1. Laboratory Medicine Practice Guidelines (LMPG) Evidence Based Practice for Point of Care Testing

2. National Academy of Clinical Biochemistry (NACB) Mission The NACB is dedicated to advancing the science and practice of clinical laboratory medicine through research, education, and professional development. NACB publishes Laboratory Medicine Practice Guidelines (LMPGs) for the application of clinical biochemistry to medical diagnosis and therapy.

3. NACB Laboratory Medicine Practice Guidelines Nutritional Status1994 Thyroid Disease (1st edition)1996 Newborn Infant1998 Therapeutic Drug Monitoring1999 Cardiac Markers1999 Hepatic Injury2000 Diabetes2002 Thyroid Disease (2nd edition)2002 Emergency Toxicology in progress Maternal / Fetal Healthin progress Cardiac Risk Factorsin progress Point of Care Testingin progress

4. Evidence Based Practice for POCT POCT is an increasingly popular means of delivering laboratory testing. When used appropriately, POCT can improve patient outcome by providing a faster result and therapeutic intervention. However, when overutilized or incorrectly performed, POCT presents a patient risk and potential for increased cost of healthcare.

5. Evidence Based Practice for POCT Clinicians, staff and laboratorians need guidance to apply POCT in the most effective manner for patient benefit. This guidance should be based on a concurrence of the scientific evidence to date. This LMPG will systematically review the existing evidence relating POCT to patient outcome, grade the literature, and make recommendations regarding the optimal utilization of POCT devices in patient care. Develop liaisons with appropriate professional, clinical organizations: ADA, ACOG, American College of Cardiology, etc.

6. Evidence Based Practice for POCT Organizing Committee James H. Nichols, Ph.D. (Chair) Naomi Aronson, Ph.D. Robert H. Christenson, Ph.D. Ellis Jacobs, Ph.D. Kent B. Lewandrowski, M.D. Rodney S. Markin, M.D., Ph.D. Christopher Price, Ph.D. David B. Sacks, M.D. Salvador F. Sena, Ph.D. William E. Winter, M.D.

7. Evidence Based Practice for POCT Schedule Fall 2002 - Form focus groups on specific topics composed of clinicians, laboratorians, industry and representatives of professional societies. Spring 2003 - Conduct a systematic review of literature and make specific recommendations. Summer 2003 – Internet availability of recommendations for public comment. Fall 2003/Spring 2004 – Groups resolve comments. Winter 2003/Spring 2004 – Internet publication of revised recommendations Summer 2004 – Present final recommendations.

8. Evidence Based Practice for POCT Focus Group Chairs Cardiac – Robert H. Christenson, Ph.D. Diabetes – Glen L. Hortin, M.D., Ph.D. Reproduction – Ann M. Gronowski, Ph.D. Infectious Disease Coagulation Parathyroid – Lori J. Sokoll, Ph.D. Toxicology/Addiction Bilirubin Screening Critical Care- Greg Shipp, M.D. Renal – William A. Clarke, Ph.D. Occult Blood – Kent Lewandrowski, M.D. pH Provider Performed Microscopies

9. Evidence Based Practice for POCT This LMPG promises to be the most comprehensive collection of our POCT knowledge base. Recommendations from this LMPG will be useful: To sort the facts from conjecture when implementing and utilizing POCT devices. To establish proven applications from off- label and alternative uses of POCT To define the mechanisms and strategies for optimizing patient outcome.

10. Evidence Based Practice for POCT THE NACB WANTS YOUR INPUT

11. Evidence Based Practice for POCT Levels of Participation Send POCT Concerns and Comments to Organizing Committee Focus Group Member Participant in Systematic Review Develop Practice Guidelines Review Draft Recommendations as a consumer and provide comment or suggestions.

12. For more information visit the NACB at www.nacb.org