What is Another Name For POCT?

Point of care testing (POCT) is a rapidly growing area of medical diagnostics. It offers many benefits, including speed of diagnosis and treatment, expanded testing capabilities and the ability to test in non-traditional locations for Non-invasive Screening Products.

The most common challenge associated with POCT is the need for quality control and quality assurance practices. These challenges are exacerbated by the fact that most POCT is performed by clinical staff, rather than laboratory trained individuals.

1. Near-patient testing

Near-patient testing, also called point-of-care testing (POCT), is a term that refers to laboratory testing that takes place close to the site of patient care. It may be conducted by personnel who are not trained in clinical laboratory science or by patients, referred to as self-testing.

POCT has become an important tool in emergency care, hospital surgery, intensive care, bedside decision-making, and personal health maintenance over the past several decades. It has been proven to improve outcomes and reduce costs by reducing test turnaround time and allowing early detection and treatment, especially in emergency situations.

It is particularly useful for diagnostic and prognostic tests such as glucose, hemoglobin A1c, urea, creatinine, and thyroid function. Rapid results are critical for timely and accurate diagnosis, and this is especially important in a high-risk group such as those with diabetes.

For example, a study showed that near-patient testing of PT/INR reduced the mean time to confirm a stroke in people with diabetes by 45 minutes and improved patient safety. This led to a faster diagnosis and treatment, saving lives in some cases.

Another study found that near-patient testing of cardiac troponins reduced the mean time to confirm a heart attack in people with acute coronary syndromes, resulting in better treatment and a lower incidence of death. This was especially true in remote areas where the central laboratory (CL) is at a distance.

However, there is limited evidence on the impact of near-patient testing in primary care. Rigorous evaluations are needed to determine the impact of near-patient testing in harder outcomes and cost-effectiveness. In addition, a new field, point-of-careology, is developing to define standards of care, test reference values, and best practices across all settings and countries.

image source: https://www.pinterest.ph

2. Ancillary testing

Point of care testing (POCT) has been a significant development in emergency medicine and intensive care settings, bringing a rapid and efficient means of monitoring patient status of Point of Care Testing. It has also been an important part of disaster and public health preparedness, allowing for improved diagnosis and treatment during a crisis.

In addition, POCT has been a major driver of improvements in patient flow in the emergency department (ED) and across the continuum of care. Despite concerns about cost and performance limitations, a growing body of research has shown that there are significant benefits to the introduction of POCT. The benefits are often attributed to a reduction in hospital referrals and unnecessary delays in the delivery of appropriate treatments based on accurate laboratory results, which could lead to lifesaving outcomes.

Cytologic specimens present a wealth of opportunities for pathology to enhance diagnostic utility and improve patient management. Especially for patients with advanced cancers, small biopsy samples and cytologic specimens can provide the only opportunity to acquire tumor material for ancillary molecular, immunohistochemical, and cytogenetic testing.

For these reasons, it is essential for pathologists to reliably triage cytologic and small biopsy samples in order to maximize the use of these patient assets. This involves a careful evaluation of sample requirements, the platforms that have been validated for these tests, and the strengths and limitations of these platforms and their applications for given testing methodologies.

Ancillary testing is a rapidly emerging and essential aspect of cytologic analysis. Pleural, pericardial, and peritoneal effusion specimens present additional clinical challenges for pathology that require the integration of ancillary studies into the cytologic workflow. In addition, a broad range of molecular assays and platforms are being developed and validated that offer a variety of additional clinical applications.

3. Bedside testing

Point-of-care testing (POCT) has a wide range of clinical benefits. It provides a rapid test result that can facilitate medical decision-making and expedite treatment of life-threatening conditions. In addition, it can be used to alleviate emergency room overcrowding and improve patient satisfaction by reducing length of stay in hospital.

One of the most common types of POCT involves haematology testing. It can include a number of different tests, such as haemoglobin concentration, blood cell count, erythrocyte sedimentation rate and prothrombin time for oral anticoagulation control. In addition, it can also include coagulation testing, such as platelet count and fibrinogen levels.

However, some POCT methods may be difficult to use and rely on a lot of skill and experience from the clinician performing the test. Therefore, it is important that a comprehensive quality assurance programme is implemented before beginning any POCT program to ensure that the results are accurate and reliable.

The best way to do this is through the use of data management systems. These platforms can connect all of the devices within a hospital to share information about test results, equipment, and procedures. This allows the laboratory to monitor and document all of this data in real-time, providing a level of quality that is almost impossible to achieve with manual documentation.

Another name for POCT is bedside testing, which refers to the testing of a patient’s specimen at their bedside. It can be a great way to reduce vein-to-brain times and enhance patient safety by eliminating pre- and postanalytical delays in the testing process. In addition, it can alleviate pressure on the central laboratory by allowing test results to be immediately provided to physicians for Bi-functional Blood Glucose Monitor.

4. Satellite testing

This testing is done to simulate the environment of space and ensure that the satellites can work properly. It includes thermal vacuum test, vibration testing and electromagnetic testing.

The main aim of this test is to verify the operational functionality of all PCBs, sensors, actuators, batteries, uplink and downlink. In addition, it is also necessary to check if the satellite can operate under various thermal loads and keep its battery and hardware temperatures in the desired range.

To perform this test the satellite is placed inside a vacuum chamber with temperature varying between minus 15 degrees Celsius to 50 degrees Celsius. It remains in the vacuum for a period of time depending on the size of the chamber.

It is important to run the test for long enough and at high enough frequency to make sure that the satellite can function properly under these different load conditions. Moreover it is necessary to prevent over-testing at critical points and apply limiting channels so that the drive signals can be lowered when they reach the predefined limits.

During this test the satellite is simulated in orbit by keeping it in a vacuum chamber with temperature varying between the minus 15 degree Celsius to 50 degrees Celsius and under a constant vibration load. It is also tested for electromagnetic compatibility and for its operation in space.

The approach is based on the use of cause-effect tables for the specification of the satellite subsystems. This was a choice that has been approved by INPE specialists, who were concerned with the need of sharing the specifications in a more efficient way. The cause-effect tables are then translated into finite state machines and submitted to formal verification in UPPAAL model checking tool.

image source: https://www.pinterest.ph

5. Decentralized testing

Another name for POCT is decentralized testing. The term decentralized testing is used to describe a wide variety of laboratory tests and devices that are performed in the patient’s environment. This includes both CLIA-waived and nonwaived tests, primarily at physician offices and small hospitals. The types of tests that can be performed at a decentralized site vary, but most are classified as moderately complex (Table 2).

For moderately complex testing, such as pH, blood gases or electrolytes, a decentralized site must comply with the minimum quality standards for that test, which include personnel, quality control and QC proficiency testing [2,3,4,5]. They also must have a plan to verify the accuracy of their moderately complex methods at least twice each year with Blood Glucose Monitor.

In addition, JCAHO inspects decentralized sites using their most recent, standards identified in their Comprehensive Accreditation Manual for Pathology and Clinical Laboratory Services. They require that a site maintain QC records for each test they perform, review those records daily and run three levels of QC on each day for pH/blood gases.

This type of monitoring is critical to ensure that all operators are operating within regulatory requirements and maintaining the integrity of their results. The process requires a significant commitment of time, but it is important to ensure that the tests are performing as expected and that all of the QA personnel at the testing site have the skills needed for quality assurance.

There are also issues around specimen transport, including the cost and logistics of shipping samples to the central lab. Decentralized testing can solve these problems by moving the collection process to the patient’s location. This can save the centralized lab money in transportation costs and reduce the number of sample transport trucks that must be driven to the laboratory.