MR-proADM test for use with clinical deterioration scores in cases of suspected infection

The technology described in this briefing is the MR-proADM test. It measures levels of mid-regional proadrenomedullin (MR-proADM), a precursor of adrenomedullin, levels of which can be increased in severe infections. The MR-proADM test is used alongside tools such as the National Early Warning Score (NEWS and NEWS2) to detect clinical deterioration in cases of suspected infection.

The innovative aspect is that the test measures a unique biomarker (MR-proADM) that allows more accurate prediction of deterioration.

The intended place in therapy would be with NEWS, NEWS2 and other tests and observations in people with suspected infection.

The main points from the evidence summarised in this briefing are from 5 observational studies of 3,217 people with suspected infections in hospital. They show that MR-proADM can improve accuracy of infection diagnosis and can predict the infection's severity.

Key uncertainties around the evidence or technology are that there are only 2 studies that evaluate MR-proADM used with the NEWS.

The cost of MR-proADM is approximately £10 to £20 per test. The resource impact could be less than standard of care because of reduced need for further tests and procedures. However, there is a lack of prospective studies showing how MR-proADM results influence clinical decisions.