New Protocol for Pioneering UTI Diagnostics Study

A newly published protocol paper from researchers including Trinity College academics outlines an innovative approach to evaluating rapid diagnostic tests for urinary tract infections (UTIs).

The TOUCAN (plaTform fOr Urinary tract infection diagnostiC evAluatioN) study is led by a group including Professorial Fellow Christopher Butler and Associate Member Philip Turner of Oxford’s Nuffield Department of Primary Care Health Sciences NIHR HealthTech Research Centre in Community Healthcare, under Chief Investigator Prof Gail Hayward. The study represents a significant shift in how new diagnostic technologies are evaluated for primary care use.

The study, which has already recruited more than a thousand patients across primary care sites in England, is evaluating technologies including the Sysmex PA-100 AST System – winner of the £10 million Longitude Prize for rapid diagnostics to combat antimicrobial resistance. The PA-100 system aims to provide results within 15 - 45 minutes, potentially enabling evidence-based prescribing decisions during a single consultation.

The need for better diagnostic tools for acute UTI is pressing. Around half of all women experience a UTI in their lifetime, with a quarter of infections associated with antibiotic resistant organisms. Current testing methods are either too inaccurate or take days to provide results and can be confounded by sample contamination, so contribute little to immediate decision making.

The protocol's publication in BMJ Open details innovative aspects of the study design, including A flexible ‘Platform’ structure allowing new diagnostic technologies to be added as they become available, collection of qualitative data on clinician experiences of test use, and evaluation of both diagnostic accuracy and real-world implementation considerations
Study lead Dr Turner says: ‘The platform approach isn't just about efficiency; by evaluating these technologies in real primary care settings, with real clinical users, we can understand not just their accuracy but also their practical usability and implementation requirements. This is crucial information for both clinicians and commissioners.’

The TOUCAN platform continues to welcome discussions with diagnostic companies developing rapid UTI tests. The study team is also exploring how this innovative platform approach could be applied to diagnostic evaluation in other clinical areas.