The national academy of clinical biochemistry laboratory medicine practice guidelines for point of care infectious disease testing

Practice guidelines for infectious disease testing at the point of care (POC) have been developed by the National Academy of Clinical Biochemistry. These guidelines were established through extensive review of the scientific literature that addressed infectious disease testing that occurred at the POC. A total of 25 guidelines were established, and in general, it was concluded that (a) rapid tests for group A streptococcal infections provided clinically useful and financially justified results; (b) there was insufficient evidence to recommend POCT for group B Streptococcus screening, however molecular testing is in development as a POC methodology; (c) there were specific and sensitive rapid tests available for Helicobacter pylori testing at POC; (d) rapid tests for influenza viruses should be used for POC testing (POCT) only when the virus is prevalent in the community, and negative results should not be used to rule out influenza virus infections; (e) the currently available human immunodeficiency virus (HIV) rapid tests, under validation conditions, are comparable to the sensitivity and specificity of laboratory-based enzyme-linked immunoassay methods; (f) HIV rapid testing is strongly recommended for source-patient exposures; (g) rapid HIV testing in the peripartum period, laboratory-based or POC, provides information to support antiretroviral prophylaxis and most likely reduce peripartum HIV transmission; and (h) there was fair evidence to support POCT for the presence of Trichomonas vaginalis in the diagnosis of vaginitis. Included are examples of how these guidelines were implemented to successfully change how POCT was being used in physician office laboratories, emergency departments, and hospital clinics at one facility.