LITERATURE UPDATE


Point-of-care testing: advantages and challenges


From early applications that saw the development of urine dipsticks, pregnancy and blood glucose testing, to lateral flow COVID devices, point-of-care testing has come far in the past 70 years. Here, Pathology in Practice Science Editor Brian Nation looks at a small selection of work focusing on POCT in the current literature.


Point-of-care testing: state-of-the-art and perspectives


Plebani M, Nichols JH, Luppa PB et al. Clin Chem Lab Med. 2024 Jun 17; 63 (1): 35–51. doi: 10.1515/cclm-2024-0675.


Point-of-care testing (POCT) is becoming an increasingly popular way to perform laboratory tests closer to the patient. This option has several recognised advantages, such as accessibility, portability, speed, convenience, ease of use, ever-growing test panels, lower cumulative healthcare costs when used within appropriate clinical pathways, beter patient empowerment and engagement, and reduction of certain pre-analytical errors, especially those related to specimen transportation. On the other hand, POCT also poses some


limitations and risks, namely the risk of lower accuracy and reliability compared to traditional laboratory tests, quality control and connectivity issues, high dependence on operators (with varying levels of expertise or training), challenges related to patient data management, higher costs per individual test, regulatory and compliance issues such as the need for appropriate validation prior to clinical use (especially for rapid diagnostic tests; RDTs), as well as additional pre-analytical sources of error that may remain undetected in this type


of testing, which is usually based on whole blood samples (ie presence of interfering substances, cloting, haemolysis, etc.). There is no doubt that POCT is a


breakthrough innovation in laboratory medicine, but the discussion on its appropriate use requires further debate and initiatives. This collective opinion paper, composed of abstracts of the lectures presented at the two-day expert meeting ‘Point-Of-Care-Testing: State of the Art and Perspective’ (Venice, 4–5 April 2024), aims to provide a thoughtful overview of the state-of-the-art in POCT, its current applications, advantages and potential limitations, as well as some interesting reflections on the future perspectives of this particular field of laboratory medicine.


Increasing Access To Sexually Transmited Infection Testing: The Promise of Point-of- Care and Over-the-Counter Tests Ma S, Osburn WO, Manabe YC. Curr HIV/ AIDS Rep. 2025 Mar 25; 22 (1): 27. doi: 10.1007/s11904-025-00736-1.


Rapid, simple, inexpensive tests that can be used to detect sexually transmited infections (STI) in symptomatic patients and for asymptomatic screening, especially in women, is a global critical unmet need in


all income setings. The authors sought to review the STI diagnostic unmet need and current landscape of diagnostic tests that are either approved or in development. Diagnostic certainty will be required


to decrease the global burden of STIs particularly in low-resource setings where empiric algorithmic care predominates. Lateral flow assays for syphilis and HIV have been successfully used in low- and middle-income countries. Although the performance of reference laboratory nucleic acid amplification tests is excellent for the detection of Neisseria gonorrhoeae and Chlamydia trachomatis, such tests remain expensive and globally unavailable due to lack of existing clinical laboratory infrastructure. Importantly, diagnostic innovations from the COVID-19 pandemic are being leveraged for developing molecular STI point-of-care tests and over- the-counter (OTC) self-tests. In the USA and other high-income


countries, point-of-care testing of both symptomatic and asymptomatic people would allow for a definitive STI diagnosis, appropriate treatment within a clinical encounter, and decreased antibiotic overuse, a significant global public health problem. Most exciting is the possibility for rapid, high performance self-tests. Inexpensive and rapid STI self-test could significantly increase access to STI care and help decrease health inequity.


Lateral flow assays for syphilis and HIV have been successfully used in low- and middle- income countries (Treponema pallidum spirochaetes stained using a modified Steiner silver method).


Point-of-care testing: revolutionizing clinical biochemistry using decentralized diagnostics Shaikh S, Panchbudhe SA, Shivkar RR, Banerjee A, Deshmukh P, Kadam CY. J Basic Clin Physiol Pharmacol. 2025 Apr 4; 36 (2-3): 113–128. doi: 10.1515/ jbcpp-2025-0029. eCollection 2025 Mar 1.


Point-of-care testing (POCT) refers to decentralised testing done using complex but compact, portable devices that can be done near the site at the patient’s bedside. These enable quick diagnosis and


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