From Fixed to Flexible Syndromic (Flex™) Testing: Lessons from Norton et al. on Advancing Respiratory Diagnostics

By Diasorin Product Management

“The flexibility in designing respiratory viral (and bacterial) testing tiers is expected to save staff time and reagent costs while increasing the clinical diagnostic yield.” — Norton et. al., Journal of Clinical Microbiology, June 2025 

In a time of rising costs and staffing shortages, clinical labs need smarter, more efficient diagnostics. The June 2025 Journal of Clinical Microbiology study by Norton et al.1 offers a compelling case for moving from traditional fixed syndromic panels to flexible syndromic testing using the LIAISON PLEX® Respiratory Flex Assay (RSP Flex).

Why flexible syndromic testing matters

Many suppliers offer fixed panel systems that do not allow for target customization or flexible pricing. These systems require labs to test—and pay for—the full panel, regardless of clinical need. Additionally, they are often utilized as reflex testing after initial influenza, RSV, and SARS-CoV-2 testing, repeating steps that consume staff time and force patients to pay twice for redundant results.

In contrast, the LIAISON PLEX RSP Flex allows on-the-fly custom panel creation and flexible pricing all on a single instrument, and labs pay only for reported results. Furthermore, if the initial panel is negative, additional results can be instantly released from the same initial test run, and no additional sample processing is required. Norton et al. evaluated the LIAISON PLEX RSP Flex against a standard two-step, fixed panel algorithm, showing that the test offers equivalent performance with far greater efficiency and customization.

Key findings from the study

  • High Accuracy: The LIAISON PLEX RSP Flex demonstrated 90% positive, and 98% negative agreement compared to the cobas® eplex Respiratory Pathogen Panel 2. Additionally, BioFire® Respiratory 2.1 agreed with the LIAISON PLEX RSP Flex for 3 out of the 5 discrepant results.
  • Improved Diagnostic Yield: Adding enterovirus/rhinovirus to a core panel can improve yield from 12.5% to nearly 26%.
  • Simple Customization: The LIAISON PLEX RSP Flex makes adding relevant targets (like enterovirus/rhinovirus) easy, unlike fixed panels, which cannot be customized.
  • Operational Efficiency: Using the LIAISON PLEX RSP Flex could eliminate over 92 hours (5,545 minutes) of staff time per respiratory season by avoiding repeat testing and second swabs.
  • Cost Control: The LIAISON PLEX RSP Flex helps reduce waste by enabling targeted testing based on seasonal trends and clinical presentation (i.e., only pay for what you report).
    • In a peer-reviewed study, it was demonstrated that including the five most prevalent targets can capture >76% of all positive results.2

Diagnostic stewardship in action

The LIAISON PLEX RSP Flex empowers labs to begin with a streamlined panel of up to seven targets and instantaneously expand testing only when clinically necessary—no retesting, no double billing, and no waste. This flexibility enhances patient care while aligning with diagnostic stewardship goals.

Ready to Step Away from “All-or-Nothing” Panels?

The Norton et al. study concludes that the LIAISON PLEX RSP Flex matches the performance of fixed panels while offering customizable panels, reduced labor, and improved diagnostic outcomes. No longer locked into overbuilt panels or forced to reflex test to uncover the root cause of infection, you can instead align testing with local pathogen trends and clinical needs while reducing costs by only paying for what you choose to report.

In a healthcare environment demanding more with less, the LIAISON PLEX RSP Flex is not just a feature—it’s a strategic advantage.

Get the details—read the paper now.

 

Citations:

  1. Norton JM, Dashler G, Klein E, Mostafa HH. The utility of syndromic respiratory pathogen panels: the premise of flexible and customizable approaches. J Clin Microbiol. 2025;0(0):e00313-25. doi:1128/jcm.00313-25.
  2. Gonzalez K., Amicarelli G. Age-Stratified Epidemiology of Respiratory Pathogens and the Value of Customizable Syndromic Testing Using the LIAISON PLEX Respiratory Flex Assay. J Mol Diagn. 2025 Jun 26:S1525-1578(25)00142-4. doi: 10.1016/j.jmoldx.2025.05.009.