Specialist commentator comments
The specialist commentators reflected that the Alere Afinion CRP test may produce cost savings through fewer follow-up appointments in primary care, less unnecessary A&E attendance, and by improving sensitivity in diagnosing pneumonia (thus preventing costly inpatient admissions). By using point-of-care CRP testing, clinicians are better equipped to prescribe antibiotics only when needed.
Several commentators noted that there are a range of point-of-care CRP tests currently available. Two commentators noted that there was a body of evidence on point-of-care CRP testing independent of the device used. One commentator noted that there is very little published data on the accuracy or precision of the Alere Afinion CRP test. They noted that the outcomes from the available studies did not give clear conclusions on these issues.
One commentator described a range of factors that may influence results and should be accounted for in any point-of-care test. For example, it is unclear whether testing whole blood, serum and plasma could give different results. The commentator also mentioned the hook effect, where beyond a critical concentration of CRP (the hook point), the signal level decreases as the CRP concentration increases. The commentator felt that there should be more technical awareness around these tests in users.
Commentators pointed out that the Afinion AS100 analyser can also be used for point-of-care testing of glycated haemoglobin, lipid profile and ACR for other national programmes. This could potentially reduce the costs associated with the Afinion AS100.