Molecular Test Insights in Shared Decision-Making for Managing Respiratory Infections

Zachary N. Goldberg, MD; Maren S. Fragala, PhD; Azia Evans, PhD; Steven E. Goldberg, MD, MBA • November 20, 2025

A new paper published in the Journal of Participatory Medicine describes how providers can offer more collaborative care for the treatment of respiratory infections by integrating the results from molecular testing into a shared decision-making approach. This approach can aid providers in enhancing health care delivery, improving patient outcomes, while enhancing diagnosis and treatment in various clinical settings.

Recent innovations in molecular diagnostics have transformed the evaluation of infectious diseases in outpatient care. These tests provide:

• Faster turnaround times, often with results in under 24 hours
• Greater diagnostic accuracy
• Parallel testing for multiple pathogens at once
• More targeted treatment decisions based on the specific organisms detected

By providing precise and timely information, molecular testing gives clinicians a clearer foundation for treatment decisions and opens the door to better alignment with patient preferences during the encounter.

Shared decision-making brings together clinical expertise and the patient’s values, concerns, and preferences to reach a mutually agreed-upon treatment plan. However, without accurate diagnostic information, these conversations can be limited.

Modern molecular diagnostics help overcome this barrier by offering concrete evidence that supports:

• Prescribing appropriate antibiotics based on test results
• Avoiding unnecessary antibiotic prescriptions
• Selecting the most appropriate treatment based on confirmed pathogens

When clinicians combine molecular results with shared decision-making, patients gain a clearer understanding of their condition, feel more engaged in their care, and are more likely to adhere to treatment recommendations. This approach promotes responsible prescribing practices, strengthens patient trust, and supports improved clinical outcomes.

To fully realize the benefits of integrating molecular testing into shared decision-making, supportive policies and accessible infrastructure are critical. Key considerations include:

• Ensuring equitable access to accurate and timely diagnostic testing, regardless of socioeconomic status or insurance coverage
• Embedding shared decision-making training into clinical education, particularly within antibiotic stewardship programs
• Helping clinicians translate test results into clear, patient-centered language that supports informed choices

These system-level measures can further strengthen responsible antibiotic use and enhance the patient experience.