Diagnostic Stewardship for Next-Generation Sequencing Assays in Clinical Microbiology: An Appeal for Thoughtful Collaboration

Clin Lab Med. 2024 Mar;44(1):63-73. doi: 10.1016/j.cll.2023.10.002. Epub 2023 Dec 6.

Abstract

Next-generation sequencing (NGS)-based assays are primarily available from reference laboratories for diagnostic use. These tests can provide helpful diagnostic data but also can be overused by ordering providers not fully understanding their limitations. At present, there are few best practice guidelines for use. NGS-based assays can carry a high cost to institutions and individual patients, requiring thoughtful use through application of diagnostic stewardship principles. This article provides an overview of diagnostic stewardship approaches as applied to these assays, focusing on principles of collaboration, differential diagnosis formation, and seeking the best patient, syndrome, sample, timing, and test for improved patient care.

Keywords: Best use practices; Infectious diseases; Outcomes; Sequencing; Value.

Publication types

  • Review

MeSH terms

  • High-Throughput Nucleotide Sequencing*
  • Humans
  • Microbiological Techniques