Clinics in laboratory medicine
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Point-of-care (POC) assays are available for a variety of coagulation tests. These assays are generally simple to perform and have a more rapid turnaround time than their central-laboratory counterparts. This article discusses the current status of coagulation POC methodologies, focusing on the potential clinical uses and the limitations of platelet function testing, prothrombin time/international normalized ratio, D-dimer, and activated clotting time (ACT). Additional studies are eagerly awaited regarding potential future uses of POC coagulation testing, including the role of platelet function testing and ACT heparin management systems.
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Turnaround time for molecular diagnostic tests is critical in detecting infectious agents, in determining a patient's ability to metabolize a drug or drug class, and in detecting minimal residual disease. These applications would benefit from the development of a point-of-care device for nucleic acid extraction, amplification, and detection. ⋯ The creation of such a device requires miniaturization of current technologies and the use of microfluidics, microarrays, and small-diameter capillary tubes to reduce reagent volumes and simplify heat conduction by convection during nucleic acid amplification. This ideal device may be available in 3 to 5 years and will revolutionize and expand the global availability of molecular diagnostic assays.