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Types of Point of Care Testing and Their Clinical Significance

Types of Point of Care Testing and Their Clinical Significance

POCT (Point of Care Testing) is a testing method that uses portable analytical instruments and accompanying reagents to obtain rapid results at the sampling site. It includes three elements: "instant", meaning rapid testing at the time of patient onset; "on-site", meaning bedside testing at the sampling site or patient site; and the operator can be a non-professional tester, or even the patient being tested.

Key technologies for POCT include dry chemistry technology, colloidal gold technology, immunofluorescence technology, chemiluminescence immunoassay technology, electrochemical technology, microfluidic technology, and microarray technology.

I. Types of POCT: Inflammation

The significance of instant testing for whole-process C-reactive protein (hsCRP+conventional CRP):

  1. Identification of infection categories: CRP is significantly elevated in bacterial infections (usually higher than 25 mg/L), but not in viral infections (usually not higher than 25mg/L), providing important evidence for the identification of early-stage infections and timely guidance for clinical medication.

  2. Monitoring disease status: The degree of CRP elevation reflects the range, severity, and activity of inflammatory tissue and infection.

  3. Infection monitoring: The continuous elevation of CRP can be used as an evaluation index for postoperative or postpartum infections, reducing the incidence of nosocomial infections.

  4. Observation, guidance, and monitoring of antibiotic efficacy: CRP is the most economical indicator for antibiotic treatment in acute infectious diseases, avoiding the production of antibiotic abuse and drug resistance.

  5. Risk assessment and guidance for cardiovascular disease: ultra-sensitive CRP is an independent risk factor outside of lipids, and some studies have reported that achieving a standard for ultra-sensitive CRP is more important than achieving a standard for blood lipids.

The significance of instant testing for procalcitonin (PCT):

  1. Differential diagnosis of bacterial inflammatory diseases and fever of unknown origin;

  2. Differential diagnosis of biliary and bacterial infectious pancreatitis;

  3. Differential diagnosis of bacterial and viral meningitis in neonates and children;

  4. Differential diagnosis of acute organ rejection and post-transplant infections;

  5. Differential diagnosis of bacterial infection in autoimmune diseases with acute inflammatory responses;

  6. Diagnosis of bacterial infections in patients with leukopenia;

  7. Routine diagnosis and monitoring of infections after major surgery;

  8. Monitoring of infections in patients with multiple injuries;

  9. Detection of urinary tract infections.

II. Types of POCT:

Cardiac The significance of instant testing for N-terminal pro-brain natriuretic peptide (NT-proBNP): An increase to a certain extent indicates the risk of heart failure, which needs to be judged in conjunction with patient age and other factors.

The significance of instant testing for cardiac troponin I (cTnl), myoglobin (MYO), and creatine kinase isoenzyme (CK-MB): An increase indicates the risk of myocardial infarction.

III. Type of instant detection: Tumor

Meaning of alpha-fetoprotein (AFP) instant detection: Elevated levels suggest possible hepatocellular carcinoma, testicular teratoma, etc. It can also be seen in benign diseases such as hepatitis, cirrhosis, or prenatal screening for Down's syndrome, spina bifida, etc.

Meaning of prostate-specific antigen (PSA) instant detection: Early screening for prostate cancer.