Abstract
In terms of testing, modern laboratory medicine can be divided into centralized testing in central laboratories and point-of-care testing (POCT). Centralized laboratory medicine offers high-quality results, as guaranteed by the use of quality management programs and the excellence of the staff. POCT is performed by clinical staff, and so such testing has moved back closer to the patient. POCT has the advantage of shortening the turnaround time, which potentially benefits the patient. However, the clinical laboratory testing expertise of clinical staff is limited. Consequently, when deciding which components of laboratory testing must be conducted in central laboratories and which components as POCT (in relation to quality and timeliness), it will be medical necessity, medical utility, technological capabilities and costs that will have to be ascertained. Provided adequate quality can be guaranteed, POCT is preferable, considering its timeliness, when testing vital parameters. It is also preferred when the central laboratory cannot guarantee the delivery of results of short turn-around-time (STAT) markers within 60 or (even better) 30 min. POCT should not replace centralized medical laboratory testing in general, but it should be used in cases where positive effects on patient care have been clearly demonstrated.
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Americal College of Medical Quality (2004) Policies 1 and 2. http://www.acmq.org/policies/policies1and2.pdf. Last accessed 18 August 2008
Stankovic AK (2004) Clin Lab Med 24:1023–1035
Carraro P, Plebani M (2007) Clin Chem 53:1338–1342
Plebani M (2006) Clin Chem Lab Med 44:750–759
Plebani M, Ceriotti F, Messeri G, Ottomano C, Pansimi N, Bonini P (2006) Clin Chem Lab Med 44:150–160
Ricos C, Garcia-Victoria M, de la Fuente B (2004) Clin Chem Lab Med 42:578–582
Nevalainen D, Berte L, Kraft C, Leigh E, Picaso L, Morgan T (2000) Arch Pathol Lab Med 124:516–519
Valenstein PN, Sours R, Wilkinson DS (2005) Arch Pathol Lab Med 129:467–473
Jacobs E, Goldsmith B, Larrson L, Richardson, St Louis P (2006) Introduction. In: Nichols JH (ed) The National Academy of Clinical Biochemistry laboratory medicine practice guidelines: evidence-based practice for point-of-care testing. AACC Press, Washington, DC, pp VI–VIII. http://www.aacc.org/members/nacb/LMPG/OnlineGuide/PublishedGuidelines/poct/Pages/poctpdf.aspx. Last accessed 18 August 2008
Nichols JH (2003) Expert Rev Mol Diagn 3:563–572
Nichols JH (ed) (2006) The National Academy of Clinical Biochemistry laboratory medicine practice guidelines: evidence-based practice for point-of-care testing. AACC Press, Washington, DC. http://www.aacc.org/members/nacb/LMPG/OnlineGuide/PublishedGuidelines/poct/Pages/poctpdf.aspx. Last accessed 18 August 2008
Fleisher M, Schwartz MK (1990) Clin Chem 36:1557–1561
Castro HJ, Oropello JM, Halpern N (1995) Am J Clin Pathol 104(4 Suppl 1):95–99
Bednarek FJ, Weisberger S, Richardson DK, Frantz ID, Shah B, Rubin LP (1998) J Pediatr 133:601–607
Fermann GJ, Suyama J (2002) J Emerg Med 22:393–404
Müller MM, Hackl W, Griesmacher A (1999) Anaesthesist 48:3–8
Jacobs E, Goldsmith B, Larrson L, Richardson H, St Louis P (1006) Management. In: Nichols JH (ed) The National Academy of Clinical Biochemistry laboratory medicine practice guidelines: evidence-based practice for point-of-care testing, pp 1–4. AACC Press, Washington, DC. http://www.aacc.org/members/nacb/LMPG/OnlineGuide/PublishedGuidelines/poct/Pages/poctpdf.aspx. Last accessed 18 August 2008
International Organization of Standardization (2006) Point-of-care testing (POCT): requirements for quality and competence (ISO 22870:2006). ISO, Geneva
St Louis P (2006) Clin Biochem 33:427–440
Gutierres SL, Welty TE (2004) Ann Pharmacother 38:119–125
Novis DA, Jones BA, Dale JC, Walsh MK, College of American Pathologists (2004) Arch Pathol Lab Med 128:158–164
Howanitz PJ (2005) Arch Pathol Lab Med 129:1252–1261
Steindel SJ, Jones BA, Howanitz PJ (1996) Clin Chim Acta 251:25–40
Winkelmann JW, Wybenga DR, Tanasijevic MJ (1994) Clin Chem 40:1628–1630
Kilgore ML, Steindel SJ, Smith JA (1998) Clin Chem 44:1597–1603
Kendall J, Reeves B, Clancy M (1998) Br Med J 316:1052–1057
Tsai WW, Nash CB, Seamonds B, Weir GJ (1997) Jt Comm J Qual Improv 23:362–380
Solomon HM, Mullins RE, Lyden P, Thompson P, Hudoff S (1998) Am J Clin Pathol 109:371–378
Becker RC, Cyr J, Corrao JM, Ball SP (1994) Am Heart J 128:719–723
Collinson PO, John C, Cramp DRG, Canepa-Anson R (1998) Clin Chem 44(suppl):A69
McCord J, Nowak RM, McCullough PA, Foreback C, Borzak S, Tokarski G, Tomlanovich MC, Jacobsen G, Weaver WD (2001) Circulation 104:1483–1488
Di Serio F, Trerotoli P, Tampoia M, Matarrese A, Pansini N (2003) Clin Chem Acta 333:185–189
Parvin CA, Lo SF, Deuser SM, Weaver LG, Lewis LM, Scott MG (1996) Clin Chem 42:711–717
Van Heyningen C, Watson ID, Morrice AE (1999) Clin Chem 45:437–438
Nichols JH, Kickler TS, Dyer KL, Humbertson SK, Cooper PC, Maughan WL, Oechsle DG (2000) Clin Chem 46:543–550
Murray RP, Leroux M, Sabga E, Palatnick W, Ludwig L (1999) J Emerg Med 17:811–814
Sand VM, Auerbach PS, Birnbaum J, Green M (1995) Acad Emerg Med 2:172–178
Despotis GJ, Santoro SA, Spitznagel E, Kater KM, Cox JL, Barnes P, Lappas DG (1994) J Thorac Cardiovasc Surg 107:271–279
Despotis GJ, Joist JH, Goodnough LT (1997) Clin Chem 43:1684–1696
Shore-Lesserson L, Manspeizer HE, DePerio M, Francis S, Vela-Cantos F, Ergin MA (1999) Anesth Analg 88:312–319
Wu AH, Clive JM (1997) Clin Chem 43:326–332
Brogan GX Jr, Bock JL (1998) Clin Chem 44:1865–1869
Singer AJ, Ardise J, Gulla J, Cangro J (2005) Ann Emerg Med 45:587–591
Stief TW, Fareed J (2003) Clin Appl Thrombosis/Hemostasis 9:191–195
Storrow AB, Apple FS, Wu AHB, Jesse R, Frabcis G, Christenson RH (2006) Use of cardiac biomarkers for acute coronary syndromes. In: Nichols JH (ed) The National Academy of Clinical Biochemistry Laboratory medicine practice guidelines: evidence-based practice for point-of-care testing. AACC Press, Washington, DC, pp 13–20. http://www.aacc.org/members/nacb/LMPG/OnlineGuide/PublishedGuidelines/poct/Pages/poctpdf.aspx. Last accessed 18 August 2008
Winkelmann JW, Woo J, Tirabassi CP, O’Connell M (1991) Centralization and decentralization of the hospital clinical laboratory. In: Vonderschmitt DJ (ed) Clinical biochemistry principles and methods. Walter de Gruyter, Berlin, pp 81–98
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Schimke, I. Quality and timeliness in medical laboratory testing. Anal Bioanal Chem 393, 1499–1504 (2009). https://doi.org/10.1007/s00216-008-2349-5
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DOI: https://doi.org/10.1007/s00216-008-2349-5