 |
 |
The issue of POCI (have you just invented that acronym, John? - very useful) has bothered me for a while. Doing something constructive from the lab with over 350,000 sets of blood gas results a year alone, with no specific clinical details, doesn't seem feasible! However, it's an important quality issue. What I have done, in a limited way, is to visit the ICUs, preferably after arrangement with the consultant, to see how they are using blood gas data in clinical situations and discuss how it impacts on decision- making. It's educational for me, too, and I've also found it useful in preparing case presentations for the department - much appreciated by my colleagues apparently, as we do very few blood gases in the lab these days. This isn't a QA process, I know, but it goes some way towards encouraging vital two-way communication on the use of POCT results. > 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 > -----Original Message----- > From: Frost, Stephen [SMTP:[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. > 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. > > Steve Frost l ________________________________________________ Dr MJ Pearson Department of Clinical Biochemistry & Immunology Old Medical School Leeds General Infirmary (Leeds Teaching Hospitals NHS Trust) LEEDS LS1 3EX Tel 0113 392 3945 Fax 0113 233 5672 http://www.leedsteachinghospitals.com