Research on point-of-care tests in outpatient care in Germany: A scoping review and definition of relevant endpoints in evaluation studies

Matthes, Anni; Bleidorn, Jutta; Markwart, Robby

doi:10.1016/j.zefq.2022.06.002

Cited by 3 publications

(3 citation statements)

References 112 publications

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“…POCT does not require specialized personnel to perform and is not limited by the environment. It can be performed on the spot, at home, in ambulances, or in hospitals [ 17 , 18 ]. With the large-scale outbreak of infectious diseases such as COVID-19, POCT plays an essential role in the rapid diagnosis and timely screening of diseases, especially in areas with limited resources [ 19 ].…”

Section: Introductionmentioning

confidence: 99%

Applications of Transistor-Based Biochemical Sensors

Gao

Ming

2023

Biosensors

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Transistor-based biochemical sensors feature easy integration with electronic circuits and non-invasive real-time detection. They have been widely used in intelligent wearable devices, electronic skins, and biological analyses and have shown broad application prospects in intelligent medical detection. Field-effect transistor (FET) sensors have high sensitivity, reasonable specificity, rapid response, and portability and provide unique signal amplification during biochemical detection. Organic field-effect transistor (OFET) sensors are lightweight, flexible, foldable, and biocompatible with wearable devices. Organic electrochemical transistor (OECT) sensors convert biological signals in body fluids into electrical signals for artificial intelligence analysis. In addition to biochemical markers in body fluids, electrophysiology indicators such as electrocardiogram (ECG) signals and body temperature can also cause changes in the current or voltage of transistor-based biochemical sensors. When modified with sensitive substances, sensors can detect specific analytes, improve sensitivity, broaden the detection range, and reduce the limit of detection (LoD). In this review, we introduce three kinds of transistor-based biochemical sensors: FET, OFET, and OECT. We also discuss the fabrication processes for transistor sources, drains, and gates. Furthermore, we demonstrated three sensor types for body fluid biomarkers, electrophysiology signals, and development trends. Transistor-based biochemical sensors exhibit excellent potential in multi-mode intelligent analysis and are good candidates for the next generation of intelligent point-of-care testing (iPOCT).

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Section: Introductionmentioning

confidence: 99%

Applications of Transistor-Based Biochemical Sensors

Gao

Ming

2023

Biosensors

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“… 15–17 However, in order to comprehensively understand potential benefits of POCTs, further aspects are important, such as impact on clinical routines and decision-making as well as acceptance among medical professionals. 18 …”

Section: Introductionmentioning

confidence: 99%

“…There is also evidence that CRP-POCTs can improve antibiotic prescriptions14 and shorten the length of stay in emergency medical services 15–17. However, in order to comprehensively understand potential benefits of POCTs, further aspects are important, such as impact on clinical routines and decision-making as well as acceptance among medical professionals 18…”

Section: Introductionmentioning

confidence: 99%

Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-hours outpatient emergency medical services

et al. 2023

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ObjectivesOut-of-hours outpatient emergency medical services (OEMS) provide healthcare for patients with non-life-threatening conditions in need for urgent care when outpatient practices are closed. We studied the use of point-of-care-testing of C-reactive protein (CRP-POCT) at OEMS.DesignCross-sectional questionnaire-based survey.SettingSingle centre OEMS practice in Hildesheim, Germany (October 2021 to March 2022).ParticipantsOEMS physicians answering a questionnaire immediately after performing CRP-POCTs (CUBE-S Analyzer, Hitado) on any patients.Primary and secondary outcomesImpact of CRP-POCTs on clinical decision-making and perceived usefulness.ResultsIn the 6-month study period, 114 valid CRP-POCTs were performed in the OEMS practice by 18 physicians and the questionnaire was answered in 112 cases (response rate: 98.2%). CRP-POCTs were used in the diagnosis of inflammatory diseases of the gastrointestinal tract (60.0%), respiratory tract infections (17.0%), urinary tract infections (9.0%) and other non-gastrointestinal/non-specified infections (11.0%). The use of a CRP-POCT resulted in a change of the physicians’ clinical decision in 83.3% of the cases. Specifically, in 13.6% and 35.1% of the cases, rapid CRP measurements led to decision changes in the (1) initiation of antimicrobial therapy and (2) other drug treatment, respectively. Notably, in 60% of all cases, the use of a CRP-POCT reportedly changed the decision on hospitalisation/non-hospitalisation of OEMS patients. In respect of antimicrobial therapy and hospitalisation, these decision changes primarily (≥73%) promoted ‘step-down’ decisions, that is, no antibiotic therapy and no hospital admission. In the great majority of CRP-POCT applications (≥95%), OEMS physicians reported that rapid CRP measurements increased the confidence in their diagnostic and therapeutic decision. In almost all cases (97%), physicians rated the CRP-POCT use as useful in the treatment situation.ConclusionQuantitative CRP-POCT promotes step-down clinical decisions and strengthens the clinical confidence of physicians in out-of-hours OEMS.

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Point-of-care laboratory testing in primary care: utilization, limitations and perspectives of general practitioners in Germany

et al. 2023

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Background Due to their fast turnaround time and user-friendliness, point-of-care tests (POCTs) possess a great potential in primary care. The purpose of the study was to assess general practitioners’ (GPs) perspectives on POCT use in German primary care, including utilization, limitations and requirements. Methods We conducted a cross-sectional survey study among GPs in Germany (federal states of Thuringia, Bremen and Bavaria (Lower Franconia), study period: 04/22–06/2022). Results From 2,014 GPs reached, 292 participated in our study (response rate: 14.5%). The median number of POCTs used per GP was 7.0 (IQR: 5.0–8.0). Six POCTs are used by the majority of surveyed GPs (> 50%): urine dipstick tests (99%), glucose (urine [91%] and plasma [69%]), SARS-CoV-2 (80%), urine microalbumin (77%), troponin I/T (74%) and prothrombin time / international normalized ratio (65%). The number of utilized POCTs did not differ between GP practice type (p = 0.307) and population size of GP practice location (p = 0.099). The great majority of participating German GPs (93%) rated POCTs as useful diagnostic tools in the GP practice. GPs ranked immediate decisions on patient management and the increase in diagnostic certainty as the most important reasons for performing POCTs. The most frequently reported limitations of POCT use in the GP practice were economic aspects (high costs and inadequate reimbursement), concerns regarding diagnostic accuracy, and difficulties to integrate POCT-testing into practice routines (e.g. time and personnel expenses). Conclusion Although participating German GPs generally perceive POCTs as useful diagnostic tools and numerous POCTs are available, several test-related and contextual factors contribute to the relatively low utilization of POCTs in primary care.

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Research on point-of-care tests in outpatient care in Germany: A scoping review and definition of relevant endpoints in evaluation studies

Cited by 3 publications

References 112 publications

Applications of Transistor-Based Biochemical Sensors

Applications of Transistor-Based Biochemical Sensors

Point-of-care measurement of C-reactive protein promotes de-escalation of treatment decisions and strengthens the perceived clinical confidence of physicians in out-of-hours outpatient emergency medical services

Point-of-care laboratory testing in primary care: utilization, limitations and perspectives of general practitioners in Germany

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