Over the past decade, the use of point-of-care testing has been on the rise. With recent advances in technology, the utility of testing in both diagnostic and therapeutic applications has greatly improved the timing and reporting of laboratory results. Consequently, the development of comprehensive guidelines is key to ensuring the clinical utility of point-of-care testing is fully understood and standardization requirements are implemented.
The British Society for Haematology (BSH) recently published a guideline update for point-of-care testing in general hematology in the British Journal of Haematology. Ciaran Mooney, of the department of laboratory medicine at Rotunda Hospital in Ireland, and coauthors updated the previous guidelines released in 2008. The new guidelines review current point-of-care assays and provide a framework for the operation of a point-of-care testing service in accordance with the International Organization for Standardization (ISO) guidelines.
Mooney told Hematology Advisor, “At an institutional level, there is a need to keep up-to-date and get involved with emerging point-of-care technologies and to implement financial, quality, and training infrastructure.”
Range of Point-of-Care Testing Technology
Due to high patient volumes and increasing complexities of care, delivery of accurate and timely laboratory results is key to ensuring optimal treatment is provided to patients. Although the array of point-of-care testing technology is broad, these methods have proven useful to simplify patient flow and deliver results rapidly to clinicians.
The range of currently available point-of-care assays includes:
- Full blood count and automated differential
- Prothrombin time (PT)
- Activated clotting time (ACT)
- Activated partial thromboplastin time (aPTT)
- Viscoelastic assays
- Direct oral anticoagulants (DOACs) and monitoring of antiplatelet agents
- Blood gas and hemoglobin (Hb)/hematocrit (Hct)
A commonly used point-of-care assay is the portable Hb meter, which allows for measurement of Hb, white cell (WBC) count with differential, and platelet count. Many studies have confirmed the accuracy and precision of these meters compared with central laboratory techniques. Other noninvasive methods for Hb measurement include near-infrared spectroscopy technology. Recent evidence suggests these methods are particularly useful for analyzing trends in Hb measurements; however, inconsistency remains when compared with measurements from central laboratories.