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What is Care Pathways Analysis?

The Newcastle MIC are mapping out the healthcare journeys of patients with suspected COVID-19 in hospitals and in the community. These “care pathway mapping” studies will identify where new technologies could have the most impact on patient health during the different phases of the pandemic. This will include reviewing the lessons learned from the pandemic so far and informing recommendations for the next winter season.

The care pathway analysis workstream will map out patients’ journeys with suspected COVID-19, ensuring that the diagnostic tests are evaluated in the most suitable clinical setting, such as hospitals or care homes, and the evidence developed by CONDOR will be appropriate for the practical use of the test.  Working with NICE, we believe this will speed up the delivery of these tests into practice.

- Dr. Ashley Price, Infectious diseases consultant, Infection clinical lead in the Newcastle MIC and co-applicant of CONDOR

There has been a swift effort to develop tests for the detection, control and management of COVID-19. However more research is needed to match the most appropriate test to the clinical decision that needs to be addressed. This includes identifying whether the test can be used in a variety of locations such as different departments of the hospital, including the intensive care unit, and diverse community settings like care homes and General Practices (GPs). These needs will evolve throughout the different phases of the pandemic as the rate of the infection changes and healthcare systems are reorganised. Our research will adapt to address these challenges and ensure that the CONDOR evaluation studies are appropriately designed to assess the clinical and economic value of the new tests.

So far, we have conducted a survey for the Department of Health and Social Care (DHSC) to prioritise requirements for COVID-19 testing in the UK in locations such as hospitals, care homes, GPs, dentists and prisons. We are also analysing new and emerging clinical guidelines and interviewing clinicians from a variety of healthcare settings to understand their needs for new COVID tests.

The care pathway mapping research aims to achieve an enhanced understanding of the most appropriate point in the patients’ healthcare journey for novel COVID-19 tests to be used. As the research will involve collecting data before, during and after the CONDOR clinical studies, the results will help us understand unmet needs now and in the future winter season. The work will also continue to inform the design of CONDOR's clinical evaluations. This includes identifying the most appropriate clinical reference standard, which will be used as a benchmark, when assessing the accuracy of the new tests. Therefore the research will support the national adoption of the most promising tests for COVID-19 benefiting patients, healthcare and the community.

Our findings will inform the activities of National Institute for Health and Care Excellence (NICE) and the Royal College of Pathologists (RCPath) who are currently identifying gaps in the evidence regarding new COVID-19 diagnostic tests and providing recommendations for clinical practice. Our work will also inform the Target Product Profiles (TPP) for COVID-19 tests which are currently being developed by DHSC, RCPath and Medicine and Healthcare products Regulatory Agency (MHRA). A TPP outlines the desired “profile” or characteristics of the test stating the intended use, target populations and other desired attributes, including safety and performance-related features. They provide a common foundation so key stakeholders understand the characteristics a test must have to be successful for the particular intended use. They also assist manufacturers to design and deliver tests that might be useful in supporting the UK testing strategy.