Point-of-care testing: no pain, no gain

Simple point‐of‐care testing (POCT) has long been a feature of hospital wards and general practice surgeries. Familiar examples include urinalysis, blood glucose measurement and ECGs. Increasingly, however, the range of tests that can be undertaken at the point of care spans the full gamut of clinical practice.1 Markers of myocardial damage can now be measured on admission in the assessment of patients with chest pain, both for diagnosis of acute myocardial infarction and for risk stratification. Measurement of D‐dimers may permit more efficient triage of patients with suspected deep‐vein thrombosis. On‐site screening for microbial antigens or inflammatory markers such as C‐reactive protein allows rapid determination of whether or not antibiotic therapy is appropriate, in advance of culture results. Screening for illicit drugs can now be carried out in the rehabilitation unit, or even in the workplace. The benefits of POCT appear to be obvious. It bypasses all of the bureaucracy involved in ordering tests, arranging transportation, transmitting results and so forth. By doing so, it dramatically reduces the time required to get a result. At out‐patient clinics and in some emergency settings, the ability to make all of the appropriate decisions at a single visit is of major benefit. For example, on‐site measurement of glycated haemoglobin at diabetic clinics enables advice to be given to patients that is based on a current result. It is not surprising, therefore, that there are calls for clinical laboratories to address the needs that are so readily met by POCT.2 Strategic pathology reviews currently underway across many parts of England and Wales have arisen in response to current and projected future demands on pathology services; their aim is to ensure that these services have the capacity to evolve and incorporate new technological and manpower developments over the years ahead. These reviews present a timely opportunity for pathologists across laboratory disciplines to respond to increasing demands for POCT.