Operational modelling to guide implementation and scale-up of diagnostic tests within the health system: exploring opportunities for parasitic disease diagnostics based on example application for tuberculosis

Langley, Ivor ORCID: https://orcid.org/0000-0002-9275-6731, Adams, Emily ORCID: https://orcid.org/0000-0002-0816-2835, Doulla, Basra and Squire, Bertie ORCID: https://orcid.org/0000-0001-7173-9038 (2014) 'Operational modelling to guide implementation and scale-up of diagnostic tests within the health system: exploring opportunities for parasitic disease diagnostics based on example application for tuberculosis'. Parasitology, Vol 141, Issue 14, pp. 1795-1802.

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Abstract

SUMMARY Research and innovation in the diagnosis of infectious and parasitic diseases has led to the development of several promising diagnostic tools, for example in malaria there is extensive literature concerning the use of rapid diagnostic tests. This means policymakers in many low and middle income countries need to make difficult decisions about which of the recommended tools and approaches to implement and scale-up. The test characteristics (e.g. sensitivity and specificity) of the tools alone are not a sufficient basis on which to make these decisions as policymakers need to also consider the best combination of tools, whether the new tools should complement or replace existing diagnostics and who should be tested. Diagnostic strategies need dovetailing to different epidemiology and structural resource constraints (e.g. existing diagnostic pathways, human resources and laboratory capacity). We propose operational modelling to assist with these complex decisions. Projections of patient, health system and cost impacts are essential and operational modelling of the relevant elements of the health system could provide these projections and support rational decisions. We demonstrate how the technique of operational modelling applied in the developing world to support decisions on diagnostics for tuberculosis, could in a parallel way, provide useful insights to support implementation of appropriate diagnostic innovations for parasitic diseases.

Item Type:	Article
Additional Information:	(Symposia of the British Society for Parasitology Volume 52 Advances in diagnostics for parasitic diseases)
Subjects:	W General Medicine. Health Professions > Health Services. Patients and Patient Advocacy > W 84 Health services. Delivery of health care QX Parasitology > QX 20 Research (General) QY Clinical Pathology > QY 25 Laboratory techniques and procedure WF Respiratory System > Tuberculosis > WF 200 Tuberculosis (General)
Faculty: Department:	Biological Sciences > Department of Tropical Disease Biology Clinical Sciences & International Health > Clinical Sciences Department
Digital Object Identifer (DOI):	https://doi.org/10.1017/S0031182014000985
Depositing User:	Helen Rigby
Date Deposited:	10 Oct 2014 08:29
Last Modified:	13 Nov 2019 11:22
URI:	https://archive.lstmed.ac.uk/id/eprint/4474

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