TY - JOUR T1 - Near-patient testing in primary care JF - British Journal of General Practice JO - Br J Gen Pract SP - 650 LP - 651 VL - 54 IS - 506 AU - David Fitzmaurice Y1 - 2004/09/01 UR - http://bjgp.org/content/54/506/650.abstract N2 - THE use of near-patient tests in primary care has received much attention, ranging from simple urinalysis strips1 and measurement of blood glucose, to more complex desktop analysers for the measurement of cholesterol.2 Screening programmes are likely to make more regular use of testing than diagnostic use, thus increasing the economy of scale of the near-patient test. If patients are tested while still in the surgery, there are potential savings on administration, and follow-up of abnormal results can be ensured.The information value of a test result is determined by the likelihood ratio of the test and the balance between the utilities of testing and not testing. Tests have an important value in reducing the uncertainty under which doctors practice. A study of the influence of a rapid transit erythrocyte sedimentation rate on the diagnosis reached by Dutch general practitioners (GPs), found that the result confirmed the GPs' original diagnosis in 82% of cases and was ‘reassuring for both doctor and patient’.3An article in this month's Journal looking at near-patient testing describes the use of C-reactive protein (CRP) measurement to diagnose bacterial sinusitis.4 This health technology assessment from Denmark indicates that antibiotic prescribing can be targeted more effectively through the use of near-patient CRP measurement.If a near-patient test is performed while the patient waits, a return visit for further management may be avoided. However, a study of desktop analysers in London revealed that approximately 15% of patients were asked to return for the … ER -