Although the concept of POCT only emerged in the 1990s, the demand for POCT actually emerged in the 1970s with the development of intensive care medicine. In anticoagulation testing, clinical doctors urgently require rapid reporting and reliable results. In emergency or perioperative bleeding, the average laboratory turnaround time (TAT) is approximately 45-90 minutes, and generally standardized laboratory time is about 1.5 hours longer than POCT. There are significant differences in specimen handling and preparation methods between POCT and laboratory testing of coagulation function. POCT is easy to operate and can quickly detect results, thus opening the door for its application in coagulation testing. POCT testing does not require blood samples to be sent for testing, and there is no need to wait for reports. It can quickly adjust the medication dosage for patients. The laboratory only reports emergency and critical values by phone, and most of them are uploaded to the hospital information system for doctors to check on their own. The time saved by POCT can generate some intangible value, especially in the intensive care unit and operating room. The length of surgery time, the amount of treatment, and time often mean saving medical costs. In addition, it can also reduce unnecessary blood transfusions in hemostasis and thrombus testing, with obvious advantages.
In terms of the value of information, although the test results are mostly quantitative indicators, for clinical diagnosis, they often boil down to the nature of "yes" or "no", that is, how to proceed next, that is, clinical decision-making. Difficult decision-making is not only harmful to patients, but also leaves doctors helpless when facing patients in pain. If there is no need to send specimens for testing, testing can be carried out at the initial stage of clinical judgment, which will help clinical doctors and also reflect the important value of testing in reducing clinical decision-making uncertainty.
When the value of POCT is ultimately reflected in its clinical relevance to disease diagnosis, management, and prognosis, our attitude towards POCT may become a demand. For example, the measurement of the normalized ratio (INR) reflects a decrease in hemostatic function and is directly used for adjusting the dosage of warfarin. POCT frees pure INR testing from the tedious procedures in hospitals, reducing waiting time for laboratory reports and shortening the cycle of notifying patients to adjust doses, greatly facilitating patients' medical treatment. Moreover, under the premise of quality control, it can ensure medication safety and has significant social benefits. If INR is not urgent enough, then APTT for intraoperative bleeding monitoring and overall coagulation function assessment are crucial. POCT's bedside convenience enables smooth clinical procedures, which is popular among specialists. However, hematology experts often tend to rely on traditional indicators, and POCT is not considered an effective tool for accurately assessing hemostasis status; Some medical laboratory scholars also have doubts about the use of POCT in clinical departments; This to some extent limits its widespread application.
Share：
