Practice guidelines for infectious disease testing at the point of care (POC) have been developed by the National Academy of Clinical Biochemistry. These guidelines were established through extensive review of the scientific literature that addressed infectious disease testing that occurred at the POC. A total of 25 guidelines were established, and in general, it was concluded that (a) rapid tests for group A streptococcal infections provided clinically useful and financially justified results; (b) there was insufficient evidence to recommend POCT for group B Streptococcus screening, however molecular testing is in development as a POC methodology; (c) there were specific and sensitive rapid tests available for Helicobacter pylori testing at POC; (d) rapid tests for influenza viruses should be used for POC testing (POCT) only when the virus is prevalent in the community, and negative results should not be used to rule out influenza virus infections; (e) the currently available human immunodeficiency virus (HIV) rapid tests, under validation conditions, are comparable to the sensitivity and specificity of laboratory-based enzyme-linked immunoassay methods; (f) HIV rapid testing is strongly recommended for source-patient exposures; (g) rapid HIV testing in the peripartum period, laboratory-based or POC, provides information to support antiretroviral prophylaxis and most likely reduce peripartum HIV transmission; and (h) there was fair evidence to support POCT for the presence of Trichomonas vaginalis in the diagnosis of vaginitis. Included are examples of how these guidelines were implemented to successfully change how POCT was being used in physician office laboratories, emergency departments, and hospital clinics at one facility.
From the *Department of Biomedical and Radiological Technologies, Medical College of Georgia, Augusta, GA; †Department of Laboratory Medicine, Yale University School of Medicine, New Haven, CT; ‡Department of Pathology and Laboratory Medicine, VA Connecticut Healthcare System, West Haven, CT; §Microbiology Laboratory, Laboratory Informatics, and Molecular Diagnostics, Department of Laboratory Medicine, Children's National Medical Center, Washington, DC; ∥Departments of Pediatrics, Pathology, Microbiology/Immunology, and Tropical Medicine, George Washington University Medical Center, Washington, DC; ¶Cleveland Clinic Section of Clinical Microbiology, Cleveland, OH; #Microbiology/Immunology Laboratories, Hospital Consolidated Laboratories, Providence Hospital, Southfield, MI; **Division of Clinical Pathology and Clinical Virology Laboratory, Penn State Hershey Medical Center, Hershey, PA; ††Lancaster General Hospital, Lancaster, PA; ‡‡Michigan Department of Community Health, Lansing, MI and §§Departments of Microbiology and Point of Care, Carolinas Pathology Group, Carolinas Laboratory Network, Carolinas Medical Center, Charlotte, NC.
Reprints: Barbara Russell, EdD, MT, SH, Department of Biomedical and Radiological Technologies, Medical College of Georgia, EC-3340, 1120 15th St, Augusta, GA 30912 (e-mail: email@example.com).