Evidence map›Paper›PMID 40359211›Full record

SynthesisPloS one2025

A qualitative systematic review of barriers and facilitators to the implementation of community-based molecular diagnostics for infectious diseases.

Hannah Nelson, Jia Tong Song, Mai-Lei Woo Kinshella, Jennifer Cochrane, Karen Mooder, Kasra Hassani, Michelle Dittrick, David M Goldfarb

Abstract readSystematic Review
In one paragraph

Synthesis in PloS one, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed.

  1. Article
  2. Review
  3. Article
  4. An automated plasma-based proteotyping immunoassay for APOE ε4 zygosity classification in Alzheimer's disease.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  5. Article
  6. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

8 authors.

Hannah NelsonExperimental Medicine Graduate Program, University of British Columbia, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0009-0007-1943-2259
Jia Tong SongDepartment of Medicine, University of British Columbia, Vancouver, British Columbia, Canada.
Mai-Lei Woo KinshellaBC Children's Hospital Research Institute, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0001-5846-3014
Jennifer CochraneCommunity Based Testing and Biomedical Initiatives, First Nations Health Authority, Vancouver, British Columbia, Canada.
Karen MooderCommunity Based Testing and Biomedical Initiatives, First Nations Health Authority, Vancouver, British Columbia, Canada.
Kasra HassaniFirst Nations Health Authority, Vancouver, British Columbia, Canada.
Michelle DittrickDepartment of Pathology and Laboratory Medicine, BC Children's and Women's Hospital & Health Centre, Vancouver, British Columbia, Canada.
David M GoldfarbDepartment of Pathology and Laboratory Medicine, BC Children's and Women's Hospital & Health Centre, Vancouver, British Columbia, Canada.ORCID https://orcid.org/0000-0003-0835-9504

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundCommunity-based molecular diagnostic testing for infectious diseases can bring equitable healthcare to resource-limited settings without hospital-based laboratories. Low-complexity molecular testing devices allow for unprecedented sensitivity and specificity for infectious disease diagnostics outside of a dedicated laboratory, which may facilitate timely initiation of therapeutics and other public health interventions in rural, remote and/or marginalized communities.

objectiveTo identify barriers and facilitators to the implementation of community-based molecular testing.

methodsA systematic search was conducted on MEDLINE Ovid, EMBASE, Web of Science, Cumulative Index to Nursing and Allied Health, Google Scholar, and reference lists. Original research that includes implementation of molecular testing systems at the community-level or at rural/remote health facilities with frontline healthcare workers and reports barriers and facilitators to implementation were included. Studies were assessed by the Critical Appraisal Skills Programme Qualitative Checklist and underwent inductive thematic analysis. The review protocol was registered to Prospero prior to conducting the review (CRD42023397800).

resultsA total of 6 studies were included in the review. We found three main themes present across all six included studies: infrastructure, usability, and staffing considerations. Infrastructure emerged as a critical determinant, with challenges ranging from physical space constraints to issues with reliable electricity and internet connectivity. The usability of testing devices, encompassing factors like ease of use and testing quality, also played a pivotal role. Staffing considerations, including workload, training, and attitudes, significantly influenced implementation outcomes.

conclusionOur review highlights the importance of addressing infrastructural challenges, ensuring usability of testing devices, and adequately supporting staff through training and workload management to realize the full potential of this new opportunity. Future implementation should consider these factors to successfully integrate molecular diagnostics into community-level healthcare delivery, particularly in rural and remote areas.

Indexed as

Communicable DiseasesCommunity Health ServicesMolecular Diagnostic TechniquesHumans

Identifiers

PMID40359211
PMCPMC12074526

What OpenQuestion holds

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LicenceCC BY
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.