Point-of-care-testing (POCT) promises a simple, accessible, cost-effective alternative to laboratory testing. But many resource-limited areas lack guidelines for quality assurance – so how can we ensure that POCT everywhere conforms to the same standards? This International Pathology Day, we posed this question to a panel of experts…
POCTs need to be as user-friendly as possible, but complex enough to address quality issues. New technologies often have internal quality control systems built in, and even some of the simple bedside or self-monitoring tests allow you to run quality checks more readily than ever, removing the need for complex laboratory backup systems.
Cost and complexity are the main barriers to accessibility. Many UK hospitals have established POCT committees and coordinators; laboratories act as a central point for deployment and quality assurance, with a fixed schedule of auditing and incident recording to maintain quality. Low-resource countries have not yet reached this level of best practice.
It’s important to determine exactly what you’re asking of the test – how is it going to change the management of the patient or outbreak? How it will inform patient flow and management? Many POCTs use the ASSURED criteria: availability, sensitivity, specificity, user-friendliness, robust, reliable, equipment-free, and deliverable.
Resource-limited countries don’t have the infrastructure to undertake processes that are established in developed countries. The main concern is the audit trail and who is managing the process. The simplicity of POCTs can sometimes mean that people grow lax in their procedures – so we must be vigilant.
Want to hear more? Watch the entire panel discussion on demand here.
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