A new report describes the challenges inherent in bringing new medical devices and technologies to the areas of the world where they are needed most.
Point-of-Care (POC) diagnostics bypass the need for sophisticated laboratory systems by leveraging new technologies to diagnose infectious diseases and other health concerns at the bedside, or “point-of-care”. Diagnostics account for 2% of the cost of health care, yet can affect 60-70% of treatment decisions. In regions where advanced laboratory services are simply not available or affordable, access to POC technologies is critical in detection and treatment of infectious diseases.
Based on an American Academy of Microbiology symposium convened in September 20122, Bringing the Lab to the Patient: Developing Point-of-Care (POC) Diagnostics for Resource Limited Settings examines the issues at play for successful employment of such technologies.
“POCTs (Point-of-Care technologies) are developed by researchers and engineers and implemented by a separate group of public health professionals at a local level. There are so many variables that can make or break the effectiveness of any test, and so often the scientists and engineers developing the test are not aware of them.” said Keith Klugman, who chaired the symposium. “POCTs that perform well in testing may not function ‘on the ground’ in resource limited areas, where there may not be running water, electricity, or trained personnel to administer the test.”
The report makes several recommendations for POC development prioritization, including improving testing for rapidly fatal diseases, those which respond to treatment only early in their course, and those which have epidemic potential.
Diagnostics which require cerebral-spinal fluid or other invasive biopsies are highlighted as prime candidates for alternative POC diagnostics development, given the risks of those sample collection techniques in austere environments.
Other priorities include replacement of tests that currently need culturing in a laboratory; technologies which simply determine whether disease symptoms are caused by a bacteria or virus; resistance profiles of causative agents; strain differentiation to better inform treatment; and tests which can alert to new mutations or drug resistance of specific pathogens.
The report goes on to recommend features that should be incorporated in the design of POC technologies to make it more effective in the field, and to identify priorities in utilization of biomarkers for improving diagnostics in this realm.
The full report is available for download here.
