Rapid and point-of-care tests accurate, convenient for hepatitis C screening

Rapid and point-of-care screening tests for hepatitis C have a high accuracy and quick turnaround time, suggest results of a systematic review and meta-analysis.

The researchers say that these tests "could play a substantial role in expanded global screening initiatives, which would eventually impact the control of hepatitis C virus(HCV) infection at the population level."

Writing in the Annals of Internal Medicine, Nitika Pant Pai (McGill University Health Centre, Montreal, Quebec, Canada) and colleagues explain that many people infected with hepatitis C remain undiagnosed. It has been suggested that rapid diagnostic tests (RDTs) and point-of-care tests (POCTs) are a time- and cost-saving alternative to conventional laboratory tests. However, their global uptake depends on their performance.

To investigate further, Pant Pai and team performed a meta-analysis of 19 studies assessing the diagnostic accuracy of POCTs and RDTs to screen for hepatitis C in adults.

They found that POCTs of blood (serum, plasma, or whole) had the highest accuracy, followed by RDTs of serum or plasma and POCTs of oral fluids. Indeed, the sensitivity of POCTs of blood was around 99%, followed by 98% for RDTs of serum or plasma, and 98% for POCTs of oral fluid.

Specificity of POCTs of blood was also high, at more than 99%, followed by 98.6% for RDTs of serum or plasma and 98.2% for POCTs of oral fluid.

"First generation point-of-care tests are convenient, effective and informative for clinical decision making," say Pant Pai et al. "These tests don't usually require specialized equipment, they can provide results within 30 minutes, or maximally within one patient visit or one working day, and many do not require electricity."

They add that, in light of the tests' accuracy and an "urgent need to increase hepatitis C screening in marginalized and at-risk populations and in endemic HCV settings," these tests may be useful in expanding first-line screening for hepatitis C.

Por Nikki Withers medwireNews

Tomado de:news-medical.net

NOTICIAS SOBRE LABORATORIO CLINICO

Mobile POCT Labs and Disaster Preparedness

In response to my recent note entitled POCT and Mobile Labs (link here), Ellen Sullivan of the ASCP has called my attention to an article from the AJCP entitled Katrina, the Tsunami, and Point-of-Care Testing: Optimizing Rapid Response Diagnosis in Disasters by Kost, Tran, Tuntideelert, Kulrattanamaneeporn, and Peungposop (link here). The article discusses how point-of-care testing (POCT) can optimize diagnosis, triage, and patient monitoring during disasters. Here is a quote from the article:

Dedicated mobile medical units equipped with POCT instruments and ICU modules can move to sites in need of help during the first week, as observed during Katrina. POCT represents an established approach valuable in clinical practice. However, research is needed to develop field-worthy POCT devices robust enough to withstand extreme ranges of humidity, temperature, salinity, altitude, earthquake shock, and battery operation during rescue operations. Reagents, tests strips, and quality control materials must withstand the same harsh conditions or be transported in environmentally controlled containers (refrigerated or heated, depending on the circumstances) that meet manufacturers specifications. Better yet, manufacturers should improve durability and validate testing cycles under disaster field conditions, license instruments specifically for this purpose, and design modular POCT formats that can be converted easily and quickly for field use with flexible test clusters suitable for different types of disasters.

These goals established by Kost et al. are important and should be pursued by lab professionals in concert with device and reagent manufacturers. Let's assume that such a group were to design a mobile POCT lab that could be operated under disaster field conditions and could support the flexible test cluster concept described above. To my way of thinking, it would be a mistake to position such mobile labs around the country (or world) in dead storage, awaiting such periodic disasters as will definitely occur. It would make much more sense to deploy such mobile POCT labs in various medical centers around the world and place them in active daily use. The cost of such labs could be shared by both the health systems operating them and the various disaster support and relief organizations around the world such as FEMA in the U.S.

With such a dual-use approach, these mobile POCT labs would always be in good operating order, stocked with fresh reagents, and their functionality could be continuously enhanced by collaboration with the manufacturers. They could then be air-lifted to global emergency sites as needed. In fact, the skilled personnel managing such mobile labs on a day-to-day basis in hospitals could even accompany the mobile labs to the emergency sites so that trained teams would be immediately available to manage them.

Posted by Bruce Friedman on October 18, 2006 at 07:02 AM in Clinical Lab Industry News, Clinical Lab Testing, Healthcare Solutions Other than Lab, Lab Processes and Procedures, Point-of-Care Testing | Permalink

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