To POCT or Not to POCT?
When commonly ordered tests have reliable POCT alternatives, why are doctors still ordering them from the laboratory?
Michael Schubert | | Quick Read
Point-of-care diagnostics are becoming increasingly valuable; they save both patients and healthcare providers time and money, and they can provide rapid answers to better triage patients’ need for care. Nonetheless, some of the most commonly ordered tests are not often performed at the point of care, despite the availability of point-of-care testing (POCT) technology.
For instance, consider C-reactive protein (CRP) and neutrophil count (NC), important markers of inflammation. A recent study from the University of Oxford suggests that both tests are in high demand, with general practitioners ordering an average of 36 CRP and 72 NC tests each week (1). But by sending these tests out to a laboratory, doctors often have to wait up to 24 hours for results that could influence their treatment decisions. POCT equivalents for both tests exist – so why aren’t they being used?
The answer might lie in practitioners’ familiarity with the laboratory versions of the tests, or a lack of information about POCT alternatives. Regardless, CRP and NC testing is ripe for the move from laboratory to POCT. “Inflammatory marker laboratory tests are requested frequently in the community, particularly in combination, with many patients needing repeat tests,” said the study’s lead author, José Ordóñez-Mena, in a recent press release (2).
“We also find that CRP test requests are becoming increasingly common in older patients. Given that these tests can now be provided by point-of-care technologies, there is scope for this testing to start moving into the community, carried out by general practitioners for results within minutes, rather than being performed by central laboratories.”
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- JM Ordóñez-Mena et al., “C-reactive protein and neutrophil count laboratory test requests from primary care: what is the demand and would substitution by point-of-care technology be viable?”, J Clin Pathol, [Epub ahead of print] (2019). PMID: 30992343.
- NIHR, “Scope for inflammatory marker laboratory tests to move into community settings” (2019). Available at: bit.ly/2EUqtKQ. Accessed June 7, 2019.