Biomedical Engineering Reference
In-Depth Information
by a factor of four, by enabling faster patient management time and an overall
better outcome for the patient [
11
].
From a more holistic viewpoint and considering the aging and increasing
population, but also the ramifications of globalization, more versatile diagnostic
technologies will be necessary. Moreover, diagnostics will have to be more fre-
quently available and hence technologies have to be found that enable patient-near
testing with the same quality as from the laboratory.
The scenario of bedside analysis is the first field of application of point-of-care
testing (POCT). A short return time from sample to the location of the decision-
maker, the so called ''turn-around time'' (TAT), is of great interest to the physician
during his visit in the clinic. Also in the doctor's office it often might be of great
help, if the doctor had access to the blood parameters or other results from the
laboratory while the patient is still in the office. The decision for therapy could
be better targeted and the patient would be pleased to be well informed about the
physician's decision.
The role of biomarkers is to support the decision, which therapy might be most
promising. A well-established biomarker might also be a guide for medication and
for the appropriate dose for the individual patient. This scenario is called ''com-
panion diagnostics'' and refers to the need of most medications to be appropriately
adjusted to the physiological and genetic constitution of each patient individually
to be most effective or sometimes even effective at all. Many drugs are known to
be metabolized more or less effectively by different patients but up to now this
information is only seldom available and useable by a doctor in his office. This
information would be of help only if it were available immediately.
The utility and usefulness of biomarkers will increase, if samples other than
blood, like saliva, urine, or other easily accessible body fluids are tested, which
may help to make diagnosis less invasive.
Individual consultation and personalized therapy are the major trends of
modern health care and both require diagnostics at the point-of-need and are what
economists call the ''market pull'' for the development of Lab-on-Chip technol-
ogies for POCT [
4
].
1.3 Integration as a Key Parameter
Technologies that can be used for point-of-care testing have to match various
requirements—especially because of the circumstances point-of-care testing is
used in. Here, samples are not taken in a lab environment which enables users
(medical personnel or physicians) to perform steps of sample preparation and its
purification until results are obtained. More precisely, the technology has to
provide user-friendly devices, that perform automatic processing of any sample of
a body fluid and gives an interpretation of the measured results on a display. With
this scenario in mind the following key features for technologies may be defined:
