BookPeter B. Luppa, Ralf Junker (eds.).
Summary: The underlying technology and the range of test parameters available are evolving rapidly. The primary advantage of POCT is the convenience of performing the test close to the patient and the speed at which test results can be obtained, compared to sending a sample to a laboratory and waiting for results to be returned. Thus, a series of clinical applications are possible that can shorten the time for clinical decision-making about additional testing or therapy, as delays are no longer caused by preparation of clinical samples, transport, and central laboratory analysis. Tests in a POC format can now be found for many medical disciplines including endocrinology/diabetes, cardiology, nephrology, critical care, fertility, hematology/coagulation, infectious disease and microbiology, and general health screening. Point-of-care testing (POCT) enables health care personnel to perform clinical laboratory testing near the patient. The idea of conventional and POCT laboratory services presiding within a hospital seems contradictory; yet, they are, in fact, complementary: together POCT and central laboratory are important for the optimal functioning of diagnostic processes. They complement each other, provided that a dedicated POCT coordination integrates the quality assurance of POCT into the overall quality management system of the central laboratory. The motivation of the third edition of the POCT book from Luppa/Junker, which is now also available in English, is to explore and describe clinically relevant analytical techniques, organizational concepts for application and future perspectives of POCT. From descriptions of the opportunities that POCT can provide to the limitations that clinician's must be cautioned about, this book provides an overview of the many aspects that challenge those who choose to implement POCT. Technologies, clinical applications, networking issues and quality regulations are describ ed as well as a survey of future technologies that are on the future horizon. The editors have spent considerable efforts to update the book in general and to highlight the latest developments, e.g., novel POCT applications of nucleic acid testing for the rapid identification of infectious agents. Of particular note is also that a cross-country comparison of POCT quality rules is being described by a team of international experts in this field.
Contents:
Intro; Preface; About the editors; List of authors; Abbreviations; Definitions and areas of application; 1.1 Introduction; 1.2 Terminology and definitions; 1.3 Areas of application; References; The relevance of POCT in healthcare; 2.1 Introduction; 2.2 The medical and financial aspects of POCT diagnostics; 2.2.1 Medical aspects; 2.2.2 Economic aspects; 2.3 The POCT market; 2.3.1 Problems with market valuation; 2.3.2 POCT categories; 2.3.3 Future market trends; References; Device classes; 3.1 Introduction; 3.2 Type 1a
Qualitative POCT methods; 3.3 Type 1b
"Unit-use" POCT systems 3.4 Type 2
Benchtop POCT instruments3.5 Type 3
Viscoelastic coagulation analyzers; 3.6 Type 4
Continuous POCT methods; 3.7 Type 5
Molecular biological POCT analyzers; 3.8 Type 6
Direct-to-consumer testing (DTC); References; Pre- and post-analytical phases; 4.1 Introduction; 4.2 Pre-analytical phase; 4.2.1 Choosing a suitable test; 4.2.2 Capillary blood sampling; 4.2.3 Venous blood sampling; 4.2.4 Arterial blood sampling; 4.2.5 Blood sampling systems and anticoagulants for blood gas analysis; 4.2.6 Blood samples from central lines; 4.2.7 Taking swabs; 4.2.8 Urine sampling 4.2.9 Inspection of the sample4.2.10 Reliable identification of patient and sample; 4.3 Post-analytical phase; 4.4 Avoiding pre- and post-analytical problems; References; Analytical methods, biosensor technology; 5.1 Biosensor technology; 5.1.1 Sensor (bioreceptor); 5.1.2 Transducers, electronic amplifiers; 5.1.3 Sample application/fluidic unit; 5.2 Continuous monitoring methods; 5.2.1 Continuous monitoring methods; 5.2.2 Continuous glucose monitoring (CGM); References; Laboratory coagulation tests 6.2.2 Combined recording of plasmatic coagulation, platelet count and fibrinolysis (viscoelastic methods)6.2.3 Analysis of platelet function; 6.2.4 POCT applications with coagulation testing methods; 6.3 Confounders and influencing variables; 6.4 Quality management; References; Analysis of cellular blood components; 7.1 Introduction; 7.2 Device technology and methods; 7.2.1 POCT blood count analyzers; 7.2.2 Blood gas analyzers; 7.2.3 Single analyses; References; Clinical chemistry parameters; 8.1 Introduction; 8.2 Device technology and methods; 8.2.1 Dry chemistry; 8.2.2 Wet chemistry 8.2.3 Dedicated devices for singular analytes8.3 Applications and indications; References; Immunological methods; 9.1 Methods; 9.1.1 Immunosensors; 9.1.2 Homogeneous and heterogeneous immunoassays; 9.1.3 Immunological rapid tests; 9.2 Device format and quality; 9.3 Areas of application; 9.3.1 Hospital setting; 9.3.2 Physician practice setting; 9.3.3 Home testing; 9.4 Aptamers as adjuncts or alternatives to antibodies; References; Molecular biological tests; 10.1 Introduction; 10.2 Integrated and miniaturized systems; 10.3 Selection criteria for POCT systems