Comparative Performance of Point-of-Care and Central Laboratory Testing

One of the fields which have benefited most from rapid technological progress in the last fifty century is the medical field. Diseases and conditions which scientists had difficulties understanding and treating are now treated successfully and with relative ease. More people, including the terminally-ill, now live longer than ever before. The 20th century has been characterized by growth in the global population.

The aging and growing population has intensified pressure on health-care resources world-wide so that no one state is currently able to match demand for health-care and supply of the same. Scientists are therefore under increasing pressure to develop new technologies to increase consumers’ timely access to health-care. A most significant and revolutionary development in medicine has been the rise and growth of point-of-care (POC) testing.

According to Ehrmeyer & Leassig [1], POCT is defined as “patient specimens assayed at or near the patient with the assumption that test results will be available instantly or in a very short timeframe to assist caregivers with immediate diagnosis and/or clinical intervention” [pg 766]. Point-of-care testing is done outside the conventional centralized laboratory, and has made self-management easier as patients can test themselves and respond to the results as advised by their physicians.

POC testing technology is critical to the success of life-saving and emergency evacuation missions as tests can be done in an ambulance and in intensive care units where decisions are time-sensitive. Some of the advantages of the fast-growing point-of-care testing technology include rapid diagnosis and treatment, reduced cost of health, higher staff productivity and revenue for manufacturers of testing equipment [2]. By keeping some patients outside hospitals, health-care providers are also reducing overcrowding in their facilities. Literature Review

The popularity of point-of-care testing technology has grown at a pace so fast that researchers have termed POCT implementation as the “silent revolution” in medicine [3]. The shorter turn-around time, fewer patient visits to hospitals, rapid diagnosis and timely treatment have given point-of-care testing advantage over centralized laboratory testing. Patients and clinicians alike have expressed increasing levels of satisfaction with the fast turn-around times and point-of-care testing programs including pregnancy tests, white-blood glucose, urinalysis and cardiac markers [4].

Despite its burgeoning popularity, point-of-care technology may not replace centralized laboratory testing. The standardized and top-end training of staff in centralized medical laboratories and access to high-tech laboratory equipment guarantee results which are more reliable and less prone to errors [5]. The risk of faulty results and medical errors associated with point-of-care testing is higher than that associated with centralized laboratory testing [6].

The cost of medical error is high, with as many as 98 000 patients dying in US hospitals due to medical errors annually [1]. Health-care professionals must therefore weigh the advantages and disadvantages of point-of-care testing vis-a-vis centralized laboratory testing before deciding which one to use for a particular case. Ideally, point-of-care testing should be used in instances where rapid results are needed, where centralized laboratory cannot be accessed easily and where the cost of health-care is a critical concern.

The usefulness of point-of-care technologies should not be overlooked and as they evolve, the risk of errors is likely to reduce significantly [1]. Comparing Point-of-Care Testing with Centralized Medical Laboratory Testing Some of the most prominent advantages of point-of-care testing include reduced health costs, shorter lengths of hospitals stay, rapid turn-around time, and more efficient use of health-care resources [6]. Point-of-care testing devices have therefore become very popular in the private sector, polyclinics, self-management and restructured hospitals [8].

Despite the growing popularity, the level of reliability of results from point-of-care tests has been found to be lower than results of centralized laboratory tests. In one series of tests, Karon et al. [7] established the existence a higher risk …

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