Ease-of-use scores

Karl G Nicholson; Keith R Abrams; Sally Batham; Marie Jo Medina; Fiona C Warren; Mike Barer; Alison Bermingham; Tristan W Clark; Nicholas Latimer; Maria Fraser; Nelun Perera; K Rajakumar; Maria Zambon

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Nicholson KG, Abrams KR, Batham S, et al. Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds. Southampton (UK): NIHR Journals Library; 2014 May. (Health Technology Assessment, No. 18.36.)

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Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds.

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Appendix 7Ease-of-use scores

TABLE 38

Component EoU scores for the QuickVUE Influenza A&B POCT for the diagnosis of influenza

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT	1
	Intermediate between descriptions listed for scores of 1 and 3
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities	1
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage	1
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile, requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled	1
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)	1
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable	1
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making	1
	Intermediate between descriptions listed for scores of 1 and 3
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement	1
	Intermediate between descriptions listed for scores of 1 and 3
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens	1
	Intermediate between descriptions listed for scores of 1 and 3
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves	1
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice	1
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention
	Total EoU score	11

TABLE 39

Component EoU scores for the BinaxNOW S. pneumoniae test POCT

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT	1
	Intermediate between descriptions listed for scores of 1 and 3
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities	1
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage	1
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile, requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled	1
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)	1
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable	1
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making	1
	Intermediate between descriptions listed for scores of 1 and 3
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement	1
	Intermediate between descriptions listed for scores of 1 and 3
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens	1
	Intermediate between descriptions listed for scores of 1 and 3
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves	1
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice	1
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention
	Total EoU score	11

TABLE 40

Component EoU scores for semi-nested multiplex PCR for influenza A subtypes H1 and H3, influenza B, and RSV A and B

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3		2
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable			3
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage
	Intermediate between descriptions listed for scores of 1 and 3		2
	May be labile, requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations			3
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)			3
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration			3
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making			3
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills, and abilities			3
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher			3
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention			3
	Total EoU score	30

TABLE 41

Component EoU scores for one-step, real-time RT-PCR tests for influenza A subtypes H1 and H3, influenza B, and RSV A and B

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3		2
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable			3
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage	1
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled
	Intermediate between descriptions listed for scores of 1 and 3		2
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration			3
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3		2
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3		2
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher			3
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention			3
	Total EoU score	25

TABLE 42

Component EoU scores for two-step, real-time, RT-PCR tests for influenza A subtypes H1 and H3, influenza B, and RSV A and B

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3		2
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable			3
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage	1
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations			3
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration			3
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3		2
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3		2
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher			3
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention			3
	Total EoU score	26

TABLE 43

Component EoU scores for virus culture for the diagnosis of influenza A and B, and RSV

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3		2
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable			3
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement			3
Operational steps	Either automatically executed or easily controlled
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations			3
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable	1
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making			3
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3		2
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death			3
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3		2
	One or more operational steps requires bio-safety level Category 3, or higher
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3		2
	Waste materials or reagents include hazardous materials that require special attention
	Total EoU score	26

TABLE 44

Component EoU scores for the BacT/ALERT 3D blood culture system

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3		2
	Requires purpose-built accommodation, ventilation systems and dedicated space
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised equipment is essential and non-portable			3
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage	1
	Intermediate between descriptions listed for scores of 1 and 3
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled	1
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable
	Intermediate between descriptions listed for scores of 1 and 3		2
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3		2
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement	1
	Intermediate between descriptions listed for scores of 1 and 3
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3		2
	One or more operational steps requires bio-safety level Category 3, or higher
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3		2
	Waste materials or reagents include hazardous materials that require special attention
	Total EoU score	20

TABLE 45

Component EoU scores for sputum culture

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3
	Requires purpose-built accommodation, ventilation systems and dedicated space			3
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised equipment is essential and non-portable
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage
	Intermediate between descriptions listed for scores of 1 and 3		2
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled	1
	Intermediate between descriptions listed for scores of 1 and 3
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable	1
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making			3
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities			3
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher			3
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention			3
	Total EoU score	25

TABLE 46

Component EoU scores for sputum Gram stain and microscopy

Categories	Criteria for categorisation	EoU score
Test site	Is a POCT
	Intermediate between descriptions listed for scores of 1 and 3
	Requires purpose-built accommodation, ventilation systems and dedicated space			3
Equipment	No specialised equipment required and is readily transferred between hospital facilities
	Intermediate between descriptions listed for scores of 1 and 3		2
	Specialised equipment is essential and non-portable
Materials and reagents	Are stable, pre-packaged and/or pre-measured, and require no special handling steps or storage
	Intermediate between descriptions listed for scores of 1 and 3		2
	May be labile requiring special storage or require special handling steps; their preparation requires manual steps, e.g. volumetric measurement
Operational steps	Either automatically executed or easily controlled
	Intermediate between descriptions listed for scores of 1 and 3		2
	Require close monitoring and control, and may require special preparation, precise temperature control or timing, accurate pipetting or extensive calculations
Training, experience and knowledge	Require minimal scientific and technical knowledge and experience; and knowledge to perform test can be obtained through on-job instruction (commensurate with AFC Band 4, or less)
	Intermediate between descriptions listed for scores of 1 and 3
	Specialised scientific and technical knowledge essential and substantial experience required (commensurate with AFC Band 7, or higher)			3
Calibration and quality control	Calibration is either automatic or not required; quality control materials are included, or readily available, and are stable	1
	Intermediate between descriptions listed for scores of 1 and 3
	Calibration and quality control materials, if available, may be labile or unavailable; or technical expertise is required for calibration
Interpretation and judgement	Minimal interpretation and judgement are required, and problems require limited interpretation, judgement and decision-making
	Intermediate between descriptions listed for scores of 1 and 3		2
	Extensive interpretation and judgement are required; resolution of problems requires extensive interpretation, judgement and decision-making
Test system troubleshooting and equipment maintenance	Test system troubleshooting is automatic or self-correcting or clearly described or requires minimal judgement
	Intermediate between descriptions listed for scores of 1 and 3		2
	Test system troubleshooting is not automatic or self-correcting and requires decision-making to resolve most problems; or equipment maintenance requires special knowledge, skills and abilities
Time to reporting of results	Results are reported within 4 hours of collection of almost all specimens
	Intermediate between descriptions listed for scores of 1 and 3		2
	Median time to reporting of results exceeds the median duration of hospitalisations/time to death
Health and safety	The test is completed using low levels of personal protection, i.e. gloves
	Intermediate between descriptions listed for scores of 1 and 3
	One or more operational steps requires bio-safety level Category 3, or higher			3
Storage and disposal of waste test materials and reagents	Waste materials and reagents are stored and disposed using medium duty ‘Clinical waste’ plastic bags and ‘Sharps’ containers, or a sluice	1
	Intermediate between descriptions listed for scores of 1 and 3
	Waste materials or reagents include hazardous materials that require special attention
	Total EoU score	23

Copyright © Queen’s Printer and Controller of HMSO 2014. This work was produced by Nicholson et al. under the terms of a commissioning contract issued by the Secretary of State for Health. This issue may be freely reproduced for the purposes of private research and study and extracts (or indeed, the full report) may be included in professional journals provided that suitable acknowledgement is made and the reproduction is not associated with any form of advertising. Applications for commercial reproduction should be addressed to: NIHR Journals Library, National Institute for Health Research, Evaluation, Trials and Studies Coordinating Centre, Alpha House, University of Southampton Science Park, Southampton SO16 7NS, UK.

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Nicholson KG, Abrams KR, Batham S, et al. Randomised controlled trial and health economic evaluation of the impact of diagnostic testing for influenza, respiratory syncytial virus and Streptococcus pneumoniae infection on the management of acute admissions in the elderly and high-risk 18- to 64-year-olds. Southampton (UK): NIHR Journals Library; 2014 May. (Health Technology Assessment, No. 18.36.) Appendix 7, Ease-of-use scores.
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