The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed while carrying out this systematic review [20]. The review aimed to identify publications that evaluated the use of POCT compared with traditional methods (i.e., where no POC tests are used) in terms of health economic outcomes. The publication had to describe any of the following health economic analyses [21]: cost minimization, cost effectiveness, cost consequence, cost utility, cost benefit, budget impact. The study could include any population, time horizon, and perspective and could be based on real-world data, trial data, experimental data, or simulation modeling.

Scopus and PubMed was searched for relevant publications in the English or Dutch language, between 2007 and 2019. The search was performed in December 2019 and included all terms and text words related to the intervention (POCT) and the type of analysis (health economic evaluations). To ensure that a wide-ranging set of relevant publications were included in the search, the selected search query was kept broad. The review protocol for this systematic review is illustrated in the electronic supplementary material (ESM) as a series of steps that were followed.

The search protocol used (in Scopus format) was:

(TITLE (“POCT” OR “Point of care” OR “Point of care testing” OR “rapid testing” OR “bedside testing” OR “laboratory-independent” OR “near patient testing”) AND TITLE-ABS-KEY (“Health effect*” OR “Economic effect*” OR “health economic” OR “cost minimization” OR “cost-effectiveness” OR “cost consequence” OR “cost-utility” OR “cost-benefit” OR “budget impact”)) AND PUBYEAR > 2006

Publications were included based on the following criteria:

Patients: any human patient population.

Intervention: an existing POC test that is used to diagnose, screen, or monitor disease. Hypothetical (non-existent) POC tests were excluded.

Comparator: the publication should compare the usage or implementation of POCT with one or more strategies, not including POCT. For example, if a publication compared different POCT guidelines without also comparing these to a strategy that did not including POCT, it was excluded from further analysis.

Study design: publications had to compare POCT with non-POCT (e.g., laboratory testing) in terms of health and/or cost outcomes. The publication had to describe a health economic evaluation, and report on its methods, data, and results. The evaluation could either be a trial-based or model-based cost-minimization analysis (CMA), cost-effectiveness analysis (CEA), cost-consequence analysis (CCA), cost-utility analysis (CUA), cost-benefit analysis (CBA), or budget impact analysis (BIA). Publications not mentioning or performing such analyses but still investigating economic and/or health aspects and comparing POCT with an alternative without POCT, were also included (if they met the other criteria). Editorials, letters, methodological/protocol articles, and reviews were excluded.

Setting: the intervention could be evaluated in any country, as long as it was applied in a primary care or secondary care setting. Publications describing a POC test evaluation in an at-home or self-monitoring setting were excluded.

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