","context":"In "The Art of Microbiology"","block_context":{"text":"The Art of Microbiology","link":"https:\/\/microbiologymatters.com\/?cat=3"},"img":{"alt_text":"","src":"https:\/\/i0.wp.com\/microbiologymatters.com\/wp-content\/uploads\/2019\/08\/PoopEmojiHP-1-300x200.jpg?resize=350%2C200","width":350,"height":200},"classes":[]},{"id":4040,"url":"https:\/\/microbiologymatters.com\/?p=4040","url_meta":{"origin":3167,"position":3},"title":"“The impact of COVID on the molecular department of microbiology laboratories”","author":"michael","date":"December 19, 2022","format":false,"excerpt":"COVID has had a profound, and ongoing impact on microbiology laboratories and everyone who works in them. But today I want to write about molecular departments in particular. This department and the staff that work in them have had some momentous experiences and unexpected changes over the last couple of\u2026","rel":"","context":"In "COVID-19"","block_context":{"text":"COVID-19","link":"https:\/\/microbiologymatters.com\/?cat=590"},"img":{"alt_text":"","src":"","width":0,"height":0},"classes":[]},{"id":2423,"url":"https:\/\/microbiologymatters.com\/?p=2423","url_meta":{"origin":3167,"position":4},"title":"“Volume Control”","author":"michael","date":"May 29, 2015","format":false,"excerpt":"Great, you have finally managed to develop that in-house multiplex\u00a0PCR to diagnose disease Y, and thus you can provide the clinicians with a \"real-time\" result on the same day. 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