"As for evidence there is very little"
"though bad practices undermined its usefulness"
I think these statements sum things up nicely. So why is it that
some of us continue to promote and advocate widespread, expensive, fairly useless and potentially unsafe PCOT? Of course we can make it safer and keep CPA happy by throwing lots of resources at it to ensure that appropriate governance is in place but is the cost of this really justified?
It seems to me that just because we can do things at POC; lots of us seem think it a good idea to do so. As a laboratory professional I find this staggering.
Ian Barlow
Chairman of local POCT committee
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of IAN WATSON
Sent: 11 May 2009 10:10
To: [log in to unmask]
Subject: Re: POCT cholesterol
The ACB along with RCPath, IBMS, MHRA, RPS, and others are working on POCT in Primary Care guidance on the basis that we are not going to stop POCT so users should do it properly and be aware of the limitations. This is supported by DH.
As for evidence there is very little to show POCT affects outcomes positively or negatively. The NACB conducted a systematic review of all POCT and showed no evidence for POCT, though bad practices undermined its usefulness. This can be accessed at: http://www.aacc.org/members/nacb/LMPG/OnlineGuide/PublishedGuidelines/poct/Pages/default.aspx
Ian
Dr Ian D Watson PhD FRCPath
President
Association for Clinical Biochemistry
Dept Clinical Biochemistry
University Hospital Aintree
Longmoor Lane
Liverpool
L9 7AL
Tel +44 151 529 3575
Fax +44 151 529 3310
Email: [log in to unmask]
-----Original Message-----
From: Clinical biochemistry discussion list [mailto:[log in to unmask]] On Behalf Of David Brown
Sent: 11 May 2009 09:52
To: [log in to unmask]
Subject: Re: POCT cholesterol
I also think it is time for a joint scientific and medical review of the usefulness of POCT in large urban hospitals, in particular, and smaller rural hospials and GPs in general.
The only POCT I ever thought worthwhile were neonatal blood gases and home monitoring glucose testing. The rest seem to be a public relations exercise or a false feeling of self-sufficiency
David Brown
Ex-MLSO
--- On Mon, 11/5/09, Ian Barlow <[log in to unmask]> wrote:
> From: Ian Barlow <[log in to unmask]>
> Subject: Re: POCT cholesterol
> To: [log in to unmask]
> Date: Monday, 11 May, 2009, 10:40 AM
> My thoughts too Tim.
>
> As a profession I think it is about time some of us jumped
> off this POCT
> bandwagon and started to be a little more critical of its
> usefulness.
>
> I find it startling that you are the only person to respond
> to this.
>
> Ian
>
> -----Original Message-----
> From: Reynolds Tim [mailto:[log in to unmask]]
>
> Sent: 11 May 2009 09:33
> To: Ian Barlow; [log in to unmask]
> Subject: RE: POCT cholesterol
>
> Overall, I would say the imprecision of POCT cholesterol is
> not
> acceptable.
>
> When a dose titration gives a 6% improvement, you need
> precision better
> than that to know whether the change has worked.
>
> And using POCT devices for screening is even less
> helpful...
>
> But that won't stop DoH from pushing for its use on grounds
> of patient
> choice - though why anyone would knowingly choose to be
> given the wrong
> result I don't know.
>
> TIM
>
>
> ************************************************************************
> *************
> Prof. Tim Reynolds,
> Queen's Hospital,
> Belvedere Rd,
> Burton-on-Trent,
> Staffordshire,
> DE13 0RB
>
> work tel: 01283 511511 ext. 4035
> work fax: 01283 593064
> work email: [log in to unmask]
> home email: [log in to unmask]
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> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]]
> On Behalf Of Ian Barlow
> Sent: 08 May 2009 16:55
> To: [log in to unmask]
> Subject: Re: POCT cholesterol
>
>
> Thanks Katie.
>
> A question for all the lipidologists out there:-
>
> Is imprecision of these analysers acceptable?
>
> Regards
>
> Ian Barlow
> Scunthorpe
> UK
>
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]]
> On Behalf Of Garner, Katie
> Sent: 08 May 2009 16:33
> To: [log in to unmask]
> Subject: Re: POCT cholesterol
>
> CEP are preparing a buyers' guide to POC cholesterol
> systems to support
> the NHS Health Checks programme. This will set out all of
> the technical,
> operational, purchasing and economic issues and include a
> market review
> with comparative tables. This guide is partly funded by DH
> and will be
> available to download free from our website at the end of
> August. Sign
> up to received a notification at www.pasa.nhs.uk/cep.
>
> We evaluated a number of these systems in detail when we
> were part of
> MHRA. These reports are a bit older but should still be
> relevant. See
> attached.
>
> CardioCek 2005
> Cholestech LDX
> Accutrend GC or Accutrend Plus
>
> Katie Garner
> Business Development Manager
> Tel: 020 7972 5388 Mob: 0774 7816958
>
> The Centre for Evidence-based Purchasing (CEP) generates,
> gathers and
> assesses evidence on medical products and related services
> to encourage
> informed decision-making around the purchase and choice of
> products used
> in the NHS.
>
> You can sign up for notification of publications, suggest
> new projects
> and view our work programme at www.pasa.nhs.uk/cep
>
> -----Original Message-----
> From: Clinical biochemistry discussion list
> [mailto:[log in to unmask]]
> On Behalf Of Mike Howell
> Sent: 07 May 2009 12:33
> To: [log in to unmask]
> Subject: POCT cholesterol
>
> Hi
>
> Does anyone have experience of POCT cholesterol and can
> anyone tell me
> about QA schemes for POCT cholesterol please
>
> Thanks
> Mike Howell
>
> Mike Howell
> Clinical Biochemistry
> The Hillingdon Hospital
> Pield Heath Road
> Uxbridge
> Middx
> UB8 3NN
> Tel 01895 279225
>
>
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