Chapter 21 - Point-of-care testing

Abstract

Point-of-care testing (POCT) also known as near patient testing is analysis of patient’s specimen near or at the site of patient care outside the clinical laboratory. Point-of-care diagnostics provide clinicians access to rapid and actionable diagnostic results at or near the site of patient care to facilitate faster treatment decision-making. POCT devices are used in emergency department, physician’s office, pain management clinic, or even roadside for identifying drunk drivers using breath alcohol analyzer. POCT can also be used in a clinical laboratory, for example, rapid pregnancy test or blood gas analysis. In addition, POCT devices may be used by a patient for home monitoring, for example, blood glucose and hemoglobin A1c. Moreover, sending specimen to a clinical laboratory for analysis of same analyte that can be performed using POCT device may cause significant delays in turnaround time. For example, turnaround time for cardiac troponins is recommended to be less than 1h when specimens are sent to clinical laboratory. Therefore POCT of cardiac troponin I is useful in emergency department for rapid analysis and quick decision-making; whether patient should be admitted or discharged. It is important to note that POCT does not replace clinical laboratory where higher precision and accuracy could be achieved compared with POCT, but complement clinical laboratory when availability of rapid results can benefit patient care. Moreover, POCT is not available for many laboratory tests and when available, results obtained by such device must be correlated with results obtained in clinical laboratory (gold standard).