I wonder how many nurses on ICU can really interprete blood gas results (or even electrolytes). Does anyone run an interpretive EQA sceheme for POCT blood gases?

One of the reasons why I took an active interest in the CIC initiative was that these communication standards would enable 2-way communications, and this would in turn eventually enable a form of interpretation advice. This is the only way that POCT can move into areas such as cardiac markers. This is a good reason for encouraging the use of CIC standards and open systems rather than sticking with closed systems.

Doug Hirst
Bradford


>>> [log in to unmask] 5/30/02 1:29:47 am >>>
This raises an important point - POCT has to be accompanied by POCI (point
of care interpretation), otherwise why bother?. At present, if it's blood
gases or electrolytes and glucose, or coagulation tests, it is probably OK
to rely on human memory for the meaning of the results. But if we ever
reach the stage of POC genetic testing before prescribing then it's likely
that a profile of multiple loci will be needed and a database of
probabilities will have to be available immediately, with the results. As
for triple-test Downs screening, but on the spot and probably with the
patient watching for any signs of uncertainty about what it all means!

Quite a challenge, both in compiling the necessary data and in making sure
it is available where and when needed.

John Whitfield
Clinical Biochemistry
Royal Prince Alfred Hospital
Sydney, Australia


Phone (+61) 2 9515 5246
Fax (+61) 2 9515 7931

Disclaimer:
This message is intended for the named addressee and may contain
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disregard it. Views are those of the sender and not necessarily those of
Royal Prince Alfred Hospital or Central Sydney Area Health Service.

-----Original Message-----
From:   Frost, Stephen [SMTP:[log in to unmask]] 
Sent:   Thursday, 30 May 2002 0:20
To:     [log in to unmask] 
Subject:        Re: POCT in a research setting

Looking further into the future of pharmaceuticals, with the likely advent
of personalised medicines there will be a big need for diagnostic testing
(biochemical or genetic)to decide which patients benefit (or don't) from
which drug.

Ultimately the logical place for most of this will be POC, i.e. just before
the medication is or isn't administered. The POC elements in these long and
hugely expensive drug development processes (like each other phase) will
have to go through research to validate the interventions.

I see this as a huge area in the long term with conventional types of POCT
being used in drug development/trials and also novel types of POC testing
becoming available, including DNA testing, for use by clinicians in
deciding
what drugs to use. The issue of QA I am sure will be grasped by the pharma
industry.

I didn't just make it up! Glyn Colebrook from GSK gave a talk about POCT
and
its interaction with pharmaceuticals yesterday at the BIVDA POCT meeting in
London.

regards

Steve Frost
The Princess Royal Hospital




-----Original Message-----
From: Jonathan Kay [mailto:[log in to unmask]] 
Sent: Tuesday, May 28, 2002 3:45 PM
To: [log in to unmask] 
Subject: Re: POCT in a research setting


I would have thought the repertoire would have been too small for most
of the research trials we see. (Later comments about glucose noted.)

Jonathan


On Tuesday, May 28, 2002, at 12:05 , Emma James wrote:

> Hi
>
> Has anyone got experience of managing POCT in a research
> setting -POCT is not the area under investigation but the study lead
> would like to monitor subjects on novel drug regimes etc using
> POCT devices.
>
> My initial response is that the results from POCT in research still
> need to be robust and withstand scrutiny - although the professions
> doing the scrutinising may be different from those encountered in
> the clinical setting.  Therefore, I feel that all guidelines regarding
> training, IQA and EQA that are applied in the clinical setting should
> apply in the research setting. However, I am not sure if there is any
> relevence of cost benefit analysis in these circumstances.
> If anyone has any thoughts or experience in this area I'd be most
> grateful................
>
> Thanks very much
> Emma
>
>
>
> Emma James
> Point of Care Coordinator
> Dept Clinical Biochemistry
> Manchester Royal Infirmary
> Oxford Road
> Manchester
> M13 9WL
> UK
>
> Tel: 0161 276 4891
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