Comments on this technology were invited from clinical experts working in the field and relevant patient organisations. The comments received are individual opinions and do not represent NICE's view.
None of the experts were familiar with or had used this technology before.
Most experts thought Actim Pancreatitis was a novel way to diagnose acute pancreatitis because it does not need blood sample collection and can be done at the bedside with fairly rapid test results. The current standard of care involves blood tests to rule disease in or out, no urinary dipstick assay is currently used for acute pancreatitis. Most of the experts felt the test would be used in addition to standard care.
Reduction in delays to diagnosis and treatment, reduced need for hospital admission for further investigations and quicker discharge from hospital were some of the main potential benefits identified by experts. One expert noted that published studies seem to have promising results. Another expert explained that the clinical advantage of urinary dipstick testing is that the test results can be available within minutes compared with hours using conventional laboratory testing. People who have had endoscopic retrograde cholangiopancreatography (ERCP) and people who present to primary or secondary care with acute abdominal pain when acute pancreatitis is suspected were identified by experts as people who would particularly benefit from Actim Pancreatitis testing. One of the experts said the test could be used for acute pancreatitis in all clinical settings. One of the experts did not think there would be any patient benefits in an emergency setting but it could help rule acute pancreatitis in or out in primary care. One expert thought that the test could change the current care pathway and clinical outcomes for post-ERCP patients. Another expert noted that the test was unlikely to change the current care pathway in emergency departments where blood tests are available and commonly used.
Potential system benefits identified by experts included avoiding further admissions or tests by helping to triage patients. One expert said that the test could help to streamline the patient care pathway from primary to secondary care and that this may improve system performance with regards to the 4‑hour access standard for patients attending emergency departments. Another expert thought that the test was unlikely to have a substantial effect on the healthcare system. Two of the experts thought the technology would cost more than standard care and the other expert said that it was difficult to say without further data. Most of the experts felt that adopting the technology would have little effect on staffing needs and resource. All experts said that no changes to facilities or infrastructure, or any specific training would be needed to use the technology. None of the experts were aware of any safety concerns surrounding this technology.
Experts were not aware of the technology being used in the NHS. One expert commented that a positive test result would not avoid the need for further confirmatory tests. Patients with a positive test would still need a CT scan to confirm the diagnosis of pancreatitis, assess its severity and the presence of local complications. Another expert said that they did not see a place for the technology in emergency care. One expert highlighted that the prevalence of acute pancreatitis is variable across different care settings and a better understanding of risk in these patients would be helpful.