Scoring Goals with Point-of-Care Technology

Interesting parallels can be made between the use of point-of-care technology on the football pitch and its use in clinical settings.

This week marks the beginning of SelectScience’s exciting in vivo football experiment, during the course of which we will see whether the Sportomics approach of applying science in the field can affect a one-time, real football match.

The Sportomics approach focuses on sport as a metabolic challenge. It involves monitoring an individual’s metabolite changes during periods of sport and exercise, and making interventions based on these results. Watch this video to find out more about the Sportomics approach.

During this experiment, SelectScience's Editor-in-Chief, Kerry Parker, traveled to Brazil to meet Professor Cameron, from the Lab of Protein Biochemistry at the Federal University of the State of Rio de Janeiro, and one of the founders of Sportomics. Together with a team of scientists, they monitored the football players involved in our experiment, on various parameters, including biochemistry and mass spectrometry analysis. The orange team had various interventions made before and during the final football match, based on the results obtained during the experiment. The red team had no interventions made.

The blood tests taken during the experiment were analyzed using a variety of different analyzers; for clinical chemistry parameters, the Piccolo Xpress point-of-care (POC) chemistry analyzer was used. The fact that this is a POC analyzer allowed it to be used at the side of the pitch during our experiment.

What is POC testing (POCT)?
The use of blood tests on a mass-testing scale, in clinical settings began in the 1950s. These tests had to be carried out in pathology laboratories by trained professionals; the methods and reagents used were often dangerous and involved hazardous chemicals. These blood tests were not carried out in real-time; rather they were tested some time after the blood had been drawn. POCT refers to diagnostic tests that can be carried out literally at the POC, and not in a laboratory. This might be, for example, at a patient’s home, in a physician’s office or in a hospital clinic.

POCT began with urine strip tests that relied on simple chemical changes to produce a visible reaction. Modern technology has now advanced to such a degree that complex technology can be harnessed into a small portable analyzer, and be operated by someone with a moderate degree of training.

Where once there was a clear argument for separate laboratories with highly skilled professionals, the development of advanced POC technology has now made it possible for many laboratory-standard tests to be carried out in real-time, at the patient’s location.

Biochemistry results
The biochemistry results of our teams were analyzed using the Piccolo Xpress POC chemistry analyzer. This analyzer is capable of performing 31 blood chemistry tests ranging from liver, kidney and metabolic functions to lipids, electrolytes and other specialty analytes. The 31 tests are configured into 16 self-contained reagent discs, 11 of which are CLIA waived (this means that the FDA has ruled these tests to be simple enough, with a low risk for erroneous results, to be used outside of a regulated laboratory setting).

Our experiment involves football; however the same principles can be applied to providing lab-accurate biochemistry analysis at the POC, the analyzer’s primary purpose. The advantage of using a Sportomics approach in football means that immediate interventions can be applied by a team's coach or manager; for example, electrolyte results indicating dehydration can be countered with immediate rehydration measures.

Facilitating immediate clinical decisions
In a clinical setting, immediate, real-time results have very significant health benefits. There are many instances where the delay in taking a sample and waiting for a laboratory test result is not beneficial to the patient. Drug decisions, infection treatments, blood transfusions, thrombosis management and myocardial infarction assessment are just some of the pathological states requiring immediate clinical decisions. Real-time POCT allows these decisions to be based on lab quality test results, in conjunction with the physician’s experience and knowledge. Accurate real-time testing also improves patient satisfaction, as faster decisions mean less waiting time and improved patient experience.

Whether immediate intervention affects our football match outcome as positively as POCT affects clinical decision making, I cannot say - keep watching the Science Behind the World Cup videos to find out which team will win - however, to take part in the voting and the biochemistry quiz yourself, you can find all of the details at our Science Behind the World Cup Special Feature.