12 | VALUE OF DIAGNOSTICS THROUGHOUT THE PATIENT PATHWAY | 2021
FIGURE 3
The value of diagnostic information ( VODI ) 7
Clinical benefit Patient empowerment
• Value of ‘ knowing ’ and ‘ deciding ’
• Planning value
• Value of a ‘ rule-out ’ test
• Option value
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Economic efficiencies
• Patient triage
• Waiting time
• ( Re- ) hospitalisation
• Avoided cost of disease progression
• Avoided adverse events
• Shift to community care
Public health benefit
• Identification of notifiable disease allowing to take measures to contain the spread of infection
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Citizens
Healthcare systems
Society
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Patients
VODI
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Carers
Healthcare providers
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Operational efficiencies
• Turnaround time
• Operational costs
• Quality ( reliability , reproducibility )
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Healthcare professionals |
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Patient management
• Facilitate rapid , appropriate clinical management
• Reduce unnecessary or ineffective testing
• Manage patient expectations regarding prognosis and treatment course
• Monitor condition and provide intervention
By improving initial prescribing decision making through diagnostic testing , the costs of the tests can be offset against the reductions in inappropriate prescribing ( less medications supplied ), reduced length of hospital admission and reductions in patient treatment failures ( hospital re-admissions or future sepsis complications ).
VODI : concept and definition Wurcel et al introduced the concept of the “ value of diagnostic information ” ( VODI ) which they define as : “ a compass for the multiple downstream consequences of diagnostic testing ” ( Figure 3 ). 7 In other words , the VODI can be determined through the impact on its different dimensions . For example , the value of the information generated from a diagnostic test helps guide a clinician ’ s treatment decision making . As a consequence of this information , which in itself is of enormous value , there are potential economic benefits , if , for instance , the diagnosis avoids the costs associated with the sequelae of disease progression , inappropriate treatment and extended hospital stay . There are also benefits to patients in terms of mental health and wellbeing through the ‘ value of knowing ’. Finally , the healthcare system benefits through the clinician – laboratory interaction as IVD test results can be incorporated into a patient ’ s electronic health record , and even at the societal level , timely screening might enable an earlier return to normal life .
VODI to improve AMS programmes Patient-level diagnostic testing also plays an important role in mitigating the risks of AMR through surveillance and epidemiology . Aggregate pathogen level or patient group specific data can be used to inform local and national policy on AMR reporting . Through time-series data , changes