Supporting diagnostic- and antimicrobial stewardship in the microbiological laboratory.


TREAT Lab™ is a tool for the clinical microbiologist; supporting diagnostic- and antimicrobial stewardship initiatives in the microbiology laboratory. At the core of TREAT Lab™ is its proprietary risk-prediction algorithm SepsisFinder™: a model that estimates the risk of death and the likelihood of a positive microbiological test. The risk-prediction algorithm uses a Causal Probabilistic Network (CPN) model of the patient’s inflammatory response. CPN technology provides significant advantages over current risk- and severity scoring methods, notably its ability to handle missing data. Sound probabilistic reasoning is provided based on the available evidence.

Additionally, TREAT Lab™ provides dashboard, analytical and statistical tools.

The focus areas for TREAT Lab™ are:

  • Risk assessment
    Risk assessment with TREAT Lab™ provides an opportunity to streamline the diagnostic work-up and treatment of the potentially septic patient. TREAT Lab™ uses only readily available information automatically acquired from the patient’s electronic health record: vital signs, blood gases and common laboratory findings.
  • Worklist
    The Worklist supplies the laboratory technicians with an invaluable quality assurance tool. It is a dashboard providing an overview of the status of each sample and possible actions. It gives the opportunity to review and control each step of the process of identifying for which samples rapid AST is optimal.
  • Inspection Tool
    The Inspection Tool allows the specialist team to review specific infectious episodes in detail. It provides a complete overview of the temporal course of the episode, including treatment, microbiology, vital parameters, biochemistry, hematology, blood gases and liver function indicators.
  • Reporting Tool
    The collection of structured data provides an opportunity for tracking and monitoring key performance measures. The Reporting Tool presents a range of statistics and filter tools, allowing the generation of custom reports and access to important data that can feed back into decision making.

Click on the elements below to learn more about the TREAT Lab™ modules.

Overview of the Diagnostic Stewardship with TREAT Lab™ Risk Assessment Worklist Inspection Tool Reporting Tool

– The diagnostic stewardship dashboard in the laboratory

Through the Worklist, TREAT Lab™ provides an overview of all blood cultures analyzed in the laboratory. The Worklist dashboard shows the current status of each sample and an evaluation of the patient’s risk level. Risk-based stratification provides an opportunity to tailor the diagnostic work-up in the laboratory and optimize resource usage and patient care. The worklist gives a range of customized actions based on the context of the individual sample: the risk level, current location and current status. If the system is able to access current antimicrobial treatments, it will also act as an antimicrobial stewardship tool, providing advice on escalation or de-escalation of treatment.

Stewardship and diagnostic dashboard with the Worklist of TREAT Lab™
The Worklist supplies an invaluable quality assurance tool to the technicians in the laboratory. The Worklist follows each sample through every stage in their progress through the microbiology laboratory. From incubation to microscopy and whether to order rapid diagnostics, TREAT Lab™ compiles the most up to date information on all the samples in the laboratory.

– Review specific infectious episodes in detail

TREAT Lab™ integrates seamlessly into a wide range of hospital IT systems, providing an elegant solution to display the temporal course of all infection-relevant information. The Inspection Tool is aimed at the clinical microbiologist, allowing microbiological findings to be set into context when giving advice to the treating physician. TREAT Lab™ provides a printable one-page overview of all information relevant for determining the current infection status of the patient. This includes vital parameters, microbiological findings, hematology, blood gases and clinical chemistry. If the system is able to access the patient’s treatment history, their current and previous antibiotic regimens will also be shown.

TREAT Lab's Inspection Tool provides a one-page overview of the patient episode
TREAT Lab’s Inspection Tool provides a one-page overview of infection relevant information. A range of filters are provided so that the user can choose to display only the most relevant information.

– Patient selection for Rapid Diagnostics

New emerging techniques for rapid sepsis diagnosis provide an opportunity for etiological diagnosis one to two days earlier than conventional methods. Identification of a causative pathogen and its susceptibility and/or resistance profile greatly increases the odds of the patient receiving appropriate antimicrobial therapy. However, most rapid diagnostics are too expensive to be used for all patients suspected of infection outside the Intensive Care Unit. Risk-based stratification, such as that provided by TREAT Lab™, ensures that the patients who need rapid diagnostics are able to benefit from their use.

There are two main decision points for whether rapid diagnostics should be used: in the clinical setting at the time of blood culture, and in the laboratory when choosing how to handle a positive blood culture bottle. TREAT Lab™ supports both these decisions, providing a risk-assessment to be used by the clinician when ordering direct blood diagnostics, and by the laboratory technician when allocating positive blood cultures to the optimal workflow.

Overview of the clinical and laboratory workflow with diagnostic stewardship
Overview of TREAT Lab’s placement in the laboratory workflow. TREAT Lab™ can be used to order additional samples from the clinic for direct blood diagnostics (e.g. multiplex PCR) and also to direct the workflow downstream of positive blood culture (PCR/Fast AST).

- Simple access to performance measures

One of the true benefits of having coded clinical information is that it can be linked to the vast knowledge within the domain of evidence-based medicine and be used for statistical- and research purposes. The Reporting Tool in TREAT Lab™ gives the user access to a range of statistics; useful for both performance tracking and infection surveillance.

TREAT Lab™ tracks e.g. laboratory throughput and quality measures along with the pathogen distributions. Plotting tools enable the user to view temporal trends in the numbers of gram positive and gram negative isolates, resistance rates for E. coli over the last six weeks stratified by region and more.

Statistics and surveillance with the Reporting Tool of TREAT Lab™
TREAT Lab’s Reporting Tool provides simple, easy access to key performance measures and statistics