Point-of-Care-Testing
The term point-of- care testing or short POCT to German near-patient laboratory diagnostics, referred to in the medical diagnostic tests that are not in a central laboratory, but in the hospital directly to the infirmary, in the practice of a medical practitioner, or a public pharmacy be performed. In certain situations such as emergencies, a use outside of such a device is possible, for example, in the home of patients or in an ambulance.
In some studies, an application by the patient is self- provided, for example, pregnancy tests, the coagulation self- management or blood glucose monitoring by diabetics.
In a broader sense, the term point-of- care testing is also used for corresponding diagnostic methods in other application areas, such as in the food and environmental analysis. Frequently used German language descriptions for such investigations are on-site tests or rapid tests.
Definition
A uniform definition of point-of - care testing does not exist. Typical properties of the near-patient laboratory diagnostics, however, are:
- Carrying out laboratory tests in the immediate vicinity of the patient, outside a central laboratory ( bed-side testing).
- No sample preparation, in particular no pipetting, the test material is usually so full of blood, urine or saliva.
- Ready to use reagents (ready-to -use), for example in tank or cassette form.
- Measuring devices that are intended for single sample measurement.
- No detailed medical - technical training to use necessary.
- Rapid availability of results.
- From the results of a diagnostic or therapeutic consequence is drawn directly.
Typical rapid tests are used for example in the
- Examination of frying fat on corruption
- PH measurement with indicator strips or indicator solution additive
- Measurement of chlorine content in drinking water or nitrate
Benefits
Point-of- care tests have the advantage that the results are available within a short time, because on the one hand, the transport of samples is accounted for by a specialized laboratory and must be taken to another without regard to the temporal sequences of the laboratory. The so-called turn-around -time ( TAT), ie the time that elapses until the result is available, often between 5 and 15 minutes. It is thus well below the achievable even under optimal conditions in the central laboratory TAT.
This time advantage is especially important in areas where quick decisions must be made on the basis of laboratory values. Therefore POCT is used mainly in intensive care units and in anesthesia, but also in outpatient clinics or in dialysis. In general, there are so- called emergency parameters, such as electrolytes, blood gas and blood coagulation, kidney function tests, cardiac enzymes, and other readings. However, urine tests, creating a blood count or the rapid detection of pathogens or autoimmune diseases such as rheumatoid arthritis are possible with the help of point- of-care methods.
Many point-of- care tests are designed as the test strip and the manual effort is reduced for the implementation at a minimum. Also measuring units for a Point - of-care use are almost completely automated and usually require from sample preparation to the test result only a few simple user interaction.
Limitations
Disadvantages of Point - of-care tests are mainly the higher reagent costs and often methodologically related lower analytical sensitivity (sensitivity ) and specificity ( accuracy). Also, the sample throughput is significantly lower than the corresponding laboratory methods in general. In addition, there are appropriate rapid test methods are available for only some parameters.