scholarly journals »Point-of-Care« D-Dimer Testing

2010 ◽  
Vol 29 (4) ◽  
pp. 282-287 ◽  
Author(s):  
Jovan Antović
Keyword(s):  
Primary Care ◽  
Venous Thromboembolism ◽  
Emergency Departments ◽  
Laboratory Testing ◽  
Point Of Care ◽  
Turnaround Time ◽  
The Other ◽  
Clinical Conditions ◽  
D Dimer ◽  
Laboratory Assay

»Point-of-Care« D-Dimer TestingD-dimer testing is efficient in the exclusion of venous thromboembolism (VTE). D-dimer laboratory assays are predominantly performed in centralised laboratories in intra-hospital settings although most patients with suspected VTE are presented in primary care. On the other hand decreasing turnaround time for laboratory testing may significantly improve efficacy in emergency departments. Therefore an introduction of a rapid, easy to perform point of care (POC) assay for the identification of D-dimer may offer improvement in diagnostics flow of VTE both in primary care and emergency departments while it could also improve our diagnostic possibilities in some other severe clinical conditions (e.g. disseminated intra-vascular coagulation (DIC) and aortic aneurism (AA)) associated with increased D-dimer. Several POC D-dimer assays have been evaluated and majority of them have met the criteria for rapid and safe exclusion of VTE. In our hands three assays (Stratus, Pathfast and Cardiac) have the laboratory performance profile comparable with our routine D-dimer laboratory assay (Tinaqaunt).

scholarly journals Geographical Profiles of COVID-19 Outbreak in Tokyo: An Analysis of the Primary Care Clinic–Based Point-of-Care Antibody Testing

2020 ◽  
Vol 11 ◽  
pp. 215013272094269 ◽  
Author(s):  
Morihito Takita ◽  
Tomoko Matsumura ◽  
Kana Yamamoto ◽  
Erika Yamashita ◽  
Kazutaka Hosoda ◽  
...  
Keyword(s):  
Primary Care ◽  
Point Of Care ◽  
Herd Immunity ◽  
Primary Care Clinic ◽  
The Other ◽  
Cumulative Number ◽  
Antibody Testing ◽  
Care Clinic ◽  
Entire Cohort ◽  
Pcr Test

Introduction: The primary care clinic plays a major role in triage for coronavirus disease 2019 (COVID-19), where seroprevalence in the setting of primary care clinic remains less clear. As a point-of-care immunodiagnostic test for the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the serosurvey represents an alternative to the polymerase chain reaction (PCR) test to measure the magnitude of COVID-19 outbreak in the communities lacking sufficient diagnostic capability for PCR testing. Methods: We assessed seropositivity for the SARS-CoV-2 IgG between April 21 and May 20, 2020, at 2 primary care clinics in Tokyo, Japan. Results: The overall positive percentage of SARS-CoV-2 IgG was 3.83% (95% confidence interval [CI]: 2.76-5.16) for the entire cohort (n = 1071). The 23 special wards of central Tokyo exhibited a significantly higher prevalence compared with the other areas of Tokyo after classification by residence ( P = .02, 4.68% [3.08-6.79] vs 1.83 [0.68-3.95] in central and suburban Tokyo, respectively). In central Tokyo, the southern area showed the highest seroprevalence compared with the other areas (7.92% [3.48-15.01]), corresponding to the cumulative number of confirmed COVID-19 patients by PCR test reported by the Tokyo Metropolitan Government. Conclusion: The seroprevalence surveyed in this study was too low for herd immunity, suggesting the need for robust disease control and prevention. A regional-level approach, rather than state- or prefectural-level, could be of importance in ascertaining detailed profiles of the COVID-19 outbreak.

Investigations and microscopy

2019 ◽  
pp. 63-80
Keyword(s):  
Nucleic Acid ◽  
Laboratory Testing ◽  
Trichomonas Vaginalis ◽  
Point Of Care ◽  
Rapid Test ◽  
The Other ◽  
Nucleic Acid Amplification ◽  
Blood Samples ◽  
Dark Ground ◽  
Point Of Care Tests

This chapter covers investigations and tests commonly used in sexual health. Some investigations can be performed on-site as the patient waits, such as urinalysis, pregnancy tests, and increasingly available point of care tests for infections such as HIV and, less commonly, the other blood-borne viruses, syphilis, Trichomonas vaginalis. On-site microscopy helps with diagnosis of genital candidiasis, bacterial vaginosis, N. gonorrhoeae infection, and T. vaginalis. Other investigations require sending samples away for laboratory testing of genital or ulcer swab, urine, or blood samples for STI and blood-borne viruses. This chapter explains the use of light and dark ground microscopy, near patient rapid test technologies, molecular methods such as nucleic acid amplification, culture and serology. Sensitivities and specificities of commonly available test kits are included.

scholarly journals Does use of point-of-care testing improve cost-effectiveness of the NHS Health Check programme in the primary care setting? A cost-minimisation analysis

BMJ Open ◽  
2017 ◽  
Vol 7 (8) ◽  
pp. e015494 ◽  
Author(s):  
Austen El-Osta ◽  
Maria Woringer ◽  
Elena Pizzo ◽  
Talitha Verhoef ◽  
Claire Dickie ◽  
...  
Keyword(s):  
Primary Care ◽  
Laboratory Testing ◽  
Care Setting ◽  
Primary Care Setting ◽  
Disease Risk ◽  
Point Of Care ◽  
Health Check ◽  
Point Of Care Testing ◽  
General Practices ◽  
Nhs Health Check

ObjectiveTo determine if use of point of care testing (POCT) is less costly than laboratory testing to the National Health Service (NHS) in delivering the NHS Health Check (NHSHC) programme in the primary care setting.DesignObservational study and theoretical mathematical model with microcosting approach.SettingWe collected data on NHSHC delivered at nine general practices (seven using POCT; two not using POCT).ParticipantsWe recruited nine general practices offering NHSHC and a pathology services laboratory in the same area.MethodsWe conducted mathematical modelling with permutations in the following fields: provider type (healthcare assistant or nurse), type of test performed (total cholesterol with either lab fasting glucose or HbA1c), cost of consumables and variable uptake rates, including rate of non-response to invite letter and rate of missed [did not attend (DNA)] appointments. We calculated total expected cost (TEC) per 100 invites, number of NHSHC conducted per 100 invites and costs for completed NHSHC for laboratory and POCT-based pathways. A univariate and probabilistic sensitivity analysis was conducted to account for uncertainty in the input parameters.Main outcome measuresWe collected data on cost, volume and type of pathology services performed at seven general practices using POCT and a pathology services laboratory. We collected data on response to the NHSHC invitation letter and DNA rates from two general practices.ResultsTEC of using POCT to deliver a routine NHSHC is lower than the laboratory-led pathway with savings of £29 per 100 invited patients up the point of cardiovascular disease risk score presentation. Use of POCT can deliver NHSHC in one sitting, whereas the laboratory pathway offers patients several opportunities to DNA appointment.ConclusionsTEC of using POCT to deliver an NHSHC in the primary care setting is lower than the laboratory-led pathway. Using POCT minimises DNA rates associated with laboratory testing and enables completion of NHSHC in one sitting.

Point-of-care D-dimer testing in emergency departments

2015 ◽  
Vol 23 (5) ◽  
pp. 29-35 ◽  
Author(s):  
Udo Marquardt ◽  
Daniel Apau
Keyword(s):  
Emergency Departments ◽  
Point Of Care ◽  
D Dimer

scholarly journals Diagnostic Accuracy and User-Friendliness of 5 Point-of-Care D-Dimer Tests for the Exclusion of Deep Vein Thrombosis

2010 ◽  
Vol 56 (11) ◽  
pp. 1758-1766 ◽  
Author(s):  
Geert-Jan Geersing ◽  
Diane B Toll ◽  
Kristel JM Janssen ◽  
Ruud Oudega ◽  
Marloes JC Blikman ◽  
...  
Keyword(s):  
Primary Care ◽  
Diagnostic Accuracy ◽  
Point Of Care ◽  
Reference Method ◽  
Roc Curves ◽  
Color Contrast ◽  
User Friendliness ◽  
Predictive Values ◽  
Point Of Care Tests ◽  
D Dimer

BACKGROUND Point-of-care D-dimer tests have recently been introduced to enable rapid exclusion of deep venous thrombosis (DVT) without the need to refer a patient for conventional laboratory-based D-dimer testing. Before implementation in practice, however, the diagnostic accuracy of each test should be validated. METHODS We analyzed data of 577 prospectively identified consecutive primary care patients suspected to have DVT, who underwent 5 point-of-care D-dimer tests—4 quantitative (Vidas®, Pathfast™, Cardiac®, and Triage®) and 1 qualitative (Clearview Simplify®)—and ultrasonography as the reference method. We evaluated the tests for the accuracy of their measurements and submitted a questionnaire to 20 users to assess the user-friendliness of each test. RESULTS All D-dimer tests showed negative predictive values higher than 98%. Sensitivity was high for all point-of-care tests, with a range of 0.91 (Clearview Simplify) to 0.99 (Vidas). Specificity varied between 0.39 (Pathfast) and 0.64 (Clearview Simplify). The quantitative point-of-care tests showed similar and high discriminative power for DVT, according to calculated areas under the ROC curves (range 0.88–0.89). The quantitative Vidas and Pathfast devices showed limited user-friendliness for primary care, owing to a laborious calibration process and long analyzer warm-up time compared to the Cardiac and Triage. For the qualitative Clearview Simplify assay, no analyzer or calibration was needed, but interpretation of a test result was sometimes difficult because of poor color contrast. CONCLUSIONS Point-of-care D-dimer assays show good and similar diagnostic accuracy. The quantitative Cardiac and Triage and the qualitative Clearview Simplify D-dimer seem most user-friendly for excluding DVT in the doctor's office.

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