The evolution of PCR diagnostics

James Beckett explains how the use of molecular point of care testing (POCT) has seen exponential growth in recent years, from its hospital-based origins to its widespread community use for detection of infections, sexual health screening and, more recently, respiratory disease diagnosis during the COVID-19 pandemic.

Healthcare systems throughout the world face challenges in delivering effective, accessible and affordable care to an increasingly elderly population with a rising incidence of complex comorbidities. Successful care requires the provision of high quality, proactive interventions within primary and secondary care settings to limit unnecessary hospital admissions.1 As a result, many POCT technologies have been repurposed or developed to improve the convenience and efficiency of the patient care pathway outside of conventional hospital settings.

The evolution of point of care testing

Diagnostic testing performed in a hospital laboratory setting can lead to unavoidable delays in results, potentially extending the duration of hospital stays, and increasing the cost of care and risk of disease transmission between patients. POCT or near-patient testing has existed in hospital settings for many years, with routine diagnostic tests – such as urine testing or blood gas analyses – performed at or close to the patient’s bedside.2 However, for more complex diagnostic assays, including molecular testing, biological samples traditionally needed to be transported to a laboratory for analysis. The logistics of this, combined with the potential demand on central laboratory workflows, could cause delays in the turnaround of results, leading to suboptimal or postponed treatments.

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