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June/July 2013
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From the President: Diagnostic Advances Offer Great Promise for Patient Care, Public Health

Diagnostic tests play an essential role in identifying and effectively managing patients with infectious diseases. They also contribute to the broader public health through their use in epidemiologic surveillance, infection control, and antimicrobial stewardship. Earlier this month, IDSA and the American Society for Microbiology jointly released a new guide to help physicians choose the most appropriate tests to aid them in diagnosing infectious diseases.

The new guide, published in Clinical Infectious Diseases, emphasizes the importance of collaboration, communication, and partnership between clinicians and lab specialists in ensuring the best outcomes for patients. Divided into sections based on infectious disease syndromes involving different anatomic systems and etiologic agent groups, this useful guide outlines the current tests that are most valuable, and the contexts in which they are so. To help ensure accurate results, it also includes 10 key tenets of specimen management for all health care providers involved in a patient’s care.

As the guide’s authors note, diagnostic microbiology is a dynamic and rapidly changing discipline, and future updates are expected. Looking ahead, newer, molecular-based technologies are providing promising glimpses of the potential that simple-to-use, rapid diagnostics, available at the point of care, may have to further improve patient outcomes, reduce the costs of care, enhance investigations of infectious diseases outbreaks, and advance public health. Well-designed clinical studies and meaningful involvement of infectious disease clinicians will be critical for assessments of clinical utility and cost-effectiveness.

Unlocking this great potential is an important priority for IDSA. In 2012, the Society created a Diagnostics Task Force, a group of volunteer members charged with evaluating current trends related to the research, development, approval, regulation, and utilization of ID diagnostics during a time of swift changes in the field. This includes identifying barriers that limit research and development (R&D) of new rapid diagnostic tests as well as challenges to their use in patient care.

A report with recommendations for how to overcome these obstacles and other challenges will be released this fall. The recommendations will focus on how to stimulate diagnostics R&D, improve test utilization in patient care, address regulatory challenges that limit R&D, provide appropriate reimbursement for testing, encourage laboratory adoption, and promote clinician education on diagnostics. The Society will work with key stakeholders, including Congress, federal agencies, the diagnostic industry, health care systems, and other professional medical societies to move this issue forward and help address unmet diagnostic needs, both in this country and in resource-limited settings around the world.

This important work complements the Society’s broader efforts to address antimicrobial resistance and the dry R&D pipeline for new antimicrobials to treat increasingly drug-resistant infections.

Better diagnostics can promote the appropriate use of antimicrobials by helping clinicians identify the precise cause of infectious diseases—and the most effective therapeutic option—more quickly, limiting the inappropriate use of these lifesaving drugs and the development of resistance. The ability to identify patients rapidly with infections caused by particular pathogens may also promote more efficient clinical trials for new antimicrobials, allowing researchers to enroll fewer total patients and still identify sufficient numbers of patients infected with the pathogen of interest.

Effective use of today’s diagnostic tools is critical in caring for patients with infectious diseases, particularly those with drug-resistant infections. If we can overcome the obstacles that hinder advances in diagnostic technologies and their integration in patient care, the benefits to patients and public health will be substantial.
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