Point-of-care testing

Point-of-care testing (POCT) also known as near-patient testing or bedside testing, is defined as medical diagnostic testing performed at or near the point of care, that is, at the time and place of patient care.This is in contrast to the historical pattern in which testing was entirely or largely confined to medical laboratories, which required sending specimens from the point of care and then waiting hours or days for results, during which time continuous testing had to continue.Carry out care without wanting information.

Technology overview 

Point-of-care tests are simple medical tests that can be done at the bedside.In many cases, this simplicity was unattainable until technological developments not only made testing possible but also masked its complexity.For example, various urine test strips have been available for decades, but portable ultrasonography did not become advanced, affordable, and widespread until the 2000s and 2010s.Today, portable ultrasonography is often seen as a "simple" test, but it wasn't simple until more sophisticated techniques became available.Likewise, pulse oximeters can today test arterial oxygen saturation in a quick, simple, non-invasive, and affordable manner, but in the early days this required an intra-arterial needle and laboratory tests; and rapid diagnostic tests,such as malaria antigen detection tests or COVID-19 rapid tests, these tests rely on state-of-the-art immunological technologies that have only been available in recent decades. As a result, testing has continued to move to the point of care more than ever for decades.A recent survey in five countries (Australia, Belgium, Netherlands, UK and US) showed that GPs/Family Physicians are more likely to use POCT.

The driving idea behind POCT is to provide patients with convenient, point-of-care testing.This increases the likelihood that patients, physicians and care teams will receive results sooner, allowing for better immediate clinical management decisions.POCT includes: blood glucose testing, blood gas and electrolyte analysis, rapid coagulation testing, rapid diagnosis of cardiac markers, drug abuse screening, diaper testing, pregnancy testing, fecal occult blood analysis, food pathogen screening, hemoglobin diagnosis, infectious disease testing (eg COVID-19 Rapid Test), Cholesterol Screening and Micronutrient Deficiency Screening and Acute Febrile Illness Diagnosis.

Lab-on-a-chip technology is one of the main drivers of point-of-care testing, especially in the field of infectious disease diagnostics. These techniques enable different bioassays such as microbial culture PCR, ELISA to be used at the point of care.POCT is usually done using removable, portable, and hand-held instruments (eg, blood glucose meters, nerve conduction research devices) and test kits (eg, CRP, HBA1C, homocysteine, HIV saliva assays, etc.).Small benchtop analyzers or stationary devices can also be used when handheld devices are not available with the goal of collecting specimens at or near the patient and obtaining results in a fraction of the time so that treatment plans can be made and adjusted as needed before the patient leaves.Cheaper, faster, and smarter POCT devices have increased the use of POCT methods, making it cost-effective for many diseases, such as diabetes,carpal tunnel syndrome (CTS)  and acute coronary syndrome. Furthermore, simultaneous measurement of various analytes in the same sample is highly desirable, allowing fast, low-cost, and reliable quantification.Thus, multiple point-of-care testing (xPOCT) has become increasingly important for medical diagnosis over the past decade.

Many point-of-care testing systems are implemented as easy-to-use membrane-based test strips, usually wrapped in a plastic test case.This concept is often implemented in test systems for the detection of pathogens, most commonly the COVID-19 rapid test. Such test systems have also recently been developed for rheumatology diagnosis.These tests require only a single drop of whole blood, urine, or saliva, which any general practitioner can perform and interpret in minutes.Recently, a portable medical diagnostic device named "BioPoC" was reported, which employs a self-contained enzyme-modified responsive polymer membrane biosensor and a newly designed low-cost transduction principle to detect Helicobacter pylori and urea.

During the COVID-19 pandemic, POCT is rapidly evolving to improve turnaround time and ease of use compared to gold-standard laboratory-based PCR testing.These include rapid antigen tests, alternative nucleic acid amplification methods, and novel sensors. have developed a series of tests, including a smartphone-based platform, and proposed tests for blood, saliva, feces, urine, and tears. Especially saliva can provide a sufficiently high detection rate as well as a non-invasive and user-friendly procedure, although the reliability needs to be improved.

Emerging technologies at the point of care are being developed to allow rapid assessment of micronutrient deficiencies.The Cornell NutriPhone is a promising technology for determining nutritional status at the point of care which allows for the assessment of iron, vitamin A vitamin D and vitamin B12 Comes from a single drop of blood about 15 minutes later. Built on the same platform, there are also proof-of-concept studies for fever and cancer.