Clinical laboratory decision analysis

A well-known example of this is the analyses for cholesterol and lipids that are used to determine risks of heart disease. Phlebotomists collect a sample of blood, which is then sent to a laboratory for analysis. A standard sample volume called an aliquot is extracted with a nonaqueous solvent to isolate the fatty portion of the blood. Specific tests for cholesterol and other hpids are then performed. Everyone who handles the sample must follow proven procedures to prevent exposures to bloodbome pathogens (BBPs) that might coexist in the blood. Clinical chemists have refined these methods so that they are reproducible and accurate, which is exactly what is desired, of course, when making a decision about prescribing drugs that (hopefully) have positive effects but also have negative side effects. 

In the routine large-scale opioid maintenance clinics we do not always do instant testing, with the sample going instead for full laboratory analysis. Of course if some decision about treatment actually depends on that day s result an instant test can be used. 

The a priori strategy is best suited for smaller studies. Possible reference individuals from the parent population are interviewed and examined clinically and by selected laboratory methods to decide whether they fulfill the defined inclusion criteria. If the decision is positive, specimens for analysis are collected by a standardized procedure (including the necessary preparation of the individuals before the collection). 

Benefits of POC technology include the lower costs of out-patient versus in-patient care, savings in both waiting time and consultation time in clinics, savings in laboratory analysis time and effort, the fact that it is often less invasive than hospital testing and that POC devices are more readily available to the public. Importantly, too, POC devices allow doctors to make decisions quickly based on the rapidly available results. Reimbursement from insurance providers is now possible for some POC devices, such as home glucose... 

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