The results have to be available quickly to allow instant therapeutic action. For example, viscoelastic coagulation tests, described below in this article as “Type 4” POCT, are to be performed near the patient in cases of active bleeding. ![]() A generally accepted definition of POCT is still under debate. However, there is a continual transition between POCT and laboratory-based methods. No previous knowledge in sample analysis should be required. All outpatient or ward personnel will be expected to be able to use these analyzers. POCT is mainly characterized by proximity to the patient, quantitative or semi-quantitative single measurements, short turnaround time, no sample preparation, no pipetting, use of pre-made reagents, user-friendly dedicated analytical instruments and instant, result-deduced therapeutic action. Clinical pathology as a discipline needs to be responsible for this field, since adherence to quality-management systems ensures accurate, reliable biochemical-test results for optimal patient care and safety, regardless of whether the individual test is performed in a central laboratory or as POCT at the bedside. This growth is supported by new analytical technologies amalgamating issues (e.g., miniaturization, nanoparticle techniques, multiplexing, wireless connectivity, and novel biomarkers). Nevertheless, it is not difficult to predict that there will be growth in the development of POCT diagnostics for parameters that are at present available only in central laboratories. However, there is still a paucity of evidence supporting the use of POCT and improved patient outcomes. However, this type of diagnosis is only useful if the results produced lead to immediate therapeutic decisions. It is clear that the use of POCT shortens the time between sample acquisition and analysis (turnaround time). There are analytical devices available that make it possible to process a whole blood sample in a simple manner, allowing untrained staff to carry out laboratory diagnostics. This modern variety of laboratory medicine is characterized by minimizing instrument size and procedures and the increasing use of current information technology. In contrast to this centralization and increased efficiency in laboratory diagnostics, there has been a recent trend towards a more decentralized diagnostic analysis, so-called point-of-care testing (POCT), which occurs directly at patients’ beds, in operating theatres or outpatient clinics, or at sites of accidents. Laboratory medicine is therefore a vital component in differential diagnosis in the clinic and in local general practice.Īn affordable, competent system of laboratory diagnostics, in the doctor’s office and hospital, has been made possible through centralization of analysis in purpose-built laboratories or in facilities provided by large hospitals. But, even today, it can be assumed that, for certain applications, near-patient testing is a useful complement to conventional laboratory analyses.Ī large number of laboratory analyses support correct diagnosis in over 50% of all diseases, in addition to aiding the monitoring of drug therapy in many other cases. However, future utilization of POCT also depends on health-care trends and new areas of application. If new instruments are not yet in practical use, it is often hard to decide whether the underlying analytical principle has real advantage over former methods. ![]() ![]() We review the underlying analytical techniques. Recent, evolving technological advances enable the development of novel POCT instruments. Improved medical outcome and lower costs may ensue. POCT shortens the time to clinical decision-making about additional testing or therapy, as delays are no longer caused by transport and preparation of clinical samples, and biochemical-test results are rapidly available at the point of care. ![]() At present, POCT ranges from basic blood-glucose measurement to complex viscoelastic coagulation assays. In this review, we first describe the state of the art of medical-laboratory tests that can be performed near the patient. Point-of-care testing (POCT) is a laboratory-medicine discipline that is evolving rapidly in analytical scope and clinical application.
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