Point Of Care Tool Research Articles

Selective laser sintering at the Point-of-Care 3D printing laboratory in hospitals for cranio-maxillo-facial surgery: A further step into industrial additive manufacturing made available to clinicians

Additive manufacturing has developed rapidly in recent years and has many useful applications in the clinical field. In particular, cranio-maxillo-facial (CMF) surgery requires high precision, which can be obtained with 3D printed patient-specific surgical guides and anatomical models. Among the many different printing options, selective laser sintering (SLS) seems to be rarely used in point-of-care applications, considering its apparent characteristics.This article examines the advantages and disadvantages of SLS printers for CMF point-of-care (PoC) by reviewing the literature and comparing in-house printed SLS and stereolithography (SLA) prints.The investigation showed that the easily sterilizable and robust materials processed by SLS printing are well suited for CMF surgical guides and have clear advantages over SLA parts.Some barriers to the use of SLS printers in PoC are likely to be the slightly higher complexity and cost.However, these will decrease as 3D printing technology advances and surgeon acceptance increases, making SLS a practical PoC tool.

Current approach to muscle imaging in myositis.

Muscle imaging is commonly utilized in idiopathic inflammatory myopathies (IIM) for diagnostic evaluation, selection of muscle biopsy site, and differentiating between disease activity versus damage. In this review, we discuss the current state and recent developments in the use of muscle imaging modalities including muscle magnetic resonance imaging (MRI), ultrasound (US), and positron emission tomography (PET) scan. Muscle MRI is a clinically useful tool in evaluation of IIM with studies showing good correlations between pattern of morphological changes on MRI and histopathological findings on muscle biopsy. The use of computer aided diagnostics to enable quantification of muscle pathology will be a welcome development for future studies and trials. New studies highlight that muscle US could be a particularly useful point of care tool in longitudinal monitoring of patients with active myositis. Muscle FDG-PET scan shows inflammatory activity in IIM muscle and can also provide additional information on extra-muscular manifestations and cancer screening. Utilization of novel tracers is an exciting development for IIM evaluation. Muscle MRI remains the gold standard for muscle imaging in IIM. Growing literature on muscle US and PET scan highlight their promising applications in IIM.

Improving Diabetes Management Screening Adherence in a Free Clinic

Uninsured people with diabetes are at-risk for inconsistent disease management and complications that are identifiable through disease management screenings. Electronic point-of-care (POC) tools can improve screening adherence but are not always available in settings with limited resources. This nurse practitioner-led quality improvement project aimed to increase the percentage of free clinic patients with diabetes who were up-to-date with disease management screenings by implementing a paper POC tool and workflow. Adherence with all 8 screenings on the POC tool increased from 0% to 15.7% over 6 months. Nurse practitioner-led projects improve health equity and quality for at-risk populations.

2023 in Health Libraries

2023 in numbers, more numbers, point of care tools, collegial banter, quotes, and journal content.

Enhancing classical swine fever virus identification: the advantages of Field-LAMP testing.

Classical swine fever virus (CSFV) identification has witnessed significant advancements with the development of rapid reverse-transcription loop-mediated isothermal amplification (RT-LAMP) assays. However, conventional RT-LAMP assays for CSFV diagnosis are hindered by a laborious RNA extraction step. Moreover, the need for thermal incubators and expensive micropipettes has limited their application in field settings. Addressing these challenges, our study presents a groundbreaking solution-an electro-free and point-of-care (POC) tool known as the field-LAMP assay-for the rapid clinical detection of CSFV. By eliminating the RNA extraction requirement, advancing the colorimetric read-out and lyophilized reaction reagents, our field-LAMP assay streamlines the diagnostic process, saving valuable time and effort. This novel approach also overcomes the dependency on electric-dependent thermal incubators and expensive micropipettes, making it practical and accessible for use in the field. The successful development of the field-LAMP assay marks a significant milestone in CSFV detection. This electro-free and POC tool offers several advantages, including its ability to deliver rapid results without compromising accuracy, facilitating prompt response and containment measures.

Sequential Flow Controllable Microfluidic Device for G-Quadruplex DNAzyme-Based Electrochemical Detection of SARS-CoV-2 Using a Pyrrolidinyl Peptide Nucleic Acid.

The coronavirus disease 2019 (COVID-19) pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has been a significant health issue globally. Point-of-care (POC) testing that can offer a rapid and accurate diagnosis of SARS-CoV-2 at the early stage of infection is highly desirable to constrain this outbreak, especially in resource-limited settings. Herein, we present a G-quadruplex DNAzyme-based electrochemical assay that is integrated with a sequential flow controllable microfluidic device for the detection of SARS-CoV-2 cDNA. According to the detection principle, a pyrrolidinyl peptide nucleic acid probe is immobilized on a screen-printed graphene electrode for capturing SARS-CoV-2 DNA. The captured DNA subsequently hybridizes with another DNA probe that carries a G-quadruplex DNAzyme as the signaling unit. The G-quadruplex DNAzyme catalyzes the H2O2-mediated oxidation of hydroquinone to benzoquinone that can be detected using square-wave voltammetry to give a signal that corresponds to the target DNA concentration. The assay exhibited high selectivity for SARS-CoV-2 DNA and showed a good experimental detection limit at 30 pM. To enable automation, the DNAzyme-based assay was combined with a capillary-driven microfluidic device featuring a burst valve technology to allow sequential sample and reagent delivery as well as the DNA target hybridization and enzymatic reaction to be operated in a precisely controlled fashion. The developed microfluidic device was successfully applied for the detection of SARS-CoV-2 from nasopharyngeal swab samples. The results were in good agreement with the standard RT-PCR method and could be performed within 20 min. Thus, this platform offers desirable characteristics that make it an alternative POC tool for COVID-19 diagnosis.

Emerging Trends and Recent Progress of MXene as a Promising 2D Material for Point of Care (POC) Diagnostics.

Two-dimensional (2D) nanomaterials with chemical and structural diversity have piqued the interest of the scientific community due to their superior photonic, mechanical, electrical, magnetic, and catalytic capabilities that distinguish them from their bulk counterparts. Among these 2D materials, two-dimensional (2D) transition metal carbides, carbonitrides, and nitrides with a general chemical formula of Mn+1XnTx (where n = 1-3), together known as MXenes, have gained tremendous popularity and demonstrated competitive performance in biosensing applications. In this review, we focus on the cutting-edge advances in MXene-related biomaterials, with a systematic summary on their design, synthesis, surface engineering approaches, unique properties, and biological properties. We particularly emphasize the property-activity-effect relationship of MXenes at the nano-bio interface. We also discuss the recent trends in the application of MXenes in accelerating the performance of conventional point of care (POC) devices towards more practical approaches as the next generation of POC tools. Finally, we explore in depth the existing problems, challenges, and potential for future improvement of MXene-based materials for POC testing, with the goal of facilitating their early realization of biological applications.

The potential of point-of-care diagnostics to optimise prehospital trauma triage: a systematic review of literature

PurposeIn the prehospital care of potentially seriously injured patients resource allocation adapted to injury severity (triage) is a challenging. Insufficiently specified triage algorithms lead to the unnecessary activation of a trauma team (over-triage), resulting in ineffective consumption of economic and human resources. A prehospital trauma triage algorithm must reliably identify a patient bleeding or suffering from significant brain injuries. By supplementing the prehospital triage algorithm with in-hospital established point-of-care (POC) tools the sensitivity of the prehospital triage is potentially increased. Possible POC tools are lactate measurement and sonography of the thorax, the abdomen and the vena cava, the sonographic intracranial pressure measurement and the capnometry in the spontaneously breathing patient. The aim of this review was to assess the potential and to determine diagnostic cut-off values of selected instrument-based POC tools and the integration of these findings into a modified ABCDE based triage algorithm.MethodsA systemic search on MEDLINE via PubMed, LIVIVO and Embase was performed for patients in an acute setting on the topic of preclinical use of the selected POC tools to identify critical cranial and peripheral bleeding and the recognition of cerebral trauma sequelae. For the determination of the final cut-off values the selected papers were assessed with the Newcastle–Ottawa scale for determining the risk of bias and according to various quality criteria to subsequently be classified as suitable or unsuitable. PROSPERO Registration: CRD 42022339193.Results267 papers were identified as potentially relevant and processed in full text form. 61 papers were selected for the final evaluation, of which 13 papers were decisive for determining the cut-off values. Findings illustrate that a preclinical use of point-of-care diagnostic is possible. These adjuncts can provide additional information about the expected long-term clinical course of patients. Clinical outcomes like mortality, need of emergency surgery, intensive care unit stay etc. were taken into account and a hypothetic cut-off value for trauma team activation could be determined for each adjunct. The cut-off values are as follows: end-expiratory CO2: < 30 mm/hg; sonography thorax + abdomen: abnormality detected; lactate measurement: > 2 mmol/L; optic nerve diameter in sonography: > 4.7 mm.DiscussionA preliminary version of a modified triage algorithm with hypothetic cut-off values for a trauma team activation was created. However, further studies should be conducted to optimize the final cut-off values in the future. Furthermore, studies need to evaluate the practical application of the modified algorithm in terms of feasibility (e.g. duration of application, technique, etc.) and the effects of the new algorithm on over-triage. Limiting factors are the restriction with the search and the heterogeneity between the studies (e.g. varying measurement devices, techniques etc.).

UCP-LF and other assay methods for schistosome circulating anodic antigen between 1978 and 2022.

Detection of circulating anodic antigen (CAA) is known for its high sensitivity in diagnosing schistosomiasis infection, even in low-prevalence settings. The Up-Converting Phosphor-Lateral Flow (UCP-LF) assay developed in 2008 presented greater sensitivity than other assay methods in use for CAA detection. Our study aims to comprehensively review all studies conducted in this area and thus generate informed conclusions on the potential for adopting the UCP-LF assay for diagnosing this important yet neglected tropical disease. Using the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA) guidelines, we generated search criteria to capture all studies in English journals available in the Scopus and PubMed databases on 20 December 2022. A total of 219 articles were identified, and 84 that met the inclusion criteria were retrieved and eventually included in the study. Twelve different assay methods were identified with a noteworthy transition from enzyme-linked immunosorbent assay (ELISA) to the UCP-LF assay, a laboratory-based assay that may be applicable as a point-of-care (POC) diagnostic test for schistosomiasis. Reducing the time, cost, and dependence on specialized laboratory skills and equipment, especially relating to the trichloroacetic acid extraction step and centrifugation in the UCP-LF CAA assay may go a long way to aid its potential as a POC tool. We also propose the development of a CAA-specific aptamer (short protein/antigen-binding oligonucleotide) as a possible alternative to monoclonal antibodies in the assay. UCP-LF has great potential for POC application.

A comparative evaluation of three point-of-care tools by registered nurses.

This study compared three point-of-care tools (PoCTs) to determine which PoCT was rated highest based on key features and characteristics by registered nurses. The PoCTs reviewed were Nursing Reference Center Plus, ClinicalKey for Nursing, and UpToDate. Nurses were asked to use each PoCT to answer three clinical questions and then rate their experience based on the following areas: currency, relevancy, layout, navigation, labeling, and use of filters. They were also asked to indicate their familiarity with each PoCT, their overall opinions, and demographic information. Seventy-six nurses completed the entire survey. Ratings of PoCTs did not differ by participant characteristics. Participants were most familiar with UpToDate, and average ratings were similar across all three PoCTs. Answers to open-ended questions suggested that nurses' experiences searching and locating relevant information to address clinical questions varied and that brand recognition might have impacted preference. None of the PoCTs was significantly preferred over the others, nor received high ratings, which suggests that organizations need to survey their nurses to determine which PoCT is preferred by their staff. Findings also suggest that institutional priorities can guide the decision whether a library should license multiple PoCTs, nursing, and/or non-nursing specific PoCTs. Research is needed to understand how PoCTs could better meet the information needs of registered nurses. Librarians should learn more about what types of information nurses are seeking and explore opportunities to educate nurses on how to better utilize PoCTs for their practice.

Improving Cancer Care in the HIV Population: Qualitative Research to Identify Provider Knowledge, Attitudes and Practices

<h3>Purpose/Objective(s)</h3> Cancer patients living with HIV are less likely to receive cancer treatment and have worse cancer survival than HIV-uninfected patients. There is minimal published data exploring drivers of the disparity and even less on mitigation strategies. We aimed to explore clinician cancer treatment decision-making for patients living with HIV, focusing on oncologist knowledge, attitudes, and practices. <h3>Materials/Methods</h3> We conducted semi-structured in-depth interviews with 25 medical, radiation, and surgical oncologists from two academic medical centers and several community practices. Participants were eligible if they recently had a consultation with a patient with both HIV and cancer as assessed through medical record review at the academic centers and by self-report for community practices. The interview guide explored oncologist attitudes, stigma, knowledge, and practices during the cancer treatment decision-making process. We audio recorded and transcribed interviews and analyzed data using an open, iterative analysis approach with ATLAS.ti. <h3>Results</h3> Study participants were 32% medical oncology, 40% radiation oncology, and 28% surgical oncology. Most (64%) were within 15 years of terminal training and between 30 and 49 years of age (84%). Many (n=14) participants described knowledge gaps on HIV-specific education during medical school and subsequent oncology training as an impediment to providing optimal care to people with HIV. Oncologists noted that patients often had financial, logistic, and psychosocial challenges that were not adequately addressed in the clinical setting. Although oncologists themselves felt comfortable discussing HIV, some (n=8) reported concerns regarding inadvertent HIV disclosure resulting in stigma from patient companions or caregivers unaware of the HIV diagnosis. Less than half of oncologists (n=11) reported collaborating with the patient's HIV care team before and during cancer therapy. <h3>Conclusion</h3> This qualitative study of oncologists in the US demonstrates that oncologists face challenges when caring for people with HIV. Point of care tools, particularly those geared towards enhancing oncologist education and connection with other care teams such as HIV/infectious diseases and social work, may enhance cancer care and reduce cancer disparities for people living with HIV.

Radiographic Identification of Cardiac Implantable Electronic Device Manufacturer: Smartphone Pacemaker-ID Application Versus X-ray Logo.

Radiographic identification of the cardiac implantable electronic device (CIED) manufacturer facilitates urgent interrogation of an unknown CIED. In the past, we relied on visualizing a manufacturer-specific X-ray logo. Recently, a free smartphone application (“Pacemaker-ID”) was made available. A photograph of a chest X-ray was subjected to an artificial intelligence (AI) algorithm that uses manufacturer characteristics (canister shape, battery design) for identification. We sought to externally validate the accuracy of this smartphone application as a point-of-care (POC) diagnostic tool, compare on-axis to off-axis photo accuracy, and compare it to X-ray logo visualization for manufacturer identification. We reviewed operative reports and chest X-rays in 156 pacemaker and 144 defibrillator patients to visualize X-ray logos and to test the application with 3 standard (on-axis) and 4 non-standard (off-axis) photos (20° cranial; caudal, leftward, and rightward). Contingency tables were created and chi-squared analyses (P < .05) were completed for manufacturer and CIED type. The accuracy of the application was 91.7% and 86.3% with single and serial application(s), respectively; 80.7% with off-axis photos; and helpful for all manufacturers (range, 85.4%–96.6%). Overall, the application proved superior to the X-ray logo, visualized in 56% overall (P < .0001) but varied significantly by manufacturer (range, 7.7%–94.8%; P < .00001). The accuracy of the Pacemaker-ID application is consistent with reports from its creators and superior to X-ray logo visualization. The accuracy of the application as a POC tool can be enhanced and maintained with further AI training using recent CIED models. Some manufacturers can enhance their X-ray logos by improving placement and design.

Microfluidic Paper-Based Preconcentration and Retrieval for Rapid Ribonucleic Acid Biomarker Detection and Visualization.

Microfluidic paper-based analytical devices (μPADs) have attracted significant attention in the field of point-of-care (POC) diagnostics. However, the heterogeneous structure of the paper often impairs the limit of detection (LOD) for low-abundance targets when those targets are directly analyzed. One viable solution to bypass this limitation is to elevate the target concentration above the LOD on-site to reach a valid readout. Here, we developed a 3D μPADs preconcentrator (3D-μP2) to increase sample concentration by electrokinetic trapping and demonstrated its application in increasing the LOD of a downstream colorimetric assay. The three-dimensional (3D) structure of this device was composed of a loading pad, a vertical fluid path formed by stacked absorbent pads, and an ion-selective membrane of PEDOT:PSS. This novel design facilitates fast preconcentration, high capacity in sample processing, and easy target retrieval. The concentration of an exemplary target, a single-stranded DNA sequence, was increased up to 170-fold within 80 s. The LOD of the colorimetric assay to verify the DNA target was increased 3 orders of magnitude with a preconcentrated sample compared to the control. The device and its analysis equipment used in this study were all cheap and portable. Thus, the 3D-μP2 can be a powerful POC tool for sample pretreatment in resource-limited areas.

732 Examining Staff Views and Perceptions After Implementation of a Laser Doppler Imaging Device Into Practice

IntroductionLaser doppler imaging (LDI) has been established as an accurate diagnostic tool to assess burn depth and measure healing potential. Despite this, its use in burn centers remain limited. While studies have examined challenges to LDI use, there is a paucity of literature factoring staff views and attitudes as a barrier to implementation into burn practice. The aim of this work was to assess and examine attitudes and perspectives following implementation of an LDI protocol into acute burn injury assessment.MethodsFollowing institutional approval, a 22-question survey was disseminated among staff involved with implementation of an LDI device as a point of care tool to assess acute burn injury at a single ABA verified burn center. The survey focused on questions examining device ease of use, understanding of the underlying LDI technology, interpretation of imaging generation from wounds, and perceptions of patients’ experience. Questions were answered on a standard 5-point Likert scale. All survey data was collected anonymously into an electronic database for assessment.ResultsOverall, there were 15 respondents to the survey questions. Five respondents found the LDI device difficult to use (33%). Barriers to device ease of use included difficulty with device movement (60%), incorporation of scanning into wound care and dressing placement (60%), and management of hardware or software issues that arise during use (60%). Challenges noted by respondents external to device use was mainly high patient census (80%). Despite this, 60% of respondents found the device easier to use after performing several scans in one or more patients and 60% found that scans generated matched their assessment of burn depth. Among respondents, 66% found patients amenable to the scanning process and 80% did not feel that that the scanning process worsened patients’ pain.ConclusionsChallenges in LDI device use, implementation with wound care and dressing placement, and high patient census were identified as barriers to LDI use. Despite this, ease of device use improved with more frequent use. Identification of views and perceptions such as these can lead to protocol changes and additional training that facilitate ease of LDI use. Further examination will be required to better elucidate this information.

Racial biases in healthcare: Examining the contributions of Point of Care tools and unintended practitioner bias to patient treatment and diagnosis.

Sophisticated algorithms are used daily to search through hundreds of medical journals in order to package updated medical insights into commercial databases. Healthcare practitioners can access these searchable databases-called Point of Care (PoC) tools-as downloadable apps on their smartphones or tablets to comprehensively and efficiently inform patient diagnosis and treatment. Because racist biases are unintentionally incorporated into the search reports that the companies generate and that practitioners regularly access, the aim of this article is to examine how healthcare practitioners' "pre-existing" racial stereotypes interact with pithy conclusions about race and ethnicity in PoC tools. I use qualitative research methods (content analysis, discourse analysis, open-ended semi-structured interviews, and role play) to frame the analysis within the Public Health Critical Race Praxis (PHCRP). This approach facilitates an understanding of how biological racism-the use of scientific evidence to support inherent differences between races-that is embedded in PoC algorithms informs a practitioner's assessment of a patient, and converges with persistent racial bias in medical training, medical research and healthcare. I contextualize the study with one semi-structured interview with an Editor of a leading PoC tool, MedScope (pseudonomized), and 10 semi-structured interviews with healthcare practitioners in S.E. Ontario, Canada. The article concludes that PoC tools and practitioners' personal biases contribute to racial prejudices in healthcare provision. This warrants further research on racial bias in medical literature and curriculum design in medical school.

Evaluation of different DNA extraction methods and loop-mediated isothermal amplification primers for the detection of Mycobacterium ulcerans in clinical specimens

BackgroundEarly diagnosis and treatment of Buruli ulcer is critical in order to avoid the debilitating effects of the disease. In this regard, the development of new diagnostic and point of care tools is encouraged. The loop-mediated isothermal amplification for the detection of Mycobacterium ulcerans represents one of the new tools with a good potential of being developed into a point of care test. There is however the need to standardize the assays, reduce sample preparation times, improve the detection/visualization system and optimize them for high-throughput screening, adaptable to low resourced laboratories.MethodsIn this study, we assessed two DNA extraction protocols (modified Boom and EasyNAT methods), three previously published LAMP primer sets (BURULI, MU 2404 and BU-LAMP), and compared the sensitivity and specificity of LAMP assays on three DNA amplification platforms.ResultsOur results show that Buruli ulcer diagnosis using primers targeting IS2404 for the LAMP method is sensitive (73.75–91.49%), depending on the DNA extraction method used. Even though the modified Boom DNA extraction method provided the best results, its instrumentation requirement prevent it from being field applicable. The EasyNAT method on the other hand is simpler and may represent the best method for DNA extraction in less resourced settings.ConclusionsFor further work on the development and use of LAMP tests for Buruli diagnosis, it is recommended that the BURULI sets of primers be used, as these yielded the best results in terms of sensitivity (87.50–91.49%) and specificity (89.23–100%), depending on the DNA extraction methods used.

Evaluation of the QUANTUM BLUE sCAL rapid test as a point of care tool to identify patients with peritonsillar abscess

S100A8/A9 (Calprotectin) serves as a biomarker for various inflammatory diseases, such as for peritonsillar abscess (PTA). Recently, the PTA score was developed for reliable PTA identification. It uses a combination of characteristic clinical symptoms and elevated calprotectin levels in serum and saliva to determine this score. Although well-established point-of-care tests (POCT) to determine serum or faecal calprotectin levels exist, a reliable and rapid tool to analyse salivary calprotectin has not yet been described. In this study, we analysed the potential of the QUANTUM BLUE sCAL Test (QBT, BÜHLMANN Laboratories AG, Switzerland) to determine S100A8/A9 levels during outpatient management. These QBT measurements are combined with other clinical factors to determine the PTA score. Significantly higher calprotectin levels were determined by QBT in patients with PTA compared to healthy controls. The receiver operating characteristic (ROC) curves for the QBT revealed cut-off values of 2940 ng/ml (sensitivity = 0.88, specificity = 0.78) in serum and 5310 ng/ml (sensitivity = 0.80, specificity = 0.50) in saliva. By adding the QBT results to determine PTA values, a ROC analysis provided a statistical cut-off score of 2.5 points to identify the existence of a PTA with a sensitivity of 100% and a specificity of 89.3%. The QUANTUM BLUE sCAL Test (QBT) is an appropriate POCT to determine serum and salivary calprotectin levels. Thus, PTA scores can be determined within a short time frame by applying the QBT during outpatient management.

Modern Medical Innovation on the Preferred Information about the Medicine using AI Technique

The number of mobile Medicare applications has grown exponentially over the past few years, and it is expected to continue to grow soon. The use of health apps promises to be a good way to improve patient care and make work easier for professional. However, some cases of malfunction or misdiagnosis and treatment recommendations have been reported. Regulation is essential to protect users and support product development. So, to suppress the malfunctions we present a pharmacopeia Medicare app in which the customer can see the original profile and the specification of any stimulant with its useful information. This inculcates a clean process which procures a less chance of misapplication of the drugs. These mobile medical app companies have improved access to clinical references and point of care tools. However, it is difficult to identify mobile medical apps that are suitable for the practice of pharmacy. This app is entirely based on our experience in accrediting websites with health-related content and journal.

BMJ Best Practice

BMJ Best Practice is an evidence-based point of care tool that helps support clinical decisions by providing the latest and highest quality research available to clinicians. The target audience for this resource is anyone delivering health care services. Currently, BMJ Best Practice is available as an institutional subscription in the United States. The resource includes clinical summaries based on the latest evidence, drug information, clinical calculators, evidence-based tool kits, and patient leaflets. The content provided goes through a rigorous editorial process by expert reviewers who have been required to disclose any financial conflicts. This process can however be relatively time consuming therefore updates that do not pose an immediate harm to patient care could potentially take anywhere from 1 to 3 months to be reflected in the clinical topic overviews. Overall, the tools and content provided on the platform are reliable and easy to navigate for the end user.

Physician Awareness and Adherence to Clinical Practice Guidelines in the Diagnosis of Vaginitis Patients: A Retrospective Chart Review.

Vaginitis is one of the main causes of primary care and gynecological visits in the United States. The most common infectious causes are bacterial vaginosis (BV), vulvovaginal candidiasis (VVC), and trichomoniasis. A physician survey was conducted to measure awareness of vaginitis clinical guidelines and availability of in-office point-of-care (POC) diagnostic tools. Participants were asked to perform a chart review to evaluate diagnostic practices for their symptomatic vaginitis patients. A total of 333 physicians and 984 patient charts were included. Physicians were most familiar with VVC and BV diagnostic guidelines; fewer than half were aware of current trichomoniasis guidelines. Although access to POC tools used to evaluate and diagnose vaginitis varied by practice, there was limited access to all 3 tools (microscope, pH test strips, potassium hydroxide solution) required to perform a full Amsel workup for BV (47% obstetricians/gynecologists vs. 32% primary care physicians, P < .05). Based on guidelines, 66% of patients evaluated for VVC, 45% of patients evaluated for BV, and 17% evaluated for trichomoniasis received an optimal workup. Among trichomoniasis positive patients, 75% received chlamydia/gonorrhea testing, 42% were tested for HIV, partner therapy was noted in 59% of cases, and 47% returned to be retested within 3 months. Limited awareness of recommended diagnostic practices and lack of access to POC tools contributed to broad guideline nonadherence. This study demonstrates that clinicians commonly fall short of current guidelines and suggests the need for lab-based assessments and appropriate insurance coverage to fill the present diagnostic void.