Novel Point-of-Care Technologies in Diagnostics 2018

A special issue of Diagnostics (ISSN 2075-4418). This special issue belongs to the section "Point-of-Care Diagnostics and Devices".

Deadline for manuscript submissions: closed (22 November 2018) | Viewed by 42141

Special Issue Editor

Departments of Global Health, Medicine (Infectious Diseases), and Epidemiology, University of Washington, 325 Ninth Ave, UW Box 359927, Seattle, WA 98104, USA
Interests: HIV/AIDS; tuberculosis; point-of-care diagnostics; point-of-care testing; implementation science; global health; resource-limited settings
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Special Issue Information

Dear Colleagues,

Point-of-care tests have changed the delivery and impact of medical care by facilitating a migration of diagnostic testing from centralized laboratories to the clinical site of patient care, or even a person’s home. Research and development of point-of-care tests has grown steadily over the last 20 years, and the global point-of-care diagnostic market is expected to surpass US $30 billion in the year 2020. Point-of-care tests have been developed for use in all medical settings, a wide variety of medical specialties and subspecialties, and for both infectious and non-communicable diseases. Novel point-of-care technologies are becoming increasing more sophisticated and complex with lab-on-a-chip capabilities, and the latest generation of point-of-care tests offer rapid analysis of human and pathogen genomic data to accelerate more appropriate and personalized therapies.

Any successful point-of-care technology will require a balancing of accuracy, rapidity, accessibility, and cost. While a fundamental objective is to be diagnostically accurate, point-of-care tests that can be quickly and easily performed by clinical health care workers and at low operational costs will be the most successful. The largest potential impact will be in resource-limited settings, where expensive laboratory infrastructure is either inaccessible or completely unavailable. However, several studies of point-of-care tests have demonstrated only minimal impact on the burden of disease in resource-limited settings, suggesting their incorporation in health systems has either been incomplete or poorly implemented.

Although centralized reference laboratories will maintain a critical role in providing confirmatory diagnosis, future healthcare delivery is likely to be more reliant on point-of-care technologies. In this Special Issue of Diagnostics, we welcome submission of articles that showcase novel point-of-care technologies in diagnostics. An article may demonstrate sophisticated laboratory technologies that are pushing technological boundaries, clinical implementation solutions that balance the complexity and accessibility of novel technologies, or modeling studies that provide information on future strategies to safely use point-of-care technologies for maximal benefit. The success of point-of-care technologies will depend on demonstrating diagnostic accuracy and clinical value for the benefit of individuals and the health of communities.

Dr. Paul K. Drain
Guest Editor

Manuscript Submission Information

Manuscripts should be submitted online at www.mdpi.com by registering and logging in to this website. Once you are registered, click here to go to the submission form. Manuscripts can be submitted until the deadline. All submissions that pass pre-check are peer-reviewed. Accepted papers will be published continuously in the journal (as soon as accepted) and will be listed together on the special issue website. Research articles, review articles as well as short communications are invited. For planned papers, a title and short abstract (about 100 words) can be sent to the Editorial Office for announcement on this website.

Submitted manuscripts should not have been published previously, nor be under consideration for publication elsewhere (except conference proceedings papers). All manuscripts are thoroughly refereed through a single-blind peer-review process. A guide for authors and other relevant information for submission of manuscripts is available on the Instructions for Authors page. Diagnostics is an international peer-reviewed open access semimonthly journal published by MDPI.

Please visit the Instructions for Authors page before submitting a manuscript. The Article Processing Charge (APC) for publication in this open access journal is 2600 CHF (Swiss Francs). Submitted papers should be well formatted and use good English. Authors may use MDPI's English editing service prior to publication or during author revisions.

Keywords

  • point-of-care test 
  • diagnostic testing 
  • screening 
  • microfluidics 
  • nucleic acid amplification 
  • lab-on-a-chip 
  • resource-limited settings

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Published Papers (6 papers)

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Research

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11 pages, 2609 KiB  
Article
Genotyping of Single Nucleotide Polymorphisms Using Allele-Specific qPCR Producing Amplicons of Small Sizes Directly from Crude Serum Isolated from Capillary Blood by a Hand-Powered Paper Centrifuge
by Gustavo Barcelos Barra, Ticiane Henriques Santa Rita, Daniella Paniago Jardim, Pedro Góes Mesquita, Camila Santos Nobre, Rafael Henriques Jácomo and Lídia Freire Abdalla Nery
Diagnostics 2019, 9(1), 9; https://doi.org/10.3390/diagnostics9010009 - 11 Jan 2019
Cited by 2 | Viewed by 5121
Abstract
The cell-free genomic DNA (gDNA) concentration in serum ranges from 1500 to 7500 copies/mL within 2 h after phlebotomy (6–24 times the concentration observed in plasma). Here, we aimed to evaluate the gDNA size distribution in serum with time after coagulation and to [...] Read more.
The cell-free genomic DNA (gDNA) concentration in serum ranges from 1500 to 7500 copies/mL within 2 h after phlebotomy (6–24 times the concentration observed in plasma). Here, we aimed to evaluate the gDNA size distribution in serum with time after coagulation and to test if crude serum can be directly used as a source of gDNA for qPCR. Next, we investigated if single nucleotide polymorphisms (SNPs) could be genotyped directly from the crude serum isolated from capillary blood using a hand-powered paper centrifuge. All tested PCR targets (65, 100, 202 and 688 base pairs) could be successfully amplified from DNA extracted from serum, irrespective of their amplicon size. The observed qPCR quantitation cycles suggested that the genomic DNA yield increased in serum with incubation at room temperature. Additionally, only 65 and 101 base pair qPCR targets could be amplified from crude serum soon after the coagulation. Incubation for 4 days at room temperature was necessary for the amplification of PCR targets of 202 base pairs. The 688 base pair qPCR target could not be amplified from serum directly. Lastly, serum was successfully separated from capillary blood using the proposed paper centrifuge and the genotypes were assigned by testing the crude serum using allele-specific qPCR, producing small amplicon sizes in complete agreement with the genotypes assigned by testing the DNA extracted from whole blood. The serum can be used directly as the template in qPCR for SNP genotyping, especially if small amplicon sizes are applied. This shortcut in the SNP genotyping process could further molecular point-of-care diagnostics due to elimination of the DNA extraction step. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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5 pages, 253 KiB  
Communication
Point-of-Care/Chairside aMMP-8 Analytics of Periodontal Diseases’ Activity and Episodic Progression
by Ismo T. Räisänen, Anna Maria Heikkinen, Eva Siren, Taina Tervahartiala, Dirk-Rolf Gieselmann, Gerrit-Jan Van der Schoor, Peter Van der Schoor and Timo Sorsa
Diagnostics 2018, 8(4), 74; https://doi.org/10.3390/diagnostics8040074 - 22 Oct 2018
Cited by 31 | Viewed by 5279
Abstract
Traditional periodontal disease diagnostics are based mainly on clinical examination and radiographs. They assess only past tissue destruction and provide no information on the current disease status or its future progression. The objective is to find out if an active matrix metalloproteinase-8 (aMMP-8) [...] Read more.
Traditional periodontal disease diagnostics are based mainly on clinical examination and radiographs. They assess only past tissue destruction and provide no information on the current disease status or its future progression. The objective is to find out if an active matrix metalloproteinase-8 (aMMP-8) point-of-care (PoC) test could provide a cost-effective way to get around this limitation. This cross-sectional study used 47 adolescents and 70 adults, who were clinically examined and their aMMP-8 PoC tested. The aMMP-8 PoC test results and patients’ treatment need, based on the community periodontal index of treatment needs (CPITN), were compared and analyzed using Fisher’s exact test. In terms of CPITN, the aMMP-8 PoC test gave no false positives for both adolescents and adults. All healthy patients got a negative test result, while a positive test result indicated periodontal treatment need correctly. Finally, there was a significant association between a patient’s aMMP-8 PoC test result and his/her treatment need (p = 0.001 for adolescents, p = 0.001 for adults). In conclusion, more accurate diagnostics of periodontal diseases’ activity and progression using an aMMP-8 PoC test may help to reduce oral health care costs by reducing patient overtreatment, improving patient outcome, and reducing the need for complex periodontal therapy. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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15 pages, 2292 KiB  
Article
Diagnosis of Newly Delivered Mothers for Periodontitis with a Novel Oral-Rinse aMMP-8 Point-of-Care Test in a Rural Malawian Population
by Jussi M. Leppilahti, Ulla Harjunmaa, Jorma Järnstedt, Charles Mangani, Marcela Hernández, Taina Tervahartiala, Rodrigo Lopez, Ulla Ashorn, Per Ashorn, Dirk-Rolf Gieselmann and Timo Sorsa
Diagnostics 2018, 8(3), 67; https://doi.org/10.3390/diagnostics8030067 - 15 Sep 2018
Cited by 26 | Viewed by 5202
Abstract
A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the [...] Read more.
A novel qualitative point-of-care test of activated matrix metalloproteinase-8 (aMMP-8) using noninvasive oral rinse sampling procedures has been developed for the early detection of collagen breakdown indicating periodontal tissue destruction. The main object of this study was to assess the reliability of the test in a low-income setting to identify participants with history of periodontal destruction detected as alveolar bone loss (ABL) in radiographs. This cross-sectional study included 486 women who had recently delivered in rural Malawi. The aMMP-8 test and dental panoramic radiographs were taken within 48 h of delivery. The performance of the test in comparison to radiological examinations was tested by following the standards for reporting of diagnostic accuracy studies protocol (STARD) with respective statistical measures and 95% confidence intervals. From the 486 eligible participants, 461 mothers with complete data, aged from 15 to 46 years (mean 24.8, SD 6.0) were included in the analysis. ABL was identified in 116 of 461 participants. There was 56% agreement between the aMMP-8 test results and detected ABL (yes or no) in radiographs. Calculated sensitivity of the test was 80% (72–87%), specificity 48% (43–54%), positive predictive value 34% (31–37%), negative predictive value 88% (83–91%), positive likelihood ratio 1.55 (1.35–1.77), and negative likelihood ratio 0.41(0.28–0.60). The aMMP-8 test sensitivity and negative predictive value to identify the ABL cases were relatively high, but there was additionally a high rate of test-positive results in participants without ABL, especially in young mothers, leading to low overall agreement between the test results and radiological bone loss. Further longitudinal studies are needed to examine if the test positive subjects are in risk of future bone loss before the detectable signs of periodontitis in radiographs. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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7 pages, 5374 KiB  
Article
A Novel Technique for Intraoral Ultrasound-Guided Aspiration of Peritonsillar Abscess
by Tobias Todsen, Mads Georg Stage and Christoffer Holst Hahn
Diagnostics 2018, 8(3), 50; https://doi.org/10.3390/diagnostics8030050 - 02 Aug 2018
Cited by 10 | Viewed by 9714
Abstract
Peritonsillar abscess (PTA) is a common complication to acute tonsillitis. The treatment is drainage of the abscess, but many needle aspirations are unsuccessful due to a low diagnostic accuracy based on oral examination only. In this article, we describe how intraoral ultrasound can [...] Read more.
Peritonsillar abscess (PTA) is a common complication to acute tonsillitis. The treatment is drainage of the abscess, but many needle aspirations are unsuccessful due to a low diagnostic accuracy based on oral examination only. In this article, we describe how intraoral ultrasound can be added to improve the diagnostic work-up of PTA and present a novel technique for ultrasound-guided aspiration of PTA, using a small pencil-shaped transducer. We present our first clinical experiences with this technique and describe how it could be integrated in a clinical setting to guide safe and successful needle aspirations of PTA. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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17 pages, 477 KiB  
Article
Improving Remote Health Monitoring: A Low-Complexity ECG Compression Approach
by Mohamed Elgendi, Abdulla Al-Ali, Amr Mohamed and Rabab Ward
Diagnostics 2018, 8(1), 10; https://doi.org/10.3390/diagnostics8010010 - 16 Jan 2018
Cited by 33 | Viewed by 7049
Abstract
Recent advances in mobile technology have created a shift towards using battery-driven devices in remote monitoring settings and smart homes. Clinicians are carrying out diagnostic and screening procedures based on the electrocardiogram (ECG) signals collected remotely for outpatients who need continuous monitoring. High-speed [...] Read more.
Recent advances in mobile technology have created a shift towards using battery-driven devices in remote monitoring settings and smart homes. Clinicians are carrying out diagnostic and screening procedures based on the electrocardiogram (ECG) signals collected remotely for outpatients who need continuous monitoring. High-speed transmission and analysis of large recorded ECG signals are essential, especially with the increased use of battery-powered devices. Exploring low-power alternative compression methodologies that have high efficiency and that enable ECG signal collection, transmission, and analysis in a smart home or remote location is required. Compression algorithms based on adaptive linear predictors and decimation by a factor B / K are evaluated based on compression ratio (CR), percentage root-mean-square difference (PRD), and heartbeat detection accuracy of the reconstructed ECG signal. With two databases (153 subjects), the new algorithm demonstrates the highest compression performance ( CR = 6 and PRD = 1.88 ) and overall detection accuracy (99.90% sensitivity, 99.56% positive predictivity) over both databases. The proposed algorithm presents an advantage for the real-time transmission of ECG signals using a faster and more efficient method, which meets the growing demand for more efficient remote health monitoring. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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Review

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18 pages, 2189 KiB  
Review
Developments in Point-of-Care Diagnostic Technology for Cancer Detection
by Bryony Hayes, Caroline Murphy, Aoife Crawley and Richard O’Kennedy
Diagnostics 2018, 8(2), 39; https://doi.org/10.3390/diagnostics8020039 - 02 Jun 2018
Cited by 73 | Viewed by 9007
Abstract
Cancer is the cause of death for one in seven individuals worldwide. It is widely acknowledged that screening and early diagnosis are of vital importance for improving the likelihood of recovery. However, given the costly, time-consuming, and invasive nature of the many methods [...] Read more.
Cancer is the cause of death for one in seven individuals worldwide. It is widely acknowledged that screening and early diagnosis are of vital importance for improving the likelihood of recovery. However, given the costly, time-consuming, and invasive nature of the many methods currently in use, patients often do not take advantage of the services available to them. Consequently, many researchers are exploring the possibility of developing fast, reliable, and non-invasive diagnostic tools that can be used directly or by local physicians at the point-of-care. Herein, we look at the use of established biomarkers in cancer therapy and investigate emerging biomarkers exhibiting future potential. The incorporation of these biomarkers into point-of-care devices could potentially reduce the strain currently experienced by screening programs in hospitals and healthcare systems. Results derived from point-of-care tests should be accurate, sensitive, and generated rapidly to assist in the selection of the best course of treatment for optimal patient care. Essentially, point-of-care diagnostics should enhance the well-being of patients and lead to a reduction in cancer-related deaths. Full article
(This article belongs to the Special Issue Novel Point-of-Care Technologies in Diagnostics 2018)
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