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CompletedNCT05467007URGENTUpdated Sep 19, 2024Results posted

Urgent Care Management of Respiratory Illness Enabled With Novel Testing Pathway

An interventional study of BioFire® Respiratory Panel 2.1-EZ in Viral Infection, Acute Respiratory Infection and Upper Resp Tract Infection, sponsored by Andrew Meltzer. Completed at 2 sites in United States. Open to participants aged 7 Years and older. Per ClinicalTrials.gov, last updated 2024-09-19.

Sponsored by Andrew Meltzer · Not applicable, Interventional, and Diagnostic

From the registry’s dates

  • Registered 3 months after the study started (first participant enrolled Apr 2022, registered Jul 2022).
Phase
Not applicable
Study type
Interventional
Enrollment
360
Allocation
Randomized
Ages
7 Years and older
Sex
All
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Study summary

Rapid diagnosis and precise treatment have become possible with multiplex polymerase chain reaction (PCR) panels that can identify a variety of causative agents of acute respiratory illnesses such as bacterial and viral infections in one urgent care visit. While real-time PCR is currently used as a standard for diagnosing acute respiratory illnesses such as influenza due to its high sensitivity and specificity, it typically takes several hours for results which is unfavorable in the urgent care setting. Highly sensitive and rapid random-access PCR tests provide the sensitivity and specificity needed to both rapidly and accurately diagnose acute respiratory illnesses. Similar PCR panels have been used in previous research for the diagnosis of gastrointestinal illnesses in the emergency department and point-of-care testing for hospitalized adults presenting with acute respiratory illness. In this study, the investigators aim to determine if a rapid multiplex PCR test for urgent care patients with symptomatic upper respiratory infections can improve patient and provider-reported outcomes. This study utilizes the Biofire® FilmArray Panel (RP2.1-EZ) which in previous studies has been shown to be highly effective in diagnosing acute respiratory illnesses.

Read the detailed description

Research assistants in the IPCs will screen for possible participants by searching the electronic health record for complaints and/or symptoms of respiratory illness. Patients who screen eligible will be approached about potential interest, review inclusion and exclusion criteria, and obtain informed consent. All consented patients will be given a study ID and recorded in enrollment log. Patients who consent will be randomized to one of the two groups: BioFire® Respiratory Panel 2.1-EZ (RP2.1-EZ; EXP) versus standard care (SC). The RP2.1-EZ panel is designed to test for a variety of bacterial and/or viral causes for illness whereas standard care procedures are essentially yes/no to patient having SARS-COV-2. Both groups will receive a nasal swab, however, the EXP group will receive the BioFire RP2.1-EZ panel, and the SC group will receive the standard nasal swab used in the IPCs. As the RP2.1-EZ panel includes SARS-COV-2, patients in the EXP group need not receive two separate nasal swabs. Nasal swabs will be performed for both groups, ideally during triage, however, the sample may be collected any time during the visit, by staff trained by BioFire Diagnostics LLC. After the nasal swab is collected, it will be either sent to LabCorp (SC) or tested on site (EXP). On site testing of samples for EXP arm will occur in the same IPC room where rapid COVID-19 tests are tested. EXP panel results should be processed within 45 minutes to 1 hour but will be communicated to patient at COB (see below). Results will be communicated to both the patient and the health care provider as soon as possible, typically on the same day as enrollment. The research team will explain the results using a standarization script written by medical professionals. If patients have further questions, they will be referred to their healthcare provider. The usage of the RP EZ-2.1 Panel will guide the managemnet of providers in the following ways: more focused advice on time to isolate and/or quartine for patients, focused advice regarding infectivity, identifying the natural course of disease faster, guiding anti-biotic decisions for providers, and helping providers identify potential anti-viral therapy in a faster manner.

Patient data will be collected regarding demographics (Form D), comorbidities (Form D), nature of current symptoms (Form D), vaccination status (Form D), quality of life measures (Form E), vital signs at triage (Form F), CPT and ICD-10 codes (Form D), and travel history (Form D). This will be collected after the nasal swab is collected before the patient leaves the clinic. Patients will complete this form on a password protected iPad through secure REDCAP survey in a private, patient room. Patients will receive their results at the end of the day via follow up phone call by the research assistants (RAs) if randomized to the EXP group. If randomized to the SC group, patients will receive their results within 24-72 hours, dependent on turn around time at LabCorp. RAs will be providing results to both patients and providers. Providers can opt to complete a brief questionnaire (i.e., five minutes or less) regarding how their course of treatment was affected by the results. RAs will call patients to complete a brief satisfaction survey (15 minutes) with their results (if available) and uploaded results can be found in patient's electronic health record. Standardized scripts written by medical professionals will be used to provide diagnostic feedback for both patient groups via phone. Research assistants will provide diagnostic feedback to the providers in person for the EXP group. Clinician ordered testing (if any) can occur at any time and will be reported per usual protocol. If testing comes back positive for a bacterial/viral pathogen for EXP arm or SARS-COV-2 for SC arm, participants be referred to their health care provider if they want to seek further treatment or have questions about results. This is not inconsistent with the standard practices now happening at the IPCs. The study coordinator or trained research assistants will follow up with all enrolled patients at 7 business days to evaluate the course of symptoms, assess patient satisfaction, and to assess other relevant medical information.

02

Conditions studied

  • Viral Infection
  • Acute Respiratory Infection
  • Upper Resp Tract Infection
03

In context

Virus Diseases

927 studies on the registry are indexed under Virus Diseases; 112 are open to participants now.

This study's enrollment of 360 is above the median of 100 across 614 interventional studies indexed under Virus Diseases.

Browse Virus Diseases studies →

Lead sponsor

Andrew Meltzer is the lead sponsor of 4 studies on the registry; none are open to participants now.

Counted across the registry records on this site, refreshed daily.

04

Who can participate

Ages eligible
7 Years and older
Sexes eligible
All
Accepts healthy volunteers
No

Go through the criteria one by one — yes, no or not sure — and take the list to your doctor or the study team. Kept in this browser only.

Inclusion criteria

  • Age >7
  • Clinically stable
  • Must present with one symptom of respiratory illness (e.g., cough, sneezing, runny or stuffy nose, sore throat, headaches, muscle aches, trouble breathing, shortness of breath, and/or fever).

Exclusion criteria

Exclusion Criteria:

  • Patient is unable to provide informed consent
  • Chronic symptoms (>14 days) or asymptomatic
  • Unstable (or "too sick" to consent)
  • Prisoner or ward of state
  • Non-English speaker
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Study design

Phase
Not applicable
Primary purpose
Diagnostic
Allocation
Randomized
Intervention model
Parallel assignment
Masking
None (open label)
Enrollment
360 participants (actual)

Study arms

  • Experimental
    BioFire® Respiratory Panel 2.1-EZ

    EXP group will receive the BioFire RP2.1-EZ panel, designed to test for a variety of bacterial and/or viral causes for illness

    Diagnostic Test: BioFire® Respiratory Panel 2.1-EZ

  • No intervention
    Standard of Care

    Standard care procedures are essentially yes/no to patient having SARS-COV-2, the SC group will receive the standard nasal swab used in the IPCs.

Interventions

  • Diagnostic testBioFire® Respiratory Panel 2.1-EZ

    BioFire RP2.1-EZ Panel uses a syndromic approach to quickly identify SARS-CoV-2, along with 18 additional viral and bacterial pathogens in patients suspected of SARS-CoV-2. This PCR test provides results in about 45 minutes.

06

What researchers measure

Primary outcomes

  1. Satisfaction With Time to Receive Result

    Based on any results you have received from today's tests, are you satisfied in the time it has taken to communicate the results?

    Time frame: Day of enrollment

Secondary outcomes

  1. Confidence in Testing

    Based on testing today, do you feel confident that you know what is causing your illness?

    Time frame: Day of Enrollment

  2. Intention to Self Isolate

    Based on the testing you received today, are you planning to isolate from friends and family?

    Time frame: Day of enrollment

  3. Plan to Seek Care From Another Doctor or Healthcare Facility

    Will you seek out additional diagnostic testing or care from another doctor or healthcare facility?

    Time frame: Day of enrollment

  4. Will Patient Plan for Work Absence

    Based on test results received today, will you plan to miss work?

    Time frame: Day of enrollment

  5. Did the Time to Receive Test Results Affect You and Prevent You From Doing Activities You Normally Would do?

    Did the time to receive test results affect you and prevent you from doing activities you normally would do?

    Time frame: Day 7 after enrollment

  6. I am Satisfied With the Time it Took to Receive the Test Results.

    Time frame: Day 7 after enrollment

  7. Were Antibiotics Prescribed as Part of the IPC Visit for Respiratory Illness?

    Practitioner-Centered Results

    Time frame: Day of Enrollment

  8. Confidence in Patient's Cause of Illness

    How confident are you that you know what is causing your patient's illness?

    Time frame: Day of Enrollment

07

Results

Posted Mar 20, 2024

Participant flow

Participant flow — Overall Study
MilestoneBioFire® Respiratory Panel 2.1-EZStandard of Care
Started205155
Completed205155
Not completed00

Outcome measures

PrimarySatisfaction With Time to Receive Result

Based on any results you have received from today's tests, are you satisfied in the time it has taken to communicate the results?

Time frame:
Day of enrollment
Reported as:
Number · participants
Satisfaction With Time to Receive Result
participantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes18053
No372
SecondaryConfidence in Testing

Based on testing today, do you feel confident that you know what is causing your illness?

Time frame:
Day of Enrollment
Reported as:
Count of participants · Participants
Confidence in Testing
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes11137
No4357
Unsure2930
Missing01
SecondaryIntention to Self Isolate

Based on the testing you received today, are you planning to isolate from friends and family?

Time frame:
Day of enrollment
Reported as:
Count of participants · Participants
Intention to Self Isolate
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes7450
No9845
Unsure927
Not Applicable23
SecondaryPlan to Seek Care From Another Doctor or Healthcare Facility

Will you seek out additional diagnostic testing or care from another doctor or healthcare facility?

Time frame:
Day of enrollment
Reported as:
Count of participants · Participants
Plan to Seek Care From Another Doctor or Healthcare Facility
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes3017
No13480
Unsure1928
SecondaryWill Patient Plan for Work Absence

Based on test results received today, will you plan to miss work?

Time frame:
Day of enrollment
Reported as:
Count of participants · Participants
Will Patient Plan for Work Absence
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes6260
No7842
Not applicable4323
SecondaryDid the Time to Receive Test Results Affect You and Prevent You From Doing Activities You Normally Would do?

Did the time to receive test results affect you and prevent you from doing activities you normally would do?

Time frame:
Day 7 after enrollment
Reported as:
Number · participants
Did the Time to Receive Test Results Affect You and Prevent You From Doing Activities You Normally Would do?
participantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes2638
No13086
SecondaryI am Satisfied With the Time it Took to Receive the Test Results.
Time frame:
Day 7 after enrollment
Reported as:
Count of participants · Participants
I am Satisfied With the Time it Took to Receive the Test Results.
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Strongly agree/Agree14573
Neither agree or disagree716
Strongly disagree/Disagree433
SecondaryWere Antibiotics Prescribed as Part of the IPC Visit for Respiratory Illness?

Practitioner-Centered Results

Time frame:
Day of Enrollment
Reported as:
Count of participants · Participants
Were Antibiotics Prescribed as Part of the IPC Visit for Respiratory Illness?
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Yes5227
No10377
SecondaryConfidence in Patient's Cause of Illness

How confident are you that you know what is causing your patient's illness?

Time frame:
Day of Enrollment
Reported as:
Count of participants · Participants
Confidence in Patient's Cause of Illness
ParticipantsBioFire® Respiratory Panel 2.1-EZStandard of Care
Less confident1015
No effect2041
More satisfied12548

Adverse events

Collected over All-cause mortality, Serious Adverse Events, and Other Adverse Events were monitored/assessed at Day 0 and Day 7. Non-serious events are listed at a 0% frequency threshold.

Adverse event summary by group
GroupDeathsSeriousOther
BioFire® Respiratory Panel 2.1-EZ0/205 (0%)0/205 (0%)0/205 (0%)
Standard of Care0/155 (0%)0/155 (0%)0/155 (0%)

Baseline characteristics

Age, Customized
Age, Customized(years)BioFire® Respiratory Panel 2.1-EZStandard of CareTotal
Age (median age, years)34 (7 to 80)34 (7 to 89)34 (7 to 89)
Sex: Female, Male
Sex: Female, Male(Participants)BioFire® Respiratory Panel 2.1-EZStandard of CareTotal
Female13894232
Male6761128
Ethnicity (NIH/OMB)
Ethnicity (NIH/OMB)(Participants)BioFire® Respiratory Panel 2.1-EZStandard of CareTotal
Hispanic or Latino191029
Not Hispanic or Latino184145329
Unknown or Not Reported202
Race (NIH/OMB)
Race (NIH/OMB)(Participants)BioFire® Respiratory Panel 2.1-EZStandard of CareTotal
American Indian or Alaska Native000
Asian13720
Native Hawaiian or Other Pacific Islander11516
Black or African American8158139
White10083183
More than one race000
Unknown or Not Reported022
08

Study locations

2 sites
  • GW Immediate & Primary Care - McPherson Square
    Washington D.C., District of Columbia 20005, United States
  • GW Immediate & Primary Care - Rhode Island Ave
    Washington D.C., District of Columbia 20018, United States
09

References and documents

Publications

  • Dugas AF, Valsamakis A, Atreya MR, Thind K, Alarcon Manchego P, Faisal A, Gaydos CA, Rothman RE. Clinical diagnosis of influenza in the ED. Am J Emerg Med. 2015 Jun;33(6):770-5. doi: 10.1016/j.ajem.2015.03.008. Epub 2015 Mar 12. PubMed 25827595 ↗
  • Beard K, Brendish N, Malachira A, Mills S, Chan C, Poole S, Clark T. Pragmatic multicentre randomised controlled trial evaluating the impact of a routine molecular point-of-care 'test-and-treat' strategy for influenza in adults hospitalised with acute respiratory illness (FluPOC): trial protocol. BMJ Open. 2019 Dec 17;9(12):e031674. doi: 10.1136/bmjopen-2019-031674. PubMed 31852699 ↗
  • Kim DK, Poudel B. Tools to detect influenza virus. Yonsei Med J. 2013 May 1;54(3):560-6. doi: 10.3349/ymj.2013.54.3.560. PubMed 23549796 ↗
  • Leber AL, Everhart K, Daly JA, Hopper A, Harrington A, Schreckenberger P, McKinley K, Jones M, Holmberg K, Kensinger B. Multicenter Evaluation of BioFire FilmArray Respiratory Panel 2 for Detection of Viruses and Bacteria in Nasopharyngeal Swab Samples. J Clin Microbiol. 2018 May 25;56(6):e01945-17. doi: 10.1128/JCM.01945-17. Print 2018 Jun. PubMed 29593057 ↗
  • Overview of influenza testing methods. Centers for Disease Control and Prevention. https://www.cdc.gov/flu/professionals/diagnosis/overview-testing-methods.htm. Published August 31, 2020. Accessed October 12, 2021.
  • Poon SJ, Schuur JD, Mehrotra A. Trends in Visits to Acute Care Venues for Treatment of Low-Acuity Conditions in the United States From 2008 to 2015. JAMA Intern Med. 2018 Oct 1;178(10):1342-1349. doi: 10.1001/jamainternmed.2018.3205. PubMed 30193357 ↗
  • Weinick RM, Burns RM, Mehrotra A. Many emergency department visits could be managed at urgent care centers and retail clinics. Health Aff (Millwood). 2010 Sep;29(9):1630-6. doi: 10.1377/hlthaff.2009.0748. PubMed 20820018 ↗

Study documents

  • Study protocol · Jan 30, 2023
  • Statistical analysis plan · Feb 13, 2024
  • Informed consent form · Mar 9, 2023

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: Undecided — We will consider per individual request, on case by case basis.

10

Updates

Tracking since Sep 25, 2026
No changes since tracking began. The registry record was last updated on Sep 19, 2024, before this site started recording changes on Sep 25, 2026. Its history is on ClinicalTrials.gov ↗
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Registry details

Key details

Study ID
NCT05467007
Lead sponsor
Andrew Meltzer
Collaborators
BioMérieux
Responsible party
Andrew Meltzer (Chief, Clinical Research Section, Department of Emergency Medicine, George Washington University) — Sponsor-investigator
First posted
Jul 20, 2022
Start date
Apr 4, 2022
Primary completion
Jan 1, 2023
Completion
Jun 1, 2023
Results posted
Mar 20, 2024
Last update
Sep 19, 2024

Study contacts

Andrew Meltzer, MD
principal investigator · Clinical Research Director, Department of Emergency Medicine

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
Yes
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Aug 2024. You cannot join it, but the record below documents what was studied.

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