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Journal articles on the topic 'Point-of-Care (PoC)'

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Author: Grafiati

Published: 10 December 2022

Last updated: 7 September 2023

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1

Zubik, A. N., G. E. Rudnitskaya, A. A. Evstrapov, and T. A. Lukashenko. "POINT-OF-CARE (POC) DEVICES: CLASSIFICATION AND BASIC REQUIREMENTS." NAUCHNOE PRIBOROSTROENIE 32, no. 3 (August 30, 2022): 3–29. http://dx.doi.org/10.18358/np-32-3-i329.

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The review presents the classification of point-of-care (POC) devices, and discusses the main characteristics of the devices and the requirements for them. The differences between the POC testing method and the laboratory method of analysis are considered. Examples of devices that fit the definition of POC for diagnosing infectious diseases are given.

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Weber, Christian Friedrich, Klaus Görlinger, Dirk Meininger, Eva Herrmann, Tobias Bingold, Anton Moritz, Lawrence H. Cohn, and Kai Zacharowski. "Point-of-Care Testing." Anesthesiology 117, no. 3 (September 1, 2012): 531–47. http://dx.doi.org/10.1097/aln.0b013e318264c644.

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Introduction The current investigation aimed to study the efficacy of hemostatic therapy guided either by conventional coagulation analyses or point-of-care (POC) testing in coagulopathic cardiac surgery patients. Methods Patients undergoing complex cardiac surgery were assessed for eligibility. Those patients in whom diffuse bleeding was diagnosed after heparin reversal or increased blood loss during the first 24 postoperative hours were enrolled and randomized to the conventional or POC group. Thromboelastometry and whole blood impedance aggregometry have been performed in the POC group. The primary outcome variable was the number of transfused units of packed erythrocytes during the first 24 h after inclusion. Secondary outcome variables included postoperative blood loss, use and costs of hemostatic therapy, and clinical outcome parameters. Sample size analysis revealed a sample size of at least 100 patients per group. Results There were 152 patients who were screened for eligibility and 100 patients were enrolled in the study. After randomization of 50 patients to each group, a planned interim analysis revealed a significant difference in erythrocyte transfusion rate in the conventional compared with the POC group [5 (4;9) versus 3 (2;6) units [median (25 and 75 percentile)], P<0.001]. The study was terminated early. The secondary outcome parameters of fresh frozen plasma and platelet transfusion rates, postoperative mechanical ventilation time, length of intensive care unit stay, composite adverse events rate, costs of hemostatic therapy, and 6-month mortality were lower in the POC group. Conclusions Hemostatic therapy based on POC testing reduced patient exposure to allogenic blood products and provided significant benefits with respect to clinical outcomes.

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Wessels, Lars, Andreas Unterberg, and Christopher Beynon. "Point-of-Care Testing in Neurosurgery." Seminars in Thrombosis and Hemostasis 43, no. 04 (March 27, 2017): 416–22. http://dx.doi.org/10.1055/s-0037-1599159.

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AbstractCoagulation disorders can have a major impact on the outcome of neurosurgical patients. The central nervous system is located within the closed space of the skull, and therefore, intracranial hemorrhage can lead to intracranial hypertension. Acute brain injury has been associated with alterations of various hemostatic parameters. Point-of-care (POC) techniques such as rotational thromboelastometry are able to identify markers of coagulopathy which are not reflected by standard assessment of hemostasis (e.g., hyperfibrinolysis). In patients with acute brain injury, POC test results have been associated with important outcome parameters such as mortality and need for neurosurgical intervention. POC devices have also been used to rapidly identify and quantify the effects of antithrombotic medication. In cases of life-threatening intracranial hemorrhage, this information can be valuable when deciding over administration of prohemostatic substances or immediate neurosurgical intervention. In elective neurosurgical procedures, POC devices can provide important information when unexpected bleeding occurs or in cases of prolonged operative time with subsequent blood loss. Initial experiences with POC devices in neurosurgical care have shown promising results but further studies are needed to characterize their full potential and limitations.

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Fries, Dietmar, and Werner Streif. "Point-of-Care Testing in Critically Ill Patients." Seminars in Thrombosis and Hemostasis 41, no. 01 (January 22, 2015): 075–83. http://dx.doi.org/10.1055/s-0035-1544184.

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Point-of-care (POC) testing in hemostasis has experienced a significant increase in the spectrum of available tests and the number of tests performed. Short turn-around time and observation of rapid changes in test results are facilitated. The quality control process in POC testing must encompass a preanalytic (collection), analytic (measurement), and postanalytic (clinical response) phase. Erroneous interpretation of findings and difficult quality controls can outweigh the advantages of POC testing.Only a limited number of hemostatic POC tests have proven useful so far: prothrombin time POC—monitoring of oral vitamin K antagonists; activated clotting time POC—monitoring of high-dose heparin therapy; platelet function analyzer (PFA; Siemens, Marburg, Germany) closure time (CT)—detection of von Willebrand disease and severe platelet function defects; whole blood aggregometry (WBA) Multiplate (Roche Diagnostics, Rotkreuz, Switzerland), and the VerifyNow system (Accumetrics, San Diego, CA)—detection of platelet dysfunction due to antiplatelet drugs; thromboelastography—continuous observation of clot formation and fibrinolysis. The use of various agonists in WBA and thromboelastography (TEG) requires some expertise. In experienced hands the PFA CT and WBA and TEG are recommended combinations.Application of POC testing depends strictly on whether it improves medical care and patient outcome. More POC test systems are in the research pipeline, but only a few will resist the ravages of time.

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Tanaka, Kenichi, and Daniel Bolliger. "Point-of-Care Coagulation Testing in Cardiac Surgery." Seminars in Thrombosis and Hemostasis 43, no. 04 (March 30, 2017): 386–96. http://dx.doi.org/10.1055/s-0037-1599153.

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AbstractBleeding complications after cardiac surgery are common and are associated with increased morbidity and mortality. Their etiology is multifactorial, and treatment decisions are time sensitive. Point-of-care (POC) testing has an advantage over standard laboratory tests for faster turn-around times, and timely decision on coagulation intervention(s). The most common POC coagulation testing is the activated clotting time (ACT), used to monitor heparin therapy while on cardiopulmonary bypass. Viscoelastic coagulation tests including thromboelastometry (ROTEM) and thromboelastography (TEG) have been recommended for the treatment of postoperative bleeding after cardiac surgery because the ROTEM/TEG-guided treatment algorithms reduced the use of blood products. Other POC tests are commercially available, but there is sparse evidence for their routine use in cardiac surgery. These devices include heparin management systems, POC prothrombin time and activated partial thromboplastin time, POC fibrinogen assay, and whole blood platelet function tests. There are multiple confounding elements and conditions associated with cardiac surgery, which can significantly alter test results. Anemia and thrombocytopenia are regularly associated with deviations in many POC devices. In summary, POC coagulation testing allows for rapid clinical decisions in hematological interventions, and, when used in conjunction with a proper transfusion algorithm, may reduce blood product usage, and potentially complications associated with blood transfusion.

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6

Drancourt, Michel, Audrey Michel-Lepage, Sylvie Boyer, and Didier Raoult. "The Point-of-Care Laboratory in Clinical Microbiology." Clinical Microbiology Reviews 29, no. 3 (March 30, 2016): 429–47. http://dx.doi.org/10.1128/cmr.00090-15.

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SUMMARYPoint-of-care (POC) laboratories that deliver rapid diagnoses of infectious diseases were invented to balance the centralization of core laboratories. POC laboratories operate 24 h a day and 7 days a week to provide diagnoses within 2 h, largely based on immunochromatography and real-time PCR tests. In our experience, these tests are conveniently combined into syndrome-based kits that facilitate sampling, including self-sampling and test operations, as POC laboratories can be operated by trained operators who are not necessarily biologists. POC laboratories are a way of easily providing clinical microbiology testing for populations distant from laboratories in developing and developed countries and on ships. Modern Internet connections enable support from core laboratories. The cost-effectiveness of POC laboratories has been established for the rapid diagnosis of tuberculosis and sexually transmitted infections in both developed and developing countries.

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Stein, Philipp, Alexander Kaserer, Gabriela Spahn, and Donat Spahn. "Point-of-Care Coagulation Monitoring in Trauma Patients." Seminars in Thrombosis and Hemostasis 43, no. 04 (March 15, 2017): 367–74. http://dx.doi.org/10.1055/s-0037-1598062.

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AbstractTrauma remains one of the major causes of death and disability all over the world. Uncontrolled blood loss and trauma-induced coagulopathy represent preventable causes of trauma-related morbidity and mortality. Treatment may consist of allogeneic blood product transfusion at a fixed ratio or in an individualized goal-directed way based on point-of-care (POC) and routine laboratory measurements. Viscoelastic POC measurement of the developing clot in whole blood and POC platelet function testing allow rapid and tailored coagulation and transfusion treatment based on goal-directed, factor concentrate–based algorithms. The first studies have been published showing that this concept reduces the need for allogeneic blood transfusion and improves outcome. This review highlights the concept of goal-directed POC coagulation management in trauma patients, introduces a selection of POC devices, and presents algorithms which allow a reduction in allogeneic blood product transfusion and an improvement of trauma patient outcome.

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8

Cozma, Angela, Camelia Vonica, Adela Sitar-Taut, and Adriana Fodor. "Point-of-care testing in diabetes management." Revista Romana de Medicina de Laborator 27, no. 2 (April 1, 2019): 125–35. http://dx.doi.org/10.2478/rrlm-2019-0014.

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Abstract The prevalence of diabetes mellitus (DM) has rapidly increased over the last decades, reaching epidemic magnitudes, particularly in lowand middle-income countries. Point-of-care (POC) technology enables decision making near or at the site of patient care. Portable blood glucose meters and HbA1c testing are used by the healthcare provider and millions of patients with diabetes to monitor the safety and effectiveness of the diabetes treatment. However, POC capillary blood glucose and POC HbA1c testing are not recommended for diabetes diagnosis. Rather, they have been used for screening diabetes in lowand middle-income countries to decrease the disease burden.

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Chamane, Nkosinothando, Desmond Kuupiel, and Tivani Phosa Mashamba-Thompson. "Stakeholders’ Perspectives for the Development of a Point-of-Care Diagnostics Curriculum in Rural Primary Clinics in South Africa—Nominal Group Technique." Diagnostics 10, no. 4 (April 1, 2020): 195. http://dx.doi.org/10.3390/diagnostics10040195.

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Poor knowledge and adherence to point-of-care (POC) HIV testing standards have been reported in rural KwaZulu-Natal (KZN), a high HIV prevalent setting. Improving compliance to HIV testing standards is critical, particularly during the gradual phasing out of lay counsellor providers and the shifting of HIV testing and counselling duties to professional nurses. The main objective of this study was to identify priority areas for development of POC diagnostics curriculum to improve competence and adherence to POC diagnostics quality standards for primary healthcare (PHC) nurses in rural South Africa. Method: PHC clinic stakeholders were invited to participate in a co-creation workshop. Participants were purposely sampled from each of the 11 KwaZulu-Natal Districts. Through the Nominal Group Technique (NGT), participants identified training related challenges concerning delivery of quality point of care diagnostics and ranked them from highest to lowest priority. An importance ranking score (scale 1–5) was calculated for each of the identified challenges. Results: Study participants included three PHC professional nurses, one TB professional nurse, one HIV lay councilor, one TB assistant and three POC diagnostics researchers, aged 23–50. Participants identified ten POC diagnostics related challenges. Amongst the highest ranked challenges were the following:absence of POC testing Curriculum for nurses, absence of training of staff on HIV testing and counselling as lay counsellor providers are gradually being phased out,. absence of Continuous Professional Development opportunities and lack of Staff involvement in POC Management programs. Conclusion: Key stakeholders perceived training of PHC nurses as the highest priority for the delivery of quality POC diagnostic testing at PHC level. We recommend continual collaboration among all POC diagnostics stakeholders in the development of an accessible curriculum to improve providers’ competence and ensure sustainable quality delivery of POC diagnostic services in rural PHC clinics.

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Straseski, Joely A., Martha E. Lyon, William Clarke, Jeffrey A. DuBois, Lois A. Phelan, and Andrew W. Lyon. "Investigating Interferences of a Whole-Blood Point-of-Care Creatinine Analyzer: Comparison to Plasma Enzymatic and Definitive Creatinine Methods in an Acute-Care Setting." Clinical Chemistry 57, no. 11 (November 1, 2011): 1566–73. http://dx.doi.org/10.1373/clinchem.2011.165480.

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BACKGROUND Although measurement of whole-blood creatinine at the point of care offers rapid assessment of renal function, agreement of point-of-care (POC) results with central laboratory methods continues to be a concern. We assessed the influence of several potential interferents on POC whole-blood creatinine measurements. METHODS We compared POC creatinine (Nova StatSensor) measurements with plasma enzymatic (Roche Modular) and isotope dilution mass spectrometry (IDMS) assays in 119 hospital inpatients. We assessed assay interference by hematocrit, pH, pO2, total and direct bilirubin, creatine, prescribed drugs, diagnosis, red blood cell water fraction, and plasma water fraction. RESULTS CVs for POC creatinine were 1.5- to 6-fold greater than those for plasma methods, in part due to meter-to-meter variation. Regression comparison of POC creatinine to IDMS results gave a standard error (Sy|x) of 0.61 mg/dL (54 μmol/L), whereas regression of plasma enzymatic creatinine to IDMS was Sy|x 0.16 mg/dL (14 μmol/L). By univariate analysis, bilirubin, creatine, drugs, pO2, pH, plasma water fraction, and hematocrit were not found to contribute to method differences. However, multivariate analysis revealed that IDMS creatinine, red blood cell and plasma water fractions, and hematocrit explained 91.8% of variance in POC creatinine results. CONCLUSIONS These data suggest that whole-blood POC creatinine measurements should be used with caution. Negative interferences observed with these measurements could erroneously suggest adequate renal function near the decision threshold, particularly if estimated glomerular filtration rate is determined. Disparity between whole-blood and plasma matrices partially explains the discordance between whole-blood and plasma creatinine methods.

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11

Tongtoyai, Jaray, Panutsaya Tientadakul, Wimol Chinswangwatanakul, and Nisarat Opartkiattikul. "Point-of-care glucose testing: on-site competency assessment." International Journal of Health Care Quality Assurance 27, no. 5 (June 3, 2014): 373–81. http://dx.doi.org/10.1108/ijhcqa-11-2012-0121.

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Purpose – The purpose of this pilot paper is to use on-site assessment to determine common non-compliance in point-of-care (POC) glucose testing, deficiencies that should be improved by the POC team or emphasized in further training. Design/methodology/approach – Assessment forms for POC site and staff competency were developed and used for direct observation in four POC sites. Nurses were sampled in these sites. Findings – The on-site assessment demonstrated that initial operator training was insufficient. Only three of 15 nurses achieved a satisfactory score on the first assessment. In all nine participants who had been assessed at least twice improved their performance. In total, 16 (30 percent) of 53 competency items were not achieved, so these should be addressed during refresher training. Improved compliance with the checklist was observed in two of four POC sites. Research limitations/implications – Medical students and residents also perform the test, so more representative samples are needed. Practical implications – The assessment of staff performance in the workplace with constructive input and POC site inspections to identify common deficiencies are recommended. Refresher trainings should be focussed on the deficiencies identified. Social implications – Assessing staff performance in the workplace with constructive input and POC site inspections to identify common deficiencies are recommended. Refresher trainings should focus on deficiencies. Originality/value – This study involved directly observing POC site staff during glucose testing. The assessment forms were based on ISO 22870:2006 technical requirements.

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12

Choi, Jane, Kar Yong, Jean Choi, and Alistair Cowie. "Emerging Point-of-care Technologies for Food Safety Analysis." Sensors 19, no. 4 (February 17, 2019): 817. http://dx.doi.org/10.3390/s19040817.

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Food safety issues have recently attracted public concern. The deleterious effects of compromised food safety on health have rendered food safety analysis an approach of paramount importance. While conventional techniques such as high-performance liquid chromatography and mass spectrometry have traditionally been utilized for the detection of food contaminants, they are relatively expensive, time-consuming and labor intensive, impeding their use for point-of-care (POC) applications. In addition, accessibility of these tests is limited in developing countries where food-related illnesses are prevalent. There is, therefore, an urgent need to develop simple and robust diagnostic POC devices. POC devices, including paper- and chip-based devices, are typically rapid, cost-effective and user-friendly, offering a tremendous potential for rapid food safety analysis at POC settings. Herein, we discuss the most recent advances in the development of emerging POC devices for food safety analysis. We first provide an overview of common food safety issues and the existing techniques for detecting food contaminants such as foodborne pathogens, chemicals, allergens, and toxins. The importance of rapid food safety analysis along with the beneficial use of miniaturized POC devices are subsequently reviewed. Finally, the existing challenges and future perspectives of developing the miniaturized POC devices for food safety monitoring are briefly discussed.

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Li, Zhao, and Ping Wang. "Point-of-Care Drug of Abuse Testing in the Opioid Epidemic." Archives of Pathology & Laboratory Medicine 144, no. 11 (June 24, 2020): 1325–34. http://dx.doi.org/10.5858/arpa.2020-0055-ra.

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Context.— The United States is experiencing an opioid overdose epidemic. Point-of-care (POC) drug of abuse testing is a useful tool to combat the intensified opioid epidemic. Objectives.— To review commercially available POC drug of abuse testing involving opioids, to review opportunities and challenges for POC opioid testing and emerging testing methods in research literature, and finally to summarize unmet clinical needs and future development prospects. Data Sources.— The Google search engine was used to access information for commercial opioid POC devices and the Google Scholar search engine was used to access research literature published from 2000 to 2019 for opioid POC tests. Conclusions.— The opioid epidemic provides unprecedented opportunities for POC drug testing, with significant clinical needs. Compared with gold standard tests, limitations for commercially available opioid POC testing include lower analytical sensitivity, lower specificity, and cross-reactivity. In response to unmet clinical needs, novel methods have emerged in research literature, such as microfluidics and miniature mass spectrometry. Future prospects include the development of quantitative POC devices and smarter and real-time drug testing.

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DuBois, Jeffrey A., and William Clarke. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 13, no. 3 (September 2014): 118–23. http://dx.doi.org/10.1097/poc.0000000000000034.

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15

Ng, Valerie. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 14, no. 4 (December 2015): 127–36. http://dx.doi.org/10.1097/poc.0000000000000059.

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Kiechle, Frederick L. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 14, no. 4 (December 2015): 157–64. http://dx.doi.org/10.1097/poc.0000000000000069.

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Isbell, T. Scott. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 14, no. 4 (December 2015): 167–68. http://dx.doi.org/10.1097/poc.0000000000000074.

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Nichols, James H. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 14, no. 4 (December 2015): 103–5. http://dx.doi.org/10.1097/poc.0000000000000079.

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Gregory, Kim. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 15, no. 2 (June 2016): 89. http://dx.doi.org/10.1097/poc.0000000000000099.

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Fitzmaurice, Emma, Jonathan Harris, Laila AbdelWareth, and Chandan Kumar. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 19, no. 2 (June 2020): 25–32. http://dx.doi.org/10.1097/poc.0000000000000201.

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Kiechle, Frederick L. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 7, no. 3 (September 2008): 97–99. http://dx.doi.org/10.1097/poc.0b013e318182ef10.

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Thompson, Karen M., Sandeep Phlora-Mann, and Susan V. Mallett. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 9, no. 1 (March 2010): 47–51. http://dx.doi.org/10.1097/poc.0b013e3181d2d8df.

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Nichols, James H. "Point-of-Care Connectivity." Point of Care: The Journal of Near-Patient Testing & Technology 9, no. 4 (December 2010): 151–54. http://dx.doi.org/10.1097/poc.0b013e3181ecca13.

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Szelag, Edwina. "Point-of-Care Connectivity." Point of Care: The Journal of Near-Patient Testing & Technology 9, no. 4 (December 2010): 174. http://dx.doi.org/10.1097/poc.0b013e3181ecca68.

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Price, Christopher P. "Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 10, no. 2 (June 2011): 88–92. http://dx.doi.org/10.1097/poc.0b013e31821c6b87.

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Gillette, Audrey. "Managing Point of Care." Point of Care: The Journal of Near-Patient Testing & Technology 12, no. 2 (June 2013): 94–96. http://dx.doi.org/10.1097/poc.0b013e318265e208.

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Schuler, Charles F., Carmen Gherasim, Kelly O’Shea, David M. Manthei, Jesse Chen, Don Giacherio, Jonathan P. Troost, James L. Baldwin, and James R. Baker. "Accurate point-of-care serology tests for COVID-19." PLOS ONE 16, no. 3 (March 16, 2021): e0248729. http://dx.doi.org/10.1371/journal.pone.0248729.

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Background As COVID-19 vaccines become available, screening individuals for prior COVID-19 infection and vaccine response in point-of-care (POC) settings has renewed interest. We prospectively screened at-risk individuals for SARS-CoV-2 spike and nucleocapsid protein antibodies in a POC setting to determine if it was a feasible method to identify antibody from prior infection. Methods Three EUA-approved lateral flow antibody assays were performed on POC finger-stick blood and compared with serum and a CLIA nucleocapsid antibody immunoassay. Variables including antibody class, time since PCR, and the assay antigen used were evaluated. Results 512 subjects enrolled, of which 104 had a COVID-19 history and positive PCR. Only three PCR-positive subjects required hospitalization, with one requiring mechanical ventilation. The POC results correlated well with the immunoassay (93–97% sensitivity) and using serum did not improve the sensitivity or specificity. Conclusions Finger-stick, POC COVID-19 antibody testing was highly effective in identifying antibody resulting from prior infections in mildly symptomatic subjects. Using high-complexity serum immunoassays did not improve the screening outcome. Almost all individuals with COVID-19 infection produced detectable antibodies to the virus. POC antibody testing is useful as a screen for prior COVID-19 infection, and should be useful in assessing vaccine response.

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Botella, José R. "Point-of-Care DNA Amplification for Disease Diagnosis and Management." Annual Review of Phytopathology 60, no. 1 (August 26, 2022): 1–20. http://dx.doi.org/10.1146/annurev-phyto-021621-115027.

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Early detection of pests and pathogens is of paramount importance in reducing agricultural losses. One approach to early detection is point-of-care (POC) diagnostics, which can provide early warning and therefore allow fast deployment of preventive measures to slow down the establishment of crop diseases. Among the available diagnostic technologies, nucleic acid amplification–based diagnostics provide the highest sensitivity and specificity, and those technologies that forego the requirement for thermocycling show the most potential for use at POC. In this review, I discuss the progress, advantages, and disadvantages of the established and most promising POC amplification technologies. The success and usefulness of POC amplification are ultimately dependent on the availability of POC-friendly nucleic acid extraction methods and amplification readouts, which are also briefly discussed in the review.

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Shu, Tong, Haley Hunter, Ziping Zhou, Yanping Sun, Xiaojun Cheng, Jianxin Ma, Lei Su, Xueji Zhang, and Michael J. Serpe. "Portable point-of-care diagnostic devices: an updated review." Analytical Methods 13, no. 45 (2021): 5418–35. http://dx.doi.org/10.1039/d1ay01643a.

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This review highlights recent examples of point-of-care (POC) diagnostics for detecting nucleic acids, proteins, bacteria, and other biomarkers, all focused on highlighting the positive impact of POC on society and human health.

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Arnold, William D., Kenneth Kupfer, Randie R. Little, Meera Amar, Barry Horowitz, Narendra Godbole, Monica Hvidsten Swensen, Yin Li, and Richard C. San George. "Accuracy and Precision of a Point-of-Care HbA1c Test." Journal of Diabetes Science and Technology 14, no. 5 (March 10, 2019): 883–89. http://dx.doi.org/10.1177/1932296819831292.

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Background: Point-of-care (POC) hemoglobin A1c (HbA1c) testing has advantages over laboratory testing, but some questions have remained regarding the accuracy and precision of these methods. The accuracy and the precision of the POC Afinion™ HbA1c Dx test were investigated. Methods: Samples spanning the assay range were collected from prospectively enrolled subjects at three clinical sites. The accuracy of the POC test using fingerstick and venous whole blood samples was estimated via correlation and bias with respect to values obtained by an NGSP secondary reference laboratory (SRL). The precision of the POC test using fingerstick samples was estimated from duplicate results by calculating the coefficient of variation (CV) and standard deviation (SD), and separated into its components using analysis of variance (ANOVA). The precision of the POC test using venous blood was evaluated from samples run in four replicates on each of three test cartridge lots, twice per day for 10 consecutive days. The SD and CV by study site and overall were calculated. Results: Across the assay range, POC test results from fingerstick and venous whole blood samples were highly correlated with results from the NGSP SRL ( r = .99). The mean bias was −0.021% HbA1c (−0.346% relative) using fingerstick samples and −0.005% HbA1c (−0.093% relative) using venous samples. Imprecision ranged from 0.62% to 1.93% CV for fingerstick samples and 1.11% to 1.69% CV for venous samples. Conclusions: The results indicate that the POC test evaluated here is accurate and precise using both fingerstick and venous whole blood.

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Haleyur Giri Setty, Mohan Kumar, and Indira K. Hewlett. "Point of Care Technologies for HIV." AIDS Research and Treatment 2014 (2014): 1–20. http://dx.doi.org/10.1155/2014/497046.

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Effective prevention of HIV/AIDS requires early diagnosis, initiation of therapy, and regular plasma viral load monitoring of the infected individual. In addition, incidence estimation using accurate and sensitive assays is needed to facilitate HIV prevention efforts in the public health setting. Therefore, more affordable and accessible point-of-care (POC) technologies capable of providing early diagnosis, HIV viral load measurements, and CD4 counts in settings where HIV is most prevalent are needed to enable appropriate intervention strategies and ultimately stop transmission of the virus within these populations to achieve the future goal of an AIDS-free generation. This review discusses the available and emerging POC technologies for future application to these unmet public health needs.

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32

De Rosa, Rosanna Carmela, Antonio Romanelli, Roberto Colonna, Annunziata Minale, and Antonio Corcione. "Point-of-Care Cardiac Ultrasound in COVID-19 Intensive Care Unit." Central European Annals of Clinical Research 2, no. 1 (September 14, 2020): 1. http://dx.doi.org/10.35995/ceacr2010004.

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(1) Background: Coronavirus disease 2019 (COVID-19) is associated with the development of Acute COVID-19 Cardiovascular Syndrome (ACovCS) in critically ill patients. In this case series, we evaluated the incidence of ACovCS by ultrasound in critically COVID-19 ill patients. (2) Methods: This case series included all patients with confirmed COVID-19 requiring admission to the ICU at Monaldi Hospital (AORN Ospedale dei Colli, Naples), between March 14th, 2020, and May 1st, 2020. On admission, in stable clinical conditions, an experienced and certified intensivist performed Point-Of-Care Cardiac Ultrasound (POC-CU). The exam was performed daily in every patient and repeated according to clinical evolution and intensivist’s judgment during the length of stay. Ex-Novo ACovCS echocardiographic patterns were noted. (3) Results: POC-CU evaluation performed on 19 patients revealed that, on admission, five patients (26.3%) presented an echocardiographic pattern like cor pulmonale. During the length of stay, seven patients (36.8%) presented ex-Novo echocardiographic alterations, suggesting ACovCS. Pericardial effusion (26.3%), acute right impairment due to pulmonary embolism (5.3%) and acute left impairment by wall motion alteration (5.3%) were the most common findings. (4) Conclusions: Ex-Novo cardiac abnormalities shown by POC-CU were common in patients with severe COVID-19. Competence in POC-CU is essential in identifying ACovCS in COVID-ICU and clinical decision-making.

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Loeffelholz, Michael J., and Yi-Wei Tang. "Detection of SARS-CoV-2 at the point of care." Bioanalysis 13, no. 15 (August 2021): 1213–23. http://dx.doi.org/10.4155/bio-2021-0078.

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Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the etiologic agent of COVID-19. Testing for SARS-CoV-2 infection is a critical element of the public health response to COVID-19. Point-of-care (POC) tests can drive patient management decisions for infectious diseases, including COVID-19. POC tests are available for the diagnosis of SARS-CoV-2 infections and include those that detect SARS-CoV-2 antigens as well as amplified RNA sequences. We provide a review of SARS-CoV-2 POC tests including their performance, settings for which they might be used, their impact and future directions. Further optimization and validation, new technologies as well as studies to determine clinical and epidemiological impact of SARS-CoV-2 POC tests are needed.

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Book, Malte, Lutz Lehmann, XiangHong Zhang, and Frank Stüber. "Point-of-Care-Monitoring – Mikrobiologische POC-Diagnostik." AINS - Anästhesiologie · Intensivmedizin · Notfallmedizin · Schmerztherapie 45, no. 11/12 (November 2010): 732–39. http://dx.doi.org/10.1055/s-0030-1268877.

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Sahli, Sebastian D., Julian Rössler, David W. Tscholl, Jan-Dirk Studt, Donat R. Spahn, and Alexander Kaserer. "Point-of-Care Diagnostics in Coagulation Management." Sensors 20, no. 15 (July 30, 2020): 4254. http://dx.doi.org/10.3390/s20154254.

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This review provides a comprehensive and up-to-date overview of point-of-care (POC) devices most commonly used for coagulation analyses in the acute settings. Fast and reliable assessment of hemostasis is essential for the management of trauma and other bleeding patients. Routine coagulation assays are not designed to visualize the process of clot formation, and their results are obtained only after 30–90 m due to the requirements of sample preparation and the analytical process. POC devices such as viscoelastic coagulation tests, platelet function tests, blood gas analysis and other coagulometers provide new options for the assessment of hemostasis, and are important tools for an individualized, goal-directed, and factor-based substitution therapy. We give a detailed overview of the related tests, their characteristics and clinical implications. This review emphasizes the evident advantages of the speed and predictive power of POC clot measurement in the context of a goal-directed and algorithm-based therapy to improve the patient’s outcome. Interpretation of viscoelastic tests is facilitated by a new visualization technology.

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Smyth, Brendan J., Rachel S. Polaski, Anton Safer, Flint A. Boettcher, Dawn Konrad-Martin, and Michael Anne Gratton. "Point-of-Care Glucose and Lipid Profile Measures Using a Human Point-of-Care Device in Mouse Models of Type 2 Diabetes Mellitus, Aging, and Alzheimer Disease." Journal of the American Association for Laboratory Animal Science 60, no. 6 (November 1, 2021): 609–15. http://dx.doi.org/10.30802/aalas-jaalas-21-000011.

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A point-of-care (POC) device to measure mouse glucose and lipid profiles is an important unmet need for cost-effective, immediate decision making in research. We compared metabolic analyte profiles obtained using a human clinical POC device with those from a veterinary laboratory chemical analyzer (LCA). Unfasted terminal blood samples were obtained by cardiac puncture from C57Bl/6J mice used in a diet-induced obesity model of type 2 diabetes mellitus; age-matched C57Bl/6J controls; a transgenic mouse model of Alzheimer's disease on a C57BL/6J background (16 wk old); and aged C57BL/6J mice (24 to 60 wk old). Aliquots of the blood were immediately assayed onsite using the POC device. Corresponding serum aliquots were sent analyzed by LCA. Measures from the POC and LCA devices were compared by using the Bland–Altman and Passing–Bablok methods. Of a total of 40 aliquots, LCA results were within reported reference ranges for each model. POC results that fell beyond the device range were excluded from the analyses. The coefficient of determination and Passing–Bablok analysis demonstrated that POC glucose and HDL had the best agreement with LCA. The Bland–Altman analysis found no value-dependent bias in glucose and no significant bias in HDL. The remaining lipid analytes (cholesterol and triglyceride) showed significant bias. Until an improved, validated mouse POC device with lipid profile capability is available, the POC device that we tested appears adequate for screening glucose and HDL in mouse blood. Disadvantages of this clinical POC device are the narrow human ranges relative to ranges found in mice and its limited precision as compared with the LCA. This study demonstrates that when the samples are within the device range limits, this human POC device can accurately track metabolic syndrome and be used to compare patterns in glucose and HDL.

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Bharadwaj, Mitasha, Michel Bengtson, Mirte Golverdingen, Loulotte Waling, and Cees Dekker. "Diagnosing point-of-care diagnostics for neglected tropical diseases." PLOS Neglected Tropical Diseases 15, no. 6 (June 17, 2021): e0009405. http://dx.doi.org/10.1371/journal.pntd.0009405.

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Inadequate and nonintegrated diagnostics are the Achilles’ heel of global efforts to monitor, control, and eradicate neglected tropical diseases (NTDs). While treatment is often available, NTDs are endemic among marginalized populations, due to the unavailability or inadequacy of diagnostic tests that cause empirical misdiagnoses. The need of the hour is early diagnosis at the point-of-care (PoC) of NTD patients. Here, we review the status quo of PoC diagnostic tests and practices for all of the 24 NTDs identified in the World Health Organization’s (WHO) 2021–2030 roadmap, based on their different diagnostic requirements. We discuss the capabilities and shortcomings of current diagnostic tests, identify diagnostic needs, and formulate prerequisites of relevant PoC tests. Next to technical requirements, we stress the importance of availability and awareness programs for establishing PoC tests that fit endemic resource-limited settings. Better understanding of NTD diagnostics will pave the path for setting realistic goals for healthcare in areas with minimal resources, thereby alleviating the global healthcare burden.

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Muiruri, Keziah, Kevin King’utu, Mary Wangui Gitahi, and George Ochieng Otieno. "Determinants of Point-of-Care Technology Use among Health Care Workers in Comprehensive Care Centres, A Case of Central Kenya." East African Journal of Information Technology 6, no. 1 (July 24, 2023): 107–18. http://dx.doi.org/10.37284/eajit.6.1.1330.

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The Point of Care (POC) approach is the highest level of interaction between health care workers (HCW) and the information system, which generally requires interaction during clinical meetings. Although it is hard to do so, it offers the most significant benefits. The POC strategy offers the system’s benefits to healthcare workers, patients, and those who monitor and evaluate them. The study focused on identifying key determinants of point-of-care technology use among healthcare workers offering services in comprehensive care centres in Central Kenya. A Cross-sectional descriptive study was adopted, two-stage cluster sampling design method was used in determining the sample size. The study involved a sample size of 217 respondents and over a 100% was achieved. The study results revealed that social demographic factors of health care workers have no significant influence on POC technology use as a p-value of above 0.05 was observed on all the variables. Some organisational factors such as adequate workstations (p = 0.0) and EMR reducing patient time (p = 0.012) were found to have significant influence on POC technology use. Significant influence on POC use was noted on source of funding for software and hardware maintenance (p = 0.001). The utilisation of EMR to review client progress in real-time (p = 0.001) was found to have a significant influence on POC technology use as well as the use of EMR to report to the national reporting system (KHIS) (p = 0.014). 71% of respondents reported that availability of clinical decision support features in the EMR was contributing to improved use of POC. An overwhelming 72% reported that they were very motivated to use POC technology due to the ability of auto generating reports. In addition, three factors were highlighted as key contributors to the success of POC use, and these were reliable power supply (44%), adequate and trained healthcare workers (24%), standard and stable EMR Systems (17%). The study recommended for adequate training of health care workers, adequate workstations, and reliable power supply. For initial implementers of EMRs, they should consider having Standard EMRs that support both clinical decision support features and automated reporting.

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Reddy, Shabashini, Andrew Gibbs, Elizabeth Spooner, Noluthando Ngomane, Tarylee Reddy, Nozipho |Luthuli, Gita Ramjee, Anna Coutsoudis, and Photini Kiepiela. "Assessment of the Impact of Rapid Point-of-Care CD4 Testing in Primary Healthcare Clinic Settings: A Survey Study of Client and Provider Perspectives." Diagnostics 10, no. 2 (February 1, 2020): 81. http://dx.doi.org/10.3390/diagnostics10020081.

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Background: The high burden of disease in South Africa presents challenges to public health services. Point-of-care (POC) technologies have the potential to address these gaps and improve healthcare systems. This study ascertained the acceptability and impact of POC CD4 testing on patients’ health and clinical management. Methods: We conducted a qualitative survey study with patients (n = 642) and healthcare providers (n = 13) at the Lancers Road (experienced POC) and Chesterville (non-experienced POC) primary healthcare (PHC) clinics from September 2015 to June 2016. Results: Patients (99%) at Lancers and Chesterville PHCs were positive about POC CD4 testing, identifying benefits: No loss/delay of test results (6.4%), cost/time saving (19.5%), and no anxiety (5.1%), and 58.2% were ready to initiate treatment. Significantly more patients at Chesterville than Lancers Road PHC felt POC would provide rapid clinical decision making (64.7% vs. 48.1%; p < 0.0001) and better clinic accessibility (40.4% vs. 24.7%; p < 0.0001) respectively. Healthcare providers thought same-day CD4 results would impact: Clinical management (46.2%), patient readiness (46.2%), and adherence (23.0%), and would reduce follow-up visits (7.7%), while 38.5% were concerned that further tests and training (15.4%) were required before antiretroviral therapy (ART) initiation. Conclusion: The high acceptability of POC CD4 testing and the immediate health, structural, and clinical management benefits necessitates POC implementation studies.

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St. Hill, Halcyon. "Point-of-Care Testing Triad." Point of Care: The Journal of Near-Patient Testing & Technology 15, no. 2 (June 2016): 86. http://dx.doi.org/10.1097/poc.0000000000000097.

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Sluss, Patrick M. "Point-of-Care Pregnancy Testing." Point of Care: The Journal of Near-Patient Testing & Technology 15, no. 4 (December 2016): 164–71. http://dx.doi.org/10.1097/poc.0000000000000112.

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Di Serio, Francesca, Gianfranco Amodio, Lucia Varraso, Vincenzo Ruggieri, Gianfranco Antonelli, and Nicola Pansini. "Point-of-Care Cardiac Markers." Point of Care: The Journal of Near-Patient Testing & Technology 6, no. 3 (September 2007): 183–86. http://dx.doi.org/10.1097/poc.0b013e3181250000.

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DuBois, Jeffrey A. "Point-of-Care Testing Connectivity." Point of Care: The Journal of Near-Patient Testing & Technology 9, no. 4 (December 2010): 196–98. http://dx.doi.org/10.1097/poc.0b013e3181fc7486.

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Deledda, John M., Gregory J. Fermann, Christopher J. Lindsell, Ronald A. Rohlfing, and W. Brian Gibler. "Cardiac Point-of-Care Testing." Point of Care: The Journal of Near-Patient Testing & Technology 10, no. 1 (March 2011): 1–6. http://dx.doi.org/10.1097/poc.0b013e3182077f63.

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Delany, Charles. "The Point-of-Care Coordinator Training Program—Standardizing Point-of-Care Coordinator Training Globally." Point of Care: The Journal of Near-Patient Testing & Technology 11, no. 3 (September 2012): 165–71. http://dx.doi.org/10.1097/poc.0b013e3182666e98.

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Oberhardt, Bruce J., Patrick D. Mize, and Cynthia G. Pritchard. "Point-of-care fibrinolytic tests: the other side of blood coagulation." Clinical Chemistry 43, no. 9 (September 1, 1997): 1697–702. http://dx.doi.org/10.1093/clinchem/43.9.1697.

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Abstract Point-of-care (POC) coagulation tests with paramagnetic iron oxide particles have provided alternatives to testing previously done only in the laboratory. With this technology, POC fibrinolytic tests have followed quietly the trail blazed by POC clotting tests and have found specific applications. These include rapid verification of in vivo thrombolytic drug action by in vitro testing with subsequent quantitative drug monitoring of the systemic lytic state, and also the determination of in vitro thrombolytic drug response before the drug is actually administered, to individualize therapy by selection of the most appropriate drug. Other applications include POC coagulation factor assays associated with fibrinolysis, and most recently the POC screening of patients with fibrinolytic defects. In this latter application, plasma from cardiac catheterization (n = 19) and venous thrombosis (n = 47) patient groups were tested. Controls consisted of two independent donor pools (n = 10, n = 21) as negatives and two plasma samples with known genetic defects in the fibrinogen molecule (Aα554 Arg → Cys) as positives.

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Learmonth, Kate, Dale McPhee, and Elizabeth M Dax. "Point of care using simple/rapid HIV tests." Microbiology Australia 27, no. 2 (2006): 82. http://dx.doi.org/10.1071/ma06082.

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Movement of HIV testing to point of care (POC) has been facilitated by the availability of simple/rapid anti-HIV immunoassays. These assays have been used at health centres in the United States, Canada and at voluntary counselling and testing centres in developing countries. While this approach has revolutionised HIV screening in some areas, there are ethical, legal and quality assurance considerations that must be addressed before POC HIV testing is universally accepted.

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Brock, BS, T. Keith, Daniel M. Mecozzi, BS, Stephanie Sumner, BS, and Gerald J. Kost, MD, PhD, MS, FACB. "Evidence-based point-of-care tests and device designs for disaster preparedness." American Journal of Disaster Medicine 5, no. 5 (September 1, 2010): 285–94. http://dx.doi.org/10.5055/ajdm.2010.0034.

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Objectives: To define pathogen tests and device specifications needed for emerging point-of-care (POC) technologies used in disasters.Design: Surveys included multiple-choice and ranking questions. Multiple-choice questions were analyzed with the _2 test for goodness-of-fit and the binomial distribution test. Rankings were scored and compared using analysis of variance and Tukey’s multiple comparison test.Participants: Disaster care experts on the editorial boards of the American Journal of Disaster Medicine and the Disaster Medicine and Public Health Preparedness, and the readers of the POC Journal.Results: Vibrio cholera and Staphylococcus aureus were top-ranked pathogens for testing in disaster settings. Respondents felt that disaster response teams should be equipped with pandemic infectious disease tests for novel 2009 H1N1 and avian H5N1 influenza (disaster care, p _ 0.05; POC, p _ 0.01). In disaster settings, respondents preferred self-contained test cassettes (disaster care, p _ 0.05; POC, p _ 0.001) for direct blood sampling (POC, p _ 0.01) and disposal of biological waste (disaster care, p _ 0.05; POC, p _ 0.001). Multiplex testing performed at the POC was preferred in urgent care and emergency room settings.Conclusions: Evidence-based needs assessment identifies pathogen detection priorities in disaster care scenarios, in which Vibrio cholera, methicillin-sensitive and methicillin-resistant Staphylococcus aureus, and Escherichia coli ranked the highest. POC testing should incorporate setting-specific design criteria such as safe disposable cassettes and direct blood sampling at the site of care.

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Manoto, Sello, Masixole Lugongolo, Ureshnie Govender, and Patience Mthunzi-Kufa. "Point of Care Diagnostics for HIV in Resource Limited Settings: An Overview." Medicina 54, no. 1 (March 13, 2018): 3. http://dx.doi.org/10.3390/medicina54010003.

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Human immunodeficiency virus (HIV) is a global health problem. Early diagnosis, rapid antiretroviral therapy (ART) initiation and monitoring of viral load are the key strategies for effective HIV management. Many people in resource limited settings where timely access to medical care is a challenge and healthcare infrastructure is poor have no access to laboratory facilities and diagnosis is dependent on the presence of point of care (POC) devices. POC instruments have shown to be easy to operate, maintain and transport and can easily be operated by less skilled health workers. Additionally, POC tests do not require laboratory technicians to operate. POC devices have resulted in a growing number of people testing for HIV and thereby receiving treatment early. In recent years, there has been great improvement in the development of POC technologies for early HIV diagnosis, HIV viral load and cluster of differentiation 4 (CD4) measurement. This review discusses POC technologies that are currently available and in the pipeline for diagnosing and monitoring HIV. We also give an overview of the technical and commercialization challenges in POC diagnostics for HIV.

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Gupta, Niharika, Shine Augustine, Tarun Narayan, Alan O’Riordan, Asmita Das, D. Kumar, John H. T. Luong, and Bansi D. Malhotra. "Point-of-Care PCR Assays for COVID-19 Detection." Biosensors 11, no. 5 (May 1, 2021): 141. http://dx.doi.org/10.3390/bios11050141.

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Molecular diagnostics has been the front runner in the world’s response to the COVID-19 pandemic. Particularly, reverse transcriptase-polymerase chain reaction (RT-PCR) and the quantitative variant (qRT-PCR) have been the gold standard for COVID-19 diagnosis. However, faster antigen tests and other point-of-care (POC) devices have also played a significant role in containing the spread of SARS-CoV-2 by facilitating mass screening and delivering results in less time. Thus, despite the higher sensitivity and specificity of the RT-PCR assays, the impact of POC tests cannot be ignored. As a consequence, there has been an increased interest in the development of miniaturized, high-throughput, and automated PCR systems, many of which can be used at point-of-care. This review summarizes the recent advances in the development of miniaturized PCR systems with an emphasis on COVID-19 detection. The distinct features of digital PCR and electrochemical PCR are detailed along with the challenges. The potential of CRISPR/Cas technology for POC diagnostics is also highlighted. Commercial RT–PCR POC systems approved by various agencies for COVID-19 detection are discussed.

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