Point-of-care testing--can we move from anecdote to evidence?

摘要

There is a progressive growth in the availability of technology for point-of-care testing (POCT). This technology is growing increasingly sophisticated. Semiquantitative strip-based technology has migrated via serum based reflectance methods (1) to fully quantitative systems using whole blood (2), which may include interpretative algorithms. Electrochemical detection offers an array of analytes on blood gas systems. This has combined with technological convergence to produce an array of sensors on a single platform. Systems such as the iSTAT offer a range of tests from electrolytes (3) to cardiac biomarkers (4) on the same hand-held device. In this issue of Clinical Chemistry and Laboratory Medicine the article by Nydegger and colleagues expresses the opinion that POCT is essential, even indispensable for clinical care. Is this backed by evidence? The underlying hypothesis is that accurate and rapid results (the goal of laboratory testing) will produce improved patient care. The rationale for POCT is that analytical accuracy will be comparable with laboratory methods and that improved turnaround time (TAT) plus the ease of access to testing will translate into even better care and so even better outcomes. What is the evidence that these criteria are met?