Point-of-care testing: Where is the evidence? A systematic survey

Valentina Pecoraro, Luca Germagnoli, Giuseppe Banfi

Research output: Contribution to journalArticle

Abstract

Point-of-care testing (POCT) has had rapid technological development and their use is widespread in clinical laboratories to assure reduction of turn-aroundtime and rapid patient management in some clinical settings where it is important to make quick decisions. Until now the papers published about the POCT have focused on the reliability of the technology used and their analytical accuracy. We aim to perform a systematic survey of the evidence of POCT efficacy focused on clinical outcomes, selecting POCT denoted special analytes characterized by possible high clinical impact. We searched in Medline and Embase. Two independent reviewers assessed the eligibility, extracted study details and assessed the methodological quality of studies. We analyzed 84 studies for five POCT instruments: neonatal bilirubin, procalcitonin, intra-operative parathyroid hormone, troponin and blood gas analysis. Studies were at high risk of bias. Most of the papers (50%) were studies of correlation between the results obtained by using POCT instruments and those obtained by using laboratory instruments. These data showed a satisfactory correlation between methods when similar analytical reactions were used. Only 13% of the studies evaluated the impact of POCT on clinical practice. POCT decreases the time elapsed for making decisions on patient management but the clinical outcomes have never been adequately evaluated. Our work shows that, although POCT has the potential to provide beneficial patient outcome, further studies may be required, especially for defining its real utility on clinical decision making.

Original languageEnglish
Pages (from-to)313-324
Number of pages12
JournalClinical Chemistry and Laboratory Medicine
Volume52
Issue number3
DOIs
Publication statusPublished - 2014

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Keywords

  • Clinical decision making
  • Clinical outcome
  • Diagnostic applications
  • Evidence
  • Patient management
  • Point-of-care testing
  • Quality of reporting

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

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