Nucleic acid testing for point-of-care using：advances in technologies and future perspectives / 中华检验医学杂志

Point-of-care testing ( POCT ) is expanding rapidly worldwide due to its simplicity and rapid testing.At present , POCT has mainly focused on detection of proteins ( antigen/antibody ) and small molecules based on immunological assay and dry chemical technology.In the past decade , rapid diagnostic assays for nucleic acid have quickly progressed.Some nucleic acid-based POCT products have been developed and approved by US FDA.Now this article discusses the advances in the field of rapid nucleic acid testing including some new technologies and their applications.As a new area of in vitro diagnostics , POCT for nucleic acid is worthy of our attention.

Installation of Network-Connected Point-of-Care Blood Glucose Meters / 임상검사와정도관리

Point-of-care (POC) testing is desirable because of both the ease with which it can be administered and its short turnaround time. However, because standard POC devices cannot transmit test results automatically to a laboratory information system (LIS), each result must be recorded by hand. This inconvenience not only increases the possibility of clerical errors, but also limits the proper use of test results. If POC test results are not saved in the LIS, it is hard to either monitor patients' health trends or to quality control (QC) the test results. In this paper, we describe how we have solved these problems by connecting 250 POC blood glucose test devices to the LIS via a local area network (LAN). After connecting the POC devices (we used the Accu-Chek Inform II; Roche Diagnostics, Germany) to a manufacturer-provided POC data management system (Roche's Cobas IT 1000; Roche Diagnostics), we developed our own interface program for delivering data from the Cobas IT 1000 system to the LIS. By installing a program to scan the identification barcode worn by patients on their wrists, network-connected POC devices enable users to omit extra ordering, receiving, and recording processes, and they also reduce the possibility of patient misidentification. Such a system also provides an effective way for physicians to follow both the current and accumulated test results of patients. We note that performing QC on glucometers and the sending of data via LAN to the LIS are necessary steps to monitor both patients' results and the QC of those results.

Performance Evaluation of the Portable Blood Gas Analyser Epoc(TM) / 임상검사와정도관리

BACKGROUND: A handheld blood gas analyser has been newly developed for mobile monitoring of blood gasses and electrolytes. We evaluated the performance of a portable blood gas analyser, Epoc(TM) (Epocal Inc., Canada) according to Clinical and Laboratory Standard Institute (CLSI) guidelines, and compared it to that of a conventional analyser used in clinical laboratories. METHODS: Precision and percent carry-over were determined using three levels of aqueous and hematocrit control materials according to CLSI EP10-A3. Linearity was determined using five levels of control materials according to CLSI EP6-A. The pH, pCO2, pO2, Na+, K+, Ca2+, glucose, lactate, and hematocrit levels were compared between the Epoc(TM) and Stat Profile Critical Care Xpress (STP CCX; Nova Biomedical, USA) analysers using whole blood samples from 40 subjects according to CLSI EP9-A2. RESULTS: The coefficient of variation of the within-run precision and total precision were 0.000% to 4.563% and 0.000% to 5.298%, respectively. The carry-over was within 5%. The Epoc(TM) analyser showed excellent linearity for all nine parameters evaluated. For the comparison study, the Epoc(TM) and conventional analysers showed comparable results (correlation coefficient [r]=0.900-0.995), except for hematocrit (r=0.764). CONCLUSIONS: The Epoc(TM) POC analyser shows reliable analytical precision and is comparable to the traditional bench-top blood gas analysers. It could be useful in clinical settings, especially in operating rooms and pediatric intensive care units.

Effect of beta-hCG with a Point-of-Care Test in the Emergency Department

PURPOSE: The rapid and accurate diagnosis of pregnancy is important in the emergency department (ED) before evaluation of radiologic tests and medication decisions. Our primary objective was to assess the agreement between whole blood pregnancy tests done in the emergency department and those done in laboratory [serum human chorionic gonadotropin (beta-hCG) and urine beta-hCG]. The secondary objective was to compare turnaround times for tests done in the ED and those done in the laboratory. METHODS: This prospective study enrolled females of childbearing age needing a pregnancy test who visited an ED. Using whole blood, urine and serum from each patient, testing was done in the ED (whole blood - Hubi Quan pro-point of care test, POCT) and in the laboratory using a urine hCG kit (iIexscreen) and in serum (ADVIA centaur). The data included time of each test, beta-hCG result, and urine pregnancy test result. RESULTS: There was a high level of agreement between the POCT using whole blood and the serum beta-hCG as indicated by a kappa value of 0.921(95% confidence interval). The POCT performed in the ED was significantly faster in time to report than tests performed in the laboratory, with mean differences of 20.21+/-2.0 minutes and 36.14+/-20.86 minutes. The sensitivity and specificity of POCT was 98.18% and 93.75%, respectively. CONCLUSION: In ED, the POCT test can perform pregnancy test as accurately as in the laboratory, and can provide results on which to base care much faster than waiting for the laboratory results. POCT may expedite the ED management of patients who require pregnancy tests. Especially, this POCT uses whole blood instead of the urine, since the latter was inconvenient for the test.

Implementation of Device Independent ECG Reporting System Using Web Development Framework / 대한의료정보학회지

OBJECTIVE: We developed a Cocoon framework-based device independent electrocardiogram(ECG) Reporting System in order to support such various web devices as desktop Personal Computer(PC), Personal Digital Assistants(PDA) and SmartPhone. METHODS: ECG Reporting System, built in the Cocoon framework, consists of modules of ECG Report Module and ECG Image Module. Two modules publish the applied ECG Report to each different templates according to the requesting device. The method of framework-based development in this paper features a reduction of development costs and the robust stability of system. RESULTS: The medical staff may require patient ECG information in ubiquitous healthcare environment, ECG Reporting System supports their correct judgment and expeditious response by servicing ECG report of the patient according to the requesting device. CONCLUSION: The proposed system and concept in this paper may be a good solution for developing the point of care service system supporting various mobile devices.