SACRAMENTO, Calif., Aug 28, 2008 (ASCRIBE NEWS via COMTEX) -- Patient side
point-of-care testing -- where diagnostic testing is conducted at or near the
site of the patient -- enables doctors to make decisions on patients presenting
with chest pain up to 20 minutes faster than those whose lab tests are evaluated
by a standard lab, according to a study appearing this month in the
peer-reviewed journal Annals of Emergency Medicine.
According to the study, entitled A Multicenter Randomized Controlled Trial
Comparing Central Laboratory and Point-of-Care Cardiac Market Testing
Strategies: The Disposition Impacted by Serial Point of Care Markers in Acute
Coronary Syndromes Trial (DISPO-ACS), is the first-ever randomized controlled
clinical trial directly evaluating the impact of patient side point-of-care
testing on 2,000 patients with chest pain, or possible acute coronary syndrome
(ACS), on the length of stay in the emergency department (ED). It was led by
Richard Ryan, M.D., vice chairman, Department of Emergency Medicine at the
University of Cincinnati College of Medicine. The four EDs involved in the study
are The Jewish Hospital in Cincinnati, William Beaumont Hospitals in Detroit,
the University of Pennsylvania, and Stanford University.
"For patients presenting with chest pain, rapid diagnosis and the initiation of
treatment can mean the difference between life and death," according to Dr.
Ryan. "Ask yourself this question, 'Would I rather wait more than an hour to
find out if I was having a heart attack or would I want to know in 15 minutes?'
The answer 100 percent of the time would be 'the sooner the better, for my
heart, my health, my life.' For these reasons, the study findings are very
significant," he said.
The study results also illustrate conclusively that patient side point-of-care
testing beats the turnaround time (the time between the drawing of a blood
sample and the receipt of test result) of less than 60 minutes recommended by
the American Heart Association, American College of Cardiology, European Society
of Cardiology and the National Academy of Clinical Biochemistry's treatment
guidelines. The preferred turnaround time, according to the guidelines, is less
than 30 minutes.
The patient side point-of-care testing in this study was conducted using the
Abbott i-STAT System, an advanced, handheld, diagnostic tool that provides
real-time lab-quality results within minutes to accelerate the patient care
decision-making process.
"The i-STAT results got to the doctor an average of 45 minutes faster than the
lab results, and that's a lot of time when heart muscle is dying," said
Christopher J. Lindsell, Ph.D., University of Cincinnati Medical Center and a
study investigator. "This is why i-STAT patient side point-of-care testing
demonstrated a trend toward reducing length of stay in the ED for both admitted
and discharged patients."
Patient side point-of-care testing with i-STAT Troponin, which is used to help
diagnose a heart attack, beats the 60-minute recommended turnaround time 98
percent of the time, compared to 53 percent for standard lab testing. Moreover,
patient side point-of-care testing with i-STAT Troponin beats the preferred
30-minute turnaround time 87 percent of the time, compared to 3 percent for
standard lab testing.
In addition to the benefits to patient care, i-STAT point-of-care testing with
troponin contributed to as much as a 20-minute reduction in overall length of
stay for some patients presenting in the ED with chest pain. The study authors
concluded that based on such results, an additional 60 hours per month in ED bed
availability could be realized in a facility that averaged a minimum of four
chest pain patients per day.
The study also noted that when implemented as one of the key components of an
overall process improvement strategy, patient side point-of-care testing with
the i-STAT System can positively impact the overall efficiency of an ED's
system.
This brings to five the number of recent peer-reviewed studies that have
recently been published or accepted for publication that demonstrate the
significant benefits of patient side point-of-care testing in EDs. The other
four studies were conducted at Yale-New Haven Hospital, Vanderbilt University
Medical Center, the University of Cincinnati College of Medicine, and Beth
Israel Deaconess Hospital in Boston.
The Abbott i-STAT System is designed to accelerate patient care decision-making
at the patient's side with the industry's most comprehensive menu of tests in a
single platform. The i-STAT System's menu includes diagnostic and treatment
indicators related to disease state management and clinical practice guidelines
supporting a patient-centric approach to health care delivery.
The study was made possible with funding from Abbott Point of Care, which had no
role in or influence on the study designs or results.
Study Information: www.annemergmed.com.