The Use of a Quantitative Point-of-Care System Greatly Reduces the Turnaround Time of Cardiac Marker Determination

Gaze, David; Collinson, Paul; Haass, Markus; Derhaschnig, Ulla; Hirschl, Michael M.; Katus, HA; Chwallek, Frank; Mueller-Bardorff, Margit; Kellett, John; Ordóñez-Llanos, Jordi; Santaló-Bel, Miquel; Mercé-Muntañola, J.; Sylvén, Christer; Schulz, Ilse; Zerback, Rainer

doi:10.1097/00134384-200412000-00003

Cited by 9 publications

(5 citation statements)

References 18 publications

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“…Studies have shown that POC testing decreases the potential time-to-clinical decision-making by 1-2 hr [ 6 7 ]. In today's busy EDs and intensive care units (ICUs), the rapid results obtained by POC testing have important implications.…”

Section: Discussionmentioning

confidence: 99%

“…Point-of-care (POC) testing, defined as the performance of laboratory analyses in a near-patient location, eliminates many of the pre- and post-analytic sources of delay associated with performance in the central laboratory. In previous studies, POC testing decreased the time required to provide results to the physician by approximately 1 hr [ 6 ], and showed a 2-hr reduction in the ED length of stay (ED LOS) in suspected myocardial infarction (MI) patients [ 7 ]. However, the impact of POC testing, in terms of reduced time to results, must be considered in comparison to its potential negatives.…”

Section: Introductionmentioning

confidence: 99%

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Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

et al. 2016

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BackgroundWe aimed to compare the diagnostic accuracy of the Alere Triage Cardio3 Tropinin I (TnI) assay (Alere, Inc., USA) and the PathFast cTnI-II (Mitsubishi Chemical Medience Corporation, Japan) against the central laboratory assay Singulex Erenna TnI assay (Singulex, USA).MethodsUsing the Markers in the Diagnosis of Acute Coronary Syndromes (MIDAS) study population, we evaluated the ability of three different assays to identify patients with acute myocardial infarction (AMI). The MIDAS dataset, described elsewhere, is a prospective multicenter dataset of emergency department (ED) patients with suspected acute coronary syndrome (ACS) and a planned objective myocardial perfusion evaluation. Myocardial infarction (MI) was diagnosed by central adjudication.ResultsThe C-statistic with 95% confidence intervals (CI) for diagnosing MI by using a common population (n=241) was 0.95 (0.91-0.99), 0.95 (0.91-0.99), and 0.93 (0.89-0.97) for the Triage, Singulex, and PathFast assays, respectively. Of samples with detectable troponin, the absolute values had high Pearson (RP) and Spearman (RS) correlations and were RP =0.94 and RS=0.94 for Triage vs Singulex, RP =0.93 and RS=0.85 for Triage vs PathFast, and RP =0.89 and RS=0.73 for PathFast vs Singulex.ConclusionsIn a single comparative population of ED patients with suspected ACS, the Triage Cardio3 TnI, PathFast, and Singulex TnI assays provided similar diagnostic performance for MI.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

et al. 2016

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“…Thresholds for cTn are assay-dependent but can be defined for each individual assay [15]. The evaluation of cTn is usually processed by a central laboratory assay and limited by the time required by the specific assay used, however, POCT of cTn has been shown to reduce the waiting time to obtain these results [1].…”

Section: Troponin Point-of-care Testingmentioning

confidence: 99%

“…In fact the "therapeutic turnaround time" has to be reduced, which means a reduction of the time between ordering a test and an interpretation of its results and making a decision; e.g., Koehler et al showed that turnaround "door-to troponin results" time significantly decreased from 105 to 51 min (p < 0.000) following troponin POCT implementation, however, this was not accompanied by a significant shortening in LOS (290-255 min, p = 0.082) [9]. The average reduction of the turnaround times shown in the different studies through the use of POCT ranges from 47 to 65 min [1,7,9].…”

Section: Introductionmentioning

confidence: 99%

“…Our choices were limited to using rapid but analytically imprecise assays or more accurate but significantly slower laboratory platforms. Since it is currently agreed that the time delay of the slower tests is "just an hour or so difference" [1], the risk of patient morbidity and mortality increases with more time spent in the emergency department (ED) [2]. A Canadian study, which examined the association between waiting times and short-term mortality and hospital admission after departure from ED of more than 13 million ED patients, showed as a secondary result, that the odds of acute death increased dramatically (OR = 1.79) when the ED length of stay (LOS) exceeded 6 h compared with > 1 h [3].…”

Section: Introductionmentioning

confidence: 99%

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Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making

Somma

Zampini

Vetrone

et al. 2014

Clinical Chemistry and Laboratory Medicine (CCLM)

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Abstract:Overcrowding of the emergency department (ED) is rapidly becoming a global challenge and a major source of concern for emergency physicians. The evaluation of cardiac biomarkers is critical for confirming diagnoses and expediting treatment decisions to reduce overcrowding, however, physicians currently face the dilemma of choosing between slow and accurate central-based laboratory tests, or faster but imprecise assays. With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training.

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Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department

Ordóñez-Llanos¹,

Santaló-Bel²,

Mercé-Muntañola³

et al. 2006

Clinica Chimica Acta

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The Use of a Quantitative Point-of-Care System Greatly Reduces the Turnaround Time of Cardiac Marker Determination

Cited by 9 publications

References 18 publications

Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

Can a Point-of-Care Troponin I Assay be as Good as a Central Laboratory Assay? A MIDAS Investigation

Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making

Risk stratification of chest pain patients by point-of-care cardiac troponin T and myoglobin measured in the emergency department

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