Laboratory Interventions to Eliminate Unnecessary Rapid COVID-19 Testing During a Reagent Shortage.

OBJECTIVES: In the fall of 2020, US medical centers were running out of rapid coronavirus disease 2019 (COVID-19) tests. The aim of this study is to evaluate the impact of an intervention to eliminate rapid test misutilization and to quantify the effect of the countermeasures to control rapid test ordering using a test utilization dashboard. METHODS: Interventions were made to preserve a severely limited supply of rapid diagnostic tests based on real-time analysis of a COVID-19 test utilization dashboard. This study is a retrospective observational study evaluating pre- and postintervention rates of appropriate rapid test use, reporting times, and cost/savings of resources used. RESULTS: This study included 14,462 severe acute respiratory syndrome coronavirus 2 reverse transcriptase polymerase chain reaction tests ordered during the study period. After the intervention, there was a 27.3% decrease in nonconforming rapid tests. Rapid test reporting time from laboratory receipt decreased by 1.47 hours. The number of days of rapid test inventory on hand increased by 39 days. CONCLUSIONS: Performing diagnostic test stewardship, informed by real-time review of a test utilization dashboard, was associated with significantly improved appropriate utilization of rapid diagnostic COVID-19 tests, improved reporting times, implied cost savings, and improved reagent inventory on hand, which facilitated the management of scarce resources during a pandemic.

Mapping Local Biospecimen Records to the OMOP Common Data Model.

Research to support precision medicine for leukemia patients requires integration of biospecimen and clinical data. The Observational Medical Outcomes Partnership common data model (OMOP CDM) and its Specimen table presents a potential solution. Although researchers have described progress and challenges in mapping electronic health record (EHR) data to populate the OMOP CDM, to our knowledge no studies have described populating the OMOP CDM with biospecimen data. Using biobank data from our institution, we mapped 26% of biospecimen records to the OMOP Specimen table. Records failed mapping due to local codes for time point that were incompatible with the OMOP reference terminology. We recommend expanding allowable codes to encompass research data, adding foreign keys to leverage additional OMOP tables with data from other sources or to store additional specimen details, and considering a new table to represent processed samples and inventory.

Evaluating Generalizability of a Biospecimen Informatics Approach: Support for Local Requirements and Best Practices.

To enable clinical and translational research, academic medical centers increasingly implement biospecimen information management systems. At our institution, one laboratory successfully implemented a multi-system solution that enabled collection and reporting of specimen- and aliquot-level data. The objective of this study was to assess the solution against the laboratory's requirements and with respect to support of best practices for biospecimen information management systems defined by the International Society for Biological and Environmental Repositories (ISBER). The solution supported the laboratory's reporting needs and 90% (n=26) of ISBER best practices. To the best of our knowledge, this is among the first studies to demonstrate the generalizability of a biospecimen informatics approach. Findings suggest that development and evaluation of biospecimen informatics approaches can potentially improve through closer collaboration of informatics and biorepository professional societies.