Point-Of-Care (POC) Tests And Their Implications For Healthcare
Traditionally, diagnostic testing was exclusively performed within complex laboratories. As the need for more convenient and rapid diagnostics grow worldwide, testing has begun to partially decentralize, and our technology has started to catch up with the growing demand. With the recent development of more portable and easy-to-use testing devices, laboratory testing is now complemented by point-of-care (POC) tests that can be performed outside of the laboratory. Here is what to know about point-of-care (POC) testing.
What are point-of-care (POC) tests?
Point-of-care (POC) testing refers to any test that is performed outside the centralized laboratory and near a patient or treatment site. As Point-of-care (POC) tests enable sample collection, analysis, and interpretation without need for laboratory technology, these tests can be performed as close as possible to the patient. They can be used to analyze a wide range of health parameters at the bedside, in ambulances, accident scenes, infectious disease containment units, remote regions, ships, and even in a space shuttle.
Point-of-care (POC) tests can be performed by a wide range of healthcare practitioners such as emergency first responders, radiologists, doctors, nurses, physician assistants, and laboratory professionals. Some point-of-care (POC) tests, called self-tests or at-home tests, even allow self-administration. Moreover, Point-of-care (POC) tests typically result within minutes, which prevents delays in decision making. Today, option of point-of-care (POC) testing is available for the screening of a myriad of conditions including blood glucose testing, pregnancy testing, blood gas and electrolytes analysis, cholesterol monitoring, fecal occult blood analysis, urine strips testing, drug abuse testing, rapid cardiac markers diagnostics, as well as infectious disease testing such as COVID-19 rapid testing, influenza testing, and HIV testing.
When to use point-of care (POC) tests?
Although the option of point-of-care testing is widely available for many health parameters ranging from pregnancy to drug abuse, point-of-care (POC) testing has proved to be particularly useful for the followings:
- the consistent screening of people with chronic diseases
- rapid screening of highly infectious diseases
- emergency situations where immediate decision making is decisive
- remote, resource-limited, or disaster-ridden settings
How do point-of-care (POC) tests work?
Point-of-care (POC) tests typically require the use of transportable, portable, disposable, or handheld kits and strips that provide non-intrusive sample collection and easy-to- follow procedure. They function by relatively simple to collect specimen such as saliva, urine, or finger-prick blood. Although these tests are generally consumer-friendly and low risk to use, it is essential for all individuals, even healthcare professionals to follow the given instructions regarding the administration of the test and the interpretation of results carefully. To prevent the occurrence of accidents and errors, the test must be performed exclusively for its intended use and in accordance with the given instructions.
Overall, while they are highly convenient, it is clinically proven that relative to centralized laboratory testing, Point-of-care (POC) tests may be less sensitive and more prone to errors. The environment of point-of-care (POC) testing is also typically less controlled than laboratory tests, which may increase the risk of contamination and further limit the accuracy of the results. Therefore, it is important to follow up your initial point-of-care test with a laboratory test to confirm your diagnosis.
What are the advantages of point-of-care (POC) tests?
Point-of-care (POC) tests offer a wide range of benefits regarding disease prevention, early detection, and screening of chronic conditions.
First, as point-of-care (POC) tests give results in real time instead of hours or days, they significantly reduce the turn-around time. Thus, these tests enable immediate decision making, follow-up testing and access to care. Especially within contexts where timing is decisive, point-of-care (POC) tests provide immense advantages. In various forms of emergencies including surgeries, organ transplantation operations, accident scenes, and infectious disease containment units, point-of-care (POC) tests prove to be very efficient tools.
Combined with rapid results, as point-of-care (POC) testing enables the completion of the screening process without need for a second visit and sometimes even without leaving your own home, it reduces the risk of complications and transmission. For instance, clinical trials have demonstrated that individuals monitoring blood thinners like warfarin at home experienced fewer major complications from the treatment. Further, as minimizing physical contact and immediate self-isolation constitute major strategies to curb the spread of many infectious diseases including COVID-19, through providing rapid results with minimal contact, and reducing unnecessary admissions to healthcare institutions, point-of-care (POC) testing helps curb the transmission of infectious pathogens.
Their role in curbing infections
In several cases, point-of-care (POC) tests also proved to improve the number of people who return for treatment after taking a test by significantly reducing the turn-around time and facilitating immediate access to treatment. In a study conducted in a Ghanaian clinic, it was found that when people at a tuberculosis clinic were offered HIV tests on the spot, they were more likely to also return for HIV care.
Especially regarding screening of chronic conditions and highly infectious diseases such as COVID-19, point-of-care (POC) tests can enable more frequent, consistent, and convenient testing by providing the individuals to test themselves wherever, whenever, and as often as they need. On one hand, they have the potential to empower people through improving their access to and control over medical care. On the other hand, the use of these tests may provide more accurate and expansive data on health and disease prevention by reaching targeted populations more efficiently.
Finally, as point-of-care (POC) tests function without laboratory technology and are portable, they are particularly convenient in remote settings or areas with scarce resources where there may be insufficient access to a clinical laboratory or lack adequate infrastructure to deliver the samples there. Further, these tests remain beneficial in the case of disasters such as earthquakes, hurricanes, and any scenario that may block the access to power, water, infrastructure, and equipment.
In addition to their abovementioned advantages, point-of-care (POC) test can be suitable to use with an analyzer. These devices eliminate the human error and provide an objective, mostly quantitative and descriptive results for the test.
Point-of-care (POC) tests offer many advantages regarding early detection, chronic disease screening, and infectious disease management. Especially under any circumstances that timing is of essence and/or there is no access to laboratory infrastructure and resources, these tests are incredibly convenient tools. Moreover, point-of-care (POC) tests prove to be very useful for the screening of chronic and infectious diseases which require frequent and consistent testing. Altogether, these tests answer to the growing demand for more convenient, accessible, and rapid diagnostics. Still, it must be remembered that due to their relative shortcomings in accuracy, point-of-care tests should be followed by a laboratory test to confirm or rule out a diagnosis.