Donald Rumsfeld and point-of-care testing (POCT): the problem of unknown unknowns—venous blood and glucose oxidase-based test strips

Reynolds, Tim; Pillay, Tahir S

doi:10.1136/jclinpath-2016-203931

Cited by 2 publications

(1 citation statement)

References 5 publications

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“…The most common POC glucose test is glucose testing strips, which comprise 53.7% of the total global POCT market. 15 Blood glucose POCT was first used primarily at home or in nursing homes and was later expanded to inpatient settings, such as intensive care and postoperative inpatient environments, to help achieve strict glycemic control. Intensive glycemic control reduces long-term microvascular complications of diabetes.…”

Section: Clinical Chemistrymentioning

confidence: 99%

Current Status of Clinical Application of Point-of-Care Testing

Park

2020

Archives of Pathology &Amp; Laboratory Medicine

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Context.— The clinical applications of point-of-care testing (POCT) are gradually increasing in many health care systems. Recently, POCT devices using molecular genetic method techniques have been developed. We need to examine clinical pathways to see where POCT can be applied to improve them. Objective.— To introduce up-to-date POCT items and equipment and to provide the content that should be prepared for clinical application of POCT. Data Sources.— Literature review based on PubMed searches containing the terms point-of-care testing, clinical chemistry, diagnostic hematology, and clinical microbiology. Conclusions.— If medical resources are limited, POCT can help clinicians make quick medical decisions. As POCT technology improves and menus expand, areas where POCT can be applied will also increase. We need to understand the limitations of POCTs so that they can be optimally used to improve patient management.

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Section: Clinical Chemistrymentioning

confidence: 99%

Current Status of Clinical Application of Point-of-Care Testing

Park

2020

Archives of Pathology &Amp; Laboratory Medicine

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Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) – does it leverage any advantage in clinical decision making?

Florkowski

Don-Wauchope²,

Giménez

et al. 2017

Critical Reviews in Clinical Laboratory Sciences

130

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Point-of-care testing (POCT) is the analysis of patient specimens outside the clinical laboratory, near or at the site of patient care, usually performed by clinical staff without laboratory training, although it also encompasses patient self-monitoring. It is able to provide a rapid result near the patient and which can be acted upon immediately. The key driver is the concept that clinical decision making may be delayed when samples are sent to the clinical laboratory. Balanced against this are considerations of increased costs for purchase and maintenance of equipment, staff training, connectivity to the laboratory information system (LIS), quality control (QC) and external quality assurance (EQA) procedures, all required for accreditation under ISO 22870. The justification for POCT depends upon being able to demonstrate that a more timely result (shorter turnaround times (TATs)) is able to leverage a clinically important advantage in decision making compared with the central laboratory (CL). In the four decades since POCT was adapted for the self-monitoring of blood glucose levels by subjects with diabetes, numerous new POCT methodologies have become available, enabling the clinician to receive results and initiate treatment more rapidly. However, these instruments are often operated by staff not trained in laboratory medicine and hence are prone to errors in the analytical phase (as opposed to laboratory testing where the analytical phase has the least errors). In some environments, particularly remote rural settings, the CL may be at a considerable distance and timely availability of cardiac troponins and other analytes can triage referrals to the main centers, thus avoiding expensive unnecessary patient transportation costs. However, in the Emergency Department, availability of more rapid results with POCT does not always translate into shorter stays due to other barriers to implementation of care. In this review, we apply the principles of evidence-based laboratory medicine (EBLM) looking for high quality systematic reviews and meta-analyses, ideally underpinned by randomized controlled trials (RCTs), looking for evidence of whether POCT confers any advantage in clinical decision making in different scenarios.

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Donald Rumsfeld and point-of-care testing (POCT): the problem of unknown unknowns—venous blood and glucose oxidase-based test strips

Cited by 2 publications

References 5 publications

Current Status of Clinical Application of Point-of-Care Testing

Current Status of Clinical Application of Point-of-Care Testing

Point-of-care testing (POCT) and evidence-based laboratory medicine (EBLM) – does it leverage any advantage in clinical decision making?

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