Point Of Care Tool Research Articles

1934P Research and contextual inquiry on information and communication technologies point of care systems for cancer follow-up

Cancer-related mortality has been decreasing in the last years, meaning that over 50% adult cancer patients are expected to survive for at least five years. Managing follow-up (FU) guidelines is a critical and indispensable activity in oncology. Timing and precision in the decision-making process impact on the long-term healthiness of cancer patients. In this sense, information and communication technologies (ICT) are essential to support clinicians in the cancer patients´ FU. This work presents the outcomes from a research work conducted for Point of Care (PoC) systems applied in cancer FU. The CeHRes (Center for eHealth Research and Disease Management) roadmap has been applied. From this, we conducted the first phase named Contextual inquiry: (1) a scoping review was carried out on the existing solutions following PRISMA guidelines; (2) recommendations from 7 experts (oncologists, technician, psychologist, epidemiologist) have been analyzed; (3) market research has been conducted on existing PoC systems and tools within eHealth market; and (4) the stakeholders have been identified by analyzing the results from the first 3 steps. A survey has been designed to verify and understand these results. The structure of the form includes i) explanation of the goal and methods; ii) profile questions; iii) questions to confirm the results. The Contextual inquiry results with around 30% of tools dedicated only to the FU phase. Regarding technology, there is a trend in the development of web-based solutions, 52% of tools analyzed are web-based. The tools generally include features such as dashboards, decision making support, data exploration and electronic health record integration. 13 stakeholders were identified, being the main beneficiaries clinicians, patients, nurses and hospital staff. This work shows currently available ICT options to support clinical practice, and reveals actual needs. The results show the lack of specialized FU tools. Besides, very few of them include a system of alerts or the possibility of customizing a personalized FU. Also, tailoring data visualization is missing in most of the existing tools. The survey would verify the results and the unmet needs identified in this work.

Current diagnostic tools for coronaviruses-From laboratory diagnosis to POC diagnosis for COVID-19.

The Coronavirus‐2019 (COVID‐19) pandemic has put tremendous strain on healthcare systems worldwide. It is challenging for clinicians to differentiate COVID‐19 from other acute respiratory tract infections via clinical symptoms because those who are infected display a wide range of symptoms. An effective, point‐of‐care (POC) diagnostic tool could mitigate healthcare system strain, protect healthcare professionals, and support quarantine efforts. We believe that a POC tool can be developed that would be rapid, easy to use, and inexpensive. It could be used in the home, in resource‐limited areas, and even in clinical settings. In this article, we summarize the current state of COVID‐19 diagnostic methods and make a case for an all‐in‐one, highly sensitive POC assay that integrates antibody detection, protein detection, and serum cytokine detection to diagnose COVID‐19 infection. We believe this article will provide insights into the current state of diagnostics for COVID‐19, and promote additional research and tool development that could be exceptionally impactful.

The contested meanings of race and ethnicity in medical research: A case study of the DynaMed Point of Care tool.

Although the use of race and ethnicity for diagnostic purposes remains a controversial practice given the socially contingent meaning of the terms (Bowker and Star, 1999), health researchers continue to report possible relationships between health outcomes and race/ethnicity in the literature. As summaries of these types of studies are incorporated into commercial databases designed to provide medical practitioners with actionable information, there is a risk that the algorithms that drive the databases may unintentionally incorporate racist biases (O'Neil, 2016) in search reports that use race and ethnicity as query terms to identify findings to help in the diagnosis and treatment of particular patients. As a first step to unpacking this risk, we conducted a content analysis of the records and related citation trails in DynaMed's Point of Care (PoC) tool that refer to racial and ethnic research findings. Our analysis demonstrates that DynaMed does not control for how meanings of race and ethnicity are constructed in its entries, does not always accurately represent the nuanced and contingent nature of the findings about race/ethnicity that it cites, and relies on sources that are not always consistent with the 'evidence-based' criterion that the company self-promotes as a feature of its PoC tool. We conclude that, by failing to acknowledge the complex and contradictory ways that race and ethnicity may, or may not, correlate with the risk of a medical ailment, algorithmically-driven tools that use these concepts to establish group risks for medical ailments may unintentionally work to 'resuscitat[e] biological theories of race by modernizing old racial typologies that were based on observations of physical differences with cutting-edge genomic research' (Roberts, 2011: 567).

Predictive accuracy of duplex sonography vs. MRI in grading of neonatal hypoxic encephalopathy

Background: To evaluate the diagnostic accuracy of Doppler in neonates with hypoxic-ischemic encephalopathy (HIE) in correlation with MRI. Materials & Methods: During the period September 2017 to October 2019, term neonates with clinical evidence of HIE who underwent MRI were enrolled for the study. Two-dimensional duplex and color Doppler ultrasound were performed, resistive index of the middle cerebral artery was documented, and findings were correlated with MRI. Results: Of 40 consecutive neonates (29 boys and 11girls), 29 neonates with mild-moderate HIE, 7 neonates had severe HIE and 4 were normal. Accuracy of Duplex ultrasound in mild HIE is limited, however in neonates with moderate hypoxia the predictive accuracy of duplex scan as 77%, with 100% accuracy in all neonates with severe HIE. All neonates with severe HIE had increased resistance index of cerebral arteries. Conclusion: Duplex ultrasound can be used as a point of care tool not only in diagnosis of HIE, but also as a tool distinguish the grades of HIE thus aid in prognostication.

Smartphone-assisted Hepatitis C detection assay based on magnetic levitation.

This work describes development of smartphone-assisted magnetic levitation assay for Point-of-Care (PoC) applications. Magnetic levitation is a technique that detects and separates particles based on their density differences in a magnetic field. Observation of the levitated micro-particles is mainly performed by light microscope or additional optical components, which mostly limits applicability of the magnetic levitation technique for PoC diagnostics. In this paper, we demonstrated the capability of the smartphone assisted-magnetic levitation platform for Hepatitis C (HCV) detection assay. This method utilizes microsensor beads (MS beads) that are functionalized with anti-HCV NS3 antibody. First, the magnetic levitation platform was optimized via density marker polyethylene beads (DMB); then HCV NS3 protein was successfully detected based on levitation height differences of MS beads caused by density changes. The capability of the magnetic levitation platform for HCV detection was determined as almost 10-fold sensitive compared to conventional techniques such as enzyme-linked immunosorbent assay (ELISA). The imaging capability and resolution of the setup was improved over previously used configurations, and the developed platform enabled visualization of micro-scale objects only by smartphone assistance. This method requires no power, it is an easy-to-use and cost effective, therefore it could be easily adaptable to varied sensing assays as PoC tool.

P6536Implementation of a mass atrial fibrillation screening program in Canadian community practice

Abstract Background Atrial fibrillation is the most common arrhythmia seen in clinical practice, and is an important cause of stroke. In up to 10% of patients, stroke is the first clinical manifestation of undiagnosed atrial fibrillation (AF). Early detection of AF is therefore desirable, as it would provide an opportunity to initiate appropriate stroke prevention with anticoagulation. While European guidelines recommend screening for AF as part of routine care in patients with risk factors, the optimal modality has not yet been determined. Smartphone enabled single lead ECG devices have been shown to be highly accurate and could prove to be an effective point of care tool for uncovering AF in the community and may facilitate implementation of screening recommendations. Purpose We sought to describe the integration of a smartphone enabled single lead ECG device into the practice of selected Canadian community-based physicians and its impact on patient care. Methods Canadian community-based physicians were provided with a smartphone enabled single lead ECG device for a period of six months. Physicians were instructed to perform a single 30 second ECG recording in patients over the age of 65 who present for a regular follow-up visit. Patients with previous AF diagnosis were excluded. Outcomes related to screening, and stroke prevention-treatment initiation were prospectively ascertained and documented using a patient flow tracker. Results Among 612 physicians who were invited to participate in the program, 315 (51%) agreed to track and report the use of the device that was provided to them. During this program, 315 physicians screened a total of 15,538 patients. AF was detected 1103 patients (7.1%). The majority of patients with a positive screen underwent a subsequent 12-lead ECG confirmatory exam (79%). AF could not be confirmed in 277 patients (31.7% of patients undergoing 12-lead ECG). A total of 677 patients were initiated on oral anticoagulation (OAC), with 262 patients (24%) being initiated on OAC prior to ECG confirmation. Conclusion Undiagnosed AF is common in patients >65 years of age in community practice. The results of this program indicate that single lead mobile ECG devices can be integrated into routine point of care use for Canadian physicians and, can be a valuable tool to detect previously undiagnosed AF. While this approach identified a large number of undiagnosed AF patients eligible for OAC therapy, undertreatment with OAC remains a concern. Acknowledgement/Funding Bristol-Myers Squibb/Pfizer Alliance

Healthcare-related smartphone use among doctors in hospitals in Kaduna, Nigeria - A Survey.

The use of smartphones is now ubiquitous in developed countries and many studies have documented their use as a point of care tool, for communication and for reference purposes among various categories of doctors. In Africa and in Nigeria, fewer studies have been conducted and these have been confined to medical students, Interns and resident doctors. The aims of our study were to examine ownership, frequency and pattern of use and problems encountered in the use of smartphones among all category of doctors in hospitals in Kaduna, Nigeria. A 20-item structured questionnaire was completed by 326 doctors from public and private/faith-based hospitals (aged 23 - 70 years, median 34, two thirds male). All but one respondent owned a smartphone and 99% reported using these during their work in hospital. The following activities were the most frequently performed (at least once a day) using smartphones: Check details about a disease (48.7% of respondents), Medscape (45.9%), voice/text to colleague (45.3%), check differential diagnosis (39.1%), Social Media (37.9%), check drug interactions (34.9%), find indications for use of drugs (34.3%), and use of drugs in special circumstances (33.8%). Younger doctors (less than 40 years) and particularly Interns/NYSC doctors and doctors within 10 years of graduation, were significantly more likely to perform above-mentioned activities. 86% of respondents graded their phones as very useful or invaluable. Perceived lack of time and unreliable internet were the most commonly reported barriers to optimal use. Smartphone use in hospitals among doctors in Kaduna is universal and is mainly for point of care, communication and reference purposes.

Gastric ultrasound as a point of care tool.

Gastric ultrasound as a point of care tool.

Paper-based graphene oxide biosensor coupled with smartphone for the quantification of glucose in oral fluid.

Rapid, disposable, point-of-care (POC) oral fluid testing has gained considerable attention in recent years as saliva contains biomarker and components of the serum proteome that offer important information on both oral and systemic disease. Microfluidic paper-based analytical devices (μPADs) coupled with smartphone reflectance sensing systems have long been considered to be an effective POC tool for the diagnostics of biomarkers in oral fluid. However, the existing portable systems are limited by the poor color distribution in the detection area as well as not being universally applicable. Therefore, using the properties of nanomaterials to our advantage, we present a simple, universally applicable approach that features graphene oxide (GO) coated μPADs coupled with smartphone-based colorimetric detection for the direct quantification of glucose. An integrated portable system is used to implement the approach. Owing to the enhanced reagents absorptivity, reactive efficiency and homogeneity of color distribution from the deposition of GO, the glucose assay performance was improved. Also, by using a self-developed app, the glucose concentrations in physiological range can be automatically quantified. Finally, the approach is universally applicable as the modification of μPADs with GO can be achieved without the use of any linker, binder or retention aid, which avoids possible enzyme cross contamination. The system was first calibrated by standard glucose buffer solutions, and the limit of detection as well as the linear dynamic range were found to be 0.02mM and 0~1mM, respectively, which are appropriate for analyzing glucose concentrations in a clinically relevant range. Finally, the system was used for quantifying glucose concentrations in artificial saliva and the results obtained using our portable system showed reasonable agreement with the actual use concentrations. Thus, the utility of the system in sensitively quantifying glucose concentrations in a portable, and repeatable manner is demonstrated.

Damage Control Resuscitation: Restarting the Machinery of Life

Resuscitation of the patients suffering major haemorrhage has seen a marked change in mind-set in the current millennium. This article contains a perspective on the history of shock, the detrimental effects of the traditional sequential resuscitation reactive approach of using clear fluids for volume expansion followed by blood and component therapy, and the current philosophy of the early proactive transfusion of red blood cells, plasma, and platelets in a recommended ratio. The debate concerning pharmacological intervention for fibrinolysis and percutaneous mechanical control of haemorrhage will be discussed. Although the initial goal should be to achieve a ratio of 1:1:1 for packed red blood cells, plasma, and platelets, thromboelastometry is an essential point of care tool to determine the need for and effect of component therapy. This point of care tool is superior to the traditional laboratory assessment of coagulation. The use of tranexamic acid has come into question with the discovery of fibrinolytic shutdown and the detrimental effects on physiological fibrinolysis. The benefit of mechanical control of haemorrhage using percutaneous aortic occlusion is debatable. Major haemorrhage remains the commonest potentially correctable cause of early in-hospital death following major trauma. Minimising the use of clear resuscitative fluids and the early use of blood and component therapy is essential to maximise oxygen delivery, reverse the oxygen deficit and debt, and correct the coagulopathy of trauma and shock. The optimal ratio remains elusive but should be guided by thromboelastometry which will also dictate the need for antifibrinolytic therapy. The benefit and extent of permissive hypotension in those with ongoing haemorrhage until surgical control of haemorrhage can be obtained is unclear. The use of endovascular balloon occlusion of the aorta is controversial. Throughout resuscitation and damage control surgery, hypothermia must be corrected by core rewarming. Commensurate with damage control resuscitation is damage control surgery, the two being complementary for maximal benefit.

Public Health Approaches and Barriers to Educating Providers about Hereditary Breast and Ovarian Cancer Syndrome.

The Michigan Department of Health and Human Services implemented and evaluated two initiatives designed to enhance provider knowledge of patients appropriate for breast and/or ovarian cancer genetic risk assessment and hereditary breast and ovarian cancer (HBOC) syndrome testing. The first initiative targeted select providers who had diagnosed patients meeting HBOC risk criteria. Specifically, the initiative used 2008–2009 state cancer registry data to identify all providers who had diagnosed breast cancers in women ≤50 years of age, male breast cancers, and ovarian cancers in four health systems with newly established cancer genetics clinics. Using a method coined bidirectional reporting (BDR), reports highlighting how many of these cases each provider had seen were generated and mailed. Reports on 475 cancers (9.5% of the 5005 cases statewide meeting criteria) were sent to 69 providers with information about how and why to refer such patients for genetic counseling. Providers who received a report were contacted to assess whether the reports increased awareness or resulted in action (genetic counseling/referral). Based on the few responses received, despite multiple attempts to contact, and attrition rate, it is not possible to ascertain the impact of this initiative on providers. However the project resulted in the MDHHS identifying which providers see the largest proportion of at-risk patients, creating an opportunity to target those providers with HBOC education efforts. The second initiative involved creating and broadly disseminating an online, interactive case-based educational module to increase awareness and referral decisions for HBOC using high- and low-risk patient scenarios. A total of 1835 unique users accessed the module in a one year. Collectively the users viewed topic pages 2724 times and the interactive case studies 1369 times. Point of care tools (fact sheets) were viewed 1624 times and downloaded 764 times. Satisfaction among the subset of users applying for continuing medical education credit was high. The online educational module had a much broader reach than the bidirectional reporting initiative but to a self-selected audience. Combining targeted and broad-based provider education efforts may be a better way to increase HBOC awareness in the target audience, starting with those providers seeing the largest proportion of patients at risk.

Point-of-Care Screening for Sickle Cell Disease By a Mobile Micro-Electrophoresis Platform

In developing countries, diagnostic tests for homozygous (HbSS) or compound heterozygous (HbSC or HbS-Beta thalassemia) sickle cell disease (SCD) are not readily available at the point-of-care (POC). Very few infants are screened in Africa for SCD because of the high cost and level of skill needed to run traditional tests. Current methods are too costly and take too much time to enable equitable and timely diagnosis to save lives. The World Health Organization recognizes a crucial need for early detection of SCD in newborns, since it is estimated that 70% SCD-related deaths in Africa are preventable with early cost-effective interventions. The diagnostic barrier can be broken with affordable, POC tools that facilitate early detection immediately after birth. We have developed a mobile micro-electrophoretic device (HemeChip) through which to quickly, accurately, and affordably screen for SCD (Fig. 1A). The HemeChip uses a microfabricated platform housing cellulose acetate electrophoresis to rapidly separate hemoglobin (Hb) types. Less than 5 microliters of blood, which can be obtained through a finger stick or heel stick, is processed on a piece of cellulose paper in alkaline buffer. The HemeChip reliably identifies and discriminates amongst Hb C/A2, S, F and A0. The micro-electrophoresis results were validated against standard clinical hemoglobin screening methods, including high performance liquid chromatography (HPLC), with Pearson Correlation Coefficient (PCC) of ≥0.96 relative to HPLC for all Hb types tested. The receiver Operating-Characteristic (ROC) curves showed more than 0.89 sensitivity and 0.86 specificity for identification of hemoglobin types using the HemeChip, based on the travelling distance from the sample application point (Fig. 1B). We developed a web-based image processing application for automated and objective quantification of HemeChip results at the POC using cloud computing resources (Fig. 1C). This intensity-based mobile phone image quantitation method showed high correlation with HPLC results for tested patient blood samples (PCC=0.95). HemeChip can distinguish between different patient phenotypes, including HbSS (HbS only), transfused HbSS (HbS and HbA), and Hemoglobin SC disease (HbS and HbC). In conclusion, the HemeChip identification and quantification of hemoglobin phenotypes, as a POC technique, were comparable to standard clinical methods. This platform has clinical potential in under-served populations worldwide, in which SCD is endemic. [Display omitted] DisclosuresNo relevant conflicts of interest to declare.

Competitive volumetric bar-chart chip with real-time internal control for point-of-care diagnostics.

Point-of-care (POC) testing has become widely used in clinical analysis because of its speed and portability; however, POC tools, such as lateral flow assays, suffer from low specificity, unclear readouts, and susceptibility to environmental and user errors. Herein, we report an ELISA-based competitive volumetric bar-chart chip (CV-chip) that eliminates these limitations. The CV-chip displays the readout in the form of ink bar charts based on direct competition between gases generated by the sample and the internal control. By employing a "competition mode", this platform decreases the potential influence of background resulting from environmental factors and provides visually clear positive or negative results without the requirement of calibration. In addition, the on-chip comparison enables the device to distinguish imperceptible differences (less than 1.3-fold) in human chorionic gonadotropin (hCG) concentrations that are near the cutoff value for pregnancy (∼1.4 ng/mL). We also utilized the ELISA-based CV-chip to successfully detect biomarkers from cancer cells. As a proof-of-concept application in a clinical setting, the CV-chip was employed to evaluate the status of drugs of abuse in 18 patients. For six different drugs, zero false-positive and very few false-negative (<2%) results were reported in more than 100 tests. This new ELISA platform offers a clinical diagnostics tool that is portable and easy to use, and provides improved clarity and sensitivity due to the inclusion of a real-time internal control.

Whole genome sequencing: A new paradigm in the surveillance and control of human tuberculosis

Whole Genome Sequencing (WGS) is emerging as a very powerful tool for the management, outbreak analyses, surveillance and determining drug resistance of human infectious pathogens including Mycobacterium tuberculosis and MRSA. WGS can also discriminate relapse TB from re-infection and the resolution provided by WGS has no comparison to conventional technologies. With current cost coming down to <£70 per bacterial genome, WGS has emerged as an alternative to all the existing technologies put together. We discuss the advantage and disadvantages of WGS and whether it can become a point of care tool in not just developed countries but also in developing countries which have a huge TB burden. The likely utility of WGS for other pathogens and also in characterizing holobionts is also discussed.

A strategic roadmap for oncology electronic medical records (EMRs) in Ontario’s complex multiregional health care system.

159 Background: Ontario’s cancer system comprises 14 regions; from large and sparsely populated to dense urban areas. Each region, and the hospitals within it, is responsible for its own IT solutions to support oncology. In 2011 Oncology EMRs in 4 regions were funded as there are no oncology specific Health Information Systems (HIS). Cancer Care Ontario (CCO) also obtained funding to develop standards, and a roadmap for their use, from eHealth Ontario. Methods: Early work focused on establishing standards based on the integrated patient cancer journey. Work-streams included functional standards, an interoperability framework for CCO tools and provincial assets and information standards to be supported through EMRs. These were evaluated through internal and external review and validation processes. The strategic IT roadmap was developed via interviews with leaders in the clinical, management and IT domains to obtain input on how the standards might be used and what role CCO should play. Results of the consultations were consolidated into key themes and validated through a facilitated workshop with an expert panel. Results: Standards can be incorporated into EMRs in a consistent way by basing the design around the patient journey and by working with the point of care tools that clinicians need to support accurate, timely and relevant data at each stage of the patient journey. This approach is location and vendor neutral. Focusing on the data needed at point of care provides insight into reporting needs and how data can be exchanged between systems; directly, via a provincial repository or via CCO provided tools. CCO’s role should be to provide support to the regions through standards and advocacy with stakeholders rather than development of tools. Conclusions: Oncology has unique IT needs that may not be fully incorporated in hospital wide IT strategic plans or decisions. The standards and roadmap provide a basis for oncology programs to ensure that IT decisions meet their needs. The role of CCO should evolve toward strategic counsel and advocacy rather than provision of IT tools.

BMJ Best Practice

BMJ Best Practice

Use of portable blood physiology point-of-care devices for basic and applied research on vertebrates: a review.

Non-human vertebrate blood is commonly collected and assayed for a variety of applications, including veterinary diagnostics and physiological research. Small, often non-lethal samples enable the assessment and monitoring of the physiological state and health of the individual. Traditionally, studies that rely on blood physiology have focused on captive animals or, in studies conducted in remote settings, have required the preservation and transport of samples for later analysis. In either situation, large, laboratory-bound equipment and traditional assays and analytical protocols are required. The use of point-of-care (POC) devices to measure various secondary blood physiological parameters, such as metabolites, blood gases and ions, has become increasingly popular recently, due to immediate results and their portability, which allows the freedom to study organisms in the wild. Here, we review the current uses of POC devices and their applicability to basic and applied studies on a variety of non-domesticated species. We located 79 individual studies that focused on non-domesticated vertebrates, including validation and application of POC tools. Studies focused on a wide spectrum of taxa, including mammals, birds and herptiles, although the majority of studies focused on fish, and typical variables measured included blood glucose, lactate and pH. We found that calibrations for species-specific blood physiology values are necessary, because ranges can vary within and among taxa and are sometimes outside the measurable range of the devices. In addition, although POC devices are portable and robust, most require durable cases, they are seldom waterproof/water-resistant, and factors such as humidity and temperature can affect the performance of the device. Overall, most studies concluded that POC devices are suitable alternatives to traditional laboratory devices and eliminate the need for transport of samples; however, there is a need for greater emphasis on rigorous calibration and validation of these units and appreciation of their limitations.

Development of a practice tool for community-based nurses: The Heart Failure Palliative Approach to Care (HeFPAC)

Patients living with advanced heart failure (HF) require a palliative approach to reduce suffering. Nurses have described significant knowledge gaps about the disease-specific palliative care (PC) needs of these patients. An intervention is required to facilitate appropriate end-of-life care for HF patients. The purpose of this study was to develop a user-friendly, evidence-informed HF-specific practice tool for community-based nurses to facilitate care and communication regarding a palliative approach to HF care. Guided by the Knowledge to Action framework, we identified key HF-specific issues related to advanced HF care provision within the context of a palliative approach to care. Informed by current evidence and subsequent iterative consultation with community-based and specialist PC and HF nurses, a pocket guide tool for community-based nurses was created. We developed the Heart Failure Palliative Approach to Care (HeFPAC) pocket guide to promote communication and a palliative approach to care for HF patients. The HeFPAC has potential to improve the quality of care and experiences for patients with advanced HF. It will be piloted in community-based practice and in a continuing education program for nurses. The HeFPAC pocket guide offers PC nurses a concise, evidence-informed and practical point-of care tool to communicate with other clinicians and patients about key HF issues that are associated with improving disease-specific HF palliative care and the quality of life of patients and their families. Pilot testing will offer insight as to its utility and potential for modification for national and international use.

On-chip analysis of respiratory viruses from nasopharyngeal samples

Point-of-care (PoC) testing followed by personalized efficient therapy of infectious diseases may result in a considerable reduction of associated health care costs. Lab-on-a-chip (LoC) systems represent a potentially high efficient class of PoC tools. Here, we present a LoC system for automated pathogen analysis of respiratory viruses from nasopharyngeal specimens. The device prepares total nucleic acids from extracted swab samples using magnetic silica beads. After reverse transcription the co-purified viral RNA is amplified in accordance with the QIAplex multiplex PCR technology. Hybridized to corresponding QIAGEN LiquiChip beads and labelled with streptavidin R-phycoerythrin, the amplified target sequences are finally detected using a QIAGEN LiquiChip200 workstation. All chemicals needed are either stored freeze-dried on the disposable chip or are provided in liquid form in a reagent cartridge for up to 24 runs. Magnetic stir bars for mixing as well as turning valves with metering structures are integrated into the injection-moulded disposable chip. The core of the controlling instrument is a rotating heating bar construction providing fixed temperatures for fast cycling. PCR times of about half an hour (for 30 cycles) could be achieved for 120 μl reactions, making this system the fastest currently available high-volume PCR chip. The functionality of the system was shown by comparing automatically processed nasopharyngeal samples to ones processed manually according to the QIAGEN “ResPlex™ II Panel v2.0” respiratory virus detection kit. A prototype of the present instrument revealed slightly weaker signal intensities with a similar sensitivity in comparison to the commercially available kit and automated nucleic acid preparation devices, even without protocol optimization.