Clinical Review Regular review

Point of care testing

BMJ 2001; 322 doi: http://dx.doi.org/10.1136/bmj.322.7297.1285 (Published 26 May 2001) Cite this as: BMJ 2001;322:1285
  1. Christopher P Price, director of pathology ([email protected])
  1. Barts and London NHS Trust, Whitechapel, London E1 1BB

    Point of care testing, otherwise referred to as near patient, bedside, or extra laboratory testing, is not new. Many of the early “diagnostic tests” were first done at the bedside—for example, urine testing. Over the past few years, however, analytical systems have been developed that enable a wide range of tests to be done quickly and simply without the need for sophisticated laboratory equipment.1

    The key objective of point of care testing is to generate a result quickly so that appropriate treatment can be implemented, leading to an improved clinical or economic outcome (figure). This article sets out the requirements for delivering an effective point of care testing service and reviews the evidence of the clinical and economic effectiveness of point of care testing.

    Summary points

    Point of care testing requires trained operators to ensure a good quality service

    Testing is effective only if action taken on the result

    Testing has been shown to reduce hospital stay, improve adherence to treatment, and reduce complications Although point of care testing is more expensive than laboratory testing, it produces wider economic benefits

    Methods

    I searched the literature with Medline and Embase using the key phrases “point of care testing,” “bedside testing,” “near patient testing,” and “extra laboratory testing.” I also hand searched relevant laboratory medicine and disease related journals (such as those on diabetes) and health technology assessment reports.

    Technology

    Two broad types of technology support point of care testing: small bench top analysers (for example, blood gas and electrolyte systems) and hand held, single use devices (such as urine albumin, blood glucose, and coagulation tests). The bench top systems are smaller versions of laboratory analysers in which vulnerable operator dependent steps have been automated—for example, automatic flushing of sample after analysis, calibration, and quality control. Hand held devices have been developed using microfabrication techniques. …

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