Current Trends in Instrumentation and Technology

Chapter 48 Current Trends in Instrumentation and Technology A Look toward the Future Patrick B. Kyle, Patrick B. KyleSearch for more papers by this authorLauren McVoy, Lauren McVoySearch for more papers by this author Patrick B. Kyle, Patrick B. KyleSearch for more papers by this authorLauren McVoy, Lauren McVoySearch for more papers by this author Book Editor(s):Lynne S. Garcia, Lynne S. Garcia LSG & Associates, Santa Monica, CaliforniaSearch for more papers by this authorTimothy C. Allen, Timothy C. Allen Corewell Health, Royal Oak, MichiganSearch for more papers by this authorVickie S. Baselski, Vickie S. Baselski University of Tennessee Health Science Center, Memphis, TennesseeSearch for more papers by this authorDeirdre L. Church, Deirdre L. Church University of Calgary, Calgary, Alberta, CanadaSearch for more papers by this authorDonald S. Karcher, Donald S. Karcher George Washington University, Washington, DCSearch for more papers by this authorMichael R. Lewis, Michael R. Lewis Banner MD Anderson Cancer Center, Gilbert, ArizonaSearch for more papers by this authorAndrea J. Linscott, Andrea J. Linscott Ochsner Medical Center, New Orleans, LouisianaSearch for more papers by this authorMelinda D. Poulter, Melinda D. Poulter University of Virginia, Charlottesville, VirginiaSearch for more papers by this authorGary W. Procop, Gary W. Procop American Board of Pathology, Tampa, FloridaSearch for more papers by this authorAlice S. Weissfeld, Alice S. Weissfeld Microbiology Specialists, Inc., Houston, TexasSearch for more papers by this authorDonna M. Wolk, Donna M. Wolk Geisinger, Diagnostic Medicine Institute, Department of Laboratory Medicine, Danville, PennsylvaniaSearch for more papers by this author First published: 22 March 2024 https://doi.org/10.1002/9781683673941.ch48 AboutPDFPDF ToolsRequest permissionExport citationAdd to favoritesTrack citation ShareShareShare a linkShare onEmailFacebookTwitterLinkedInRedditWechat Summary This chapter provides an overview of current trends in instrumentation and technology in the clinical laboratory (hematology, chemistry, microbiology, blood transfusion/coagulation, point-of-care testing, and molecular diagnostics). It also provides perspectives on how recent developments and other technologies are and will be shaping the laboratory. The modern hematology analyzer incorporates impedance, conductivity, optical absorbance, cytochemical detection, and basic flow-cytometric principles to differentiate cell types. Advances in instrumentation have facilitated the movement of a multitude of tests into the "core" chemistry laboratory, such as those for tumor markers, therapeutic drugs, endocrinology, reproduction, drugs of abuse, and others. Molecular diagnostics in hematology include RNA and DNA analysis to detect and quantify genetic abnormalities and to determine disease heterogeneity. Molecular diagnostics have become very important in treating hematologic diseases for which targeted therapies are available. The microbiology laboratory continues to be transformed by advances in automation, incorporation of mass spectrometry, and molecular tests for microorganisms. REFERENCES Durham J , Hackman S . 2020 . Better approaches to clinical laboratory design . Clin Lab Manag (July): 32 – 35 . Google Scholar Lippi G , Da Rin G . 2019 . Advantages and limitations of total laboratory automation: a personal overview . Clin Chem Lab Med 57 : 802 – 811 . 10.1515/cclm-2018-1323 CASPubMedWeb of Science®Google Scholar Felder R. 2006 . Masahide Sasaki (obituary) . Clin Chem 52 : 791 – 792 . 10.1373/clinchem.2006.067686 Web of Science®Google Scholar Aller RD , Felder R . 2007 . Laboratory automation systems and workcells (survey) . CAP Today 21 : 30 – 48 . Google Scholar Vercruysse K , Lambrecht S , Oyaert M . 2021 . Total lab automation: sample stability of clinical chemistry parameters in an automated storage and retrieval module . Clin Chem Lab Med 60 : 52 – 59 . 10.1515/cclm-2021-0866 PubMedGoogle Scholar Petrides AK , Bixho I , Goonan EM , Bates DW , Shaykevich S , Lipsitz SR , Landman AB , Tanasijevic MJ , Melanson SE . 2017 . The benefits and challenges of an interfaced electronic health record and laboratory information system: effects on laboratory processes . Arch Pathol Lab Med 141 : 410 – 417 . 10.5858/arpa.2016-0146-OA PubMedWeb of Science®Google Scholar Lippi G , Plebani M . 2016 . Toxic alcohol concentrations and misinterpretation of laboratory results . JAMA Intern Med 176 : 1228 – 1229 . 10.1001/jamainternmed.2016.3720 PubMedGoogle Scholar Topcu DI , Gulbahar O . 2021 . A model to establish autoverification in the clinical laboratory . Clin Biochem 93 : 90 – 98 . 10.1016/j.clinbiochem.2021.03.018 PubMedGoogle Scholar CMS . 2012 . Medicare and Medicaid programs; electronic health record incentive program-stage 2. Final rule. Centers for Medicare & Medicaid Services (CMS) . Fed Regist 77 : 53967 – 54162 . PubMedGoogle Scholar U.S. Food and Drug Administration . 15 June 2018 . Logical Observation Identifiers Names and Codes for in vitro diagnostic tests. Guidance for industry and Food and Drug Administration Staff . https://www.fda.gov/media/113967/download . Accessed 19 March 2022. Google Scholar Johnson C , Pylypchuk Y. 2021 . Use of certified health IT and methods to enable interoperability by U.S. non-federal acute hospitals, 2019 . ONC data brief, no. 54. https://www.healthit.gov/sites/default/files/page/2021-03/Hospital%20Use%20of%20Certified%20HIT_Interop%20v10_1.pdf . Accessed 19 March 2022. Google Scholar Davis BH , Barnes PW . 2012 . Automated cell analysis: principles , p 26 – 32 . In K Kottke-Marchant , BH Davis (ed), Laboratory Hematology Practice . Blackwell Publishing, Ltd ., Oxford, UK . 10.1002/9781444398595.ch3 Google Scholar Dabkowski B. 2011 . New applications, middleware, and more for hematology analyzers . CAP Today 25 : 24 – 39 . Google Scholar Ward PCJ . 2000 . The CBC at the turn of the millennium: an overview . Clin Chem 46 : 1215 – 1220 . 10.1093/clinchem/46.8.1215 CASPubMedWeb of Science®Google Scholar D'Onofrio G , Zini G , Tommasi M , Van Hove L . 1996 . Integration of fluorescence and hemocytometry in the CELL-DYN 4000: reticulocyte, nucleated red blood cell, and white blood cell viability study . Lab Hematol 2 : 131 – 138 . Google Scholar Bó SD , Fragoso ALR , Farias MG , Hubner DPG , de Castro SM . 2023 . Evaluation of RET-He values as an early indicator of iron deficiency anemia in pregnant women . Hematol Transfus Cell Ther 45 : 52 – 57 . 10.1016/j.htct.2021.05.006 PubMedGoogle Scholar Chapman DH , Hardin J , Miers M , Moyle S , Kinney MC . 2001 . Reduction of the platelet review rate using the two-dimensional platelet method . Am J Clin Pathol 115 : 894 – 898 . 10.1309/C563-49VA-JYDU-LEJG CASPubMedWeb of Science®Google Scholar Schoorl M , Schoorl M , Oomes J , van Pelt J . 2013 . New fluorescent method (PLT-F) on Sysmex XN2000 hematology analyzer achieved higher accuracy in low platelet counting . Am J Clin Pathol 140 : 495 – 499 . 10.1309/AJCPUAGGB4URL5XO PubMedWeb of Science®Google Scholar Ceelie H , Dinkelaar RB , van Gelder W . 2007 . Examination of peripheral blood films using automated microscopy; evaluation of Diffmaster Octavia and Cellavision DM96 . J Clin Pathol 60 : 72 – 79 . 10.1136/jcp.2005.035402 CASPubMedWeb of Science®Google Scholar Khartabil TA , de Rijke YB , Koelewijn R , van Hellemond JJ , Russcher H . 2022 . Fast detection and quantification of Plasmodium species infected erythrocytes in a non-endemic region by using the Sysmex XN-31 analyzer . Malar J 21 : 119 . 10.1186/s12936-022-04147-0 CASPubMedGoogle Scholar Wu AHB , Sellers J . 2019 . XW-100: first FDA CLIA-waived CBC analyzer designed for physician office use . J Appl Lab Med 3 : 839 – 846 . 10.1373/jalm.2018.027383 CASPubMedGoogle Scholar Ostermann M , Zarbock A , Goldstein S , Kashani K , Macedo E , Murugan R , Bell M , Forni L , Guzzi L , Joannidis M , Kane-Gill SL , Legrand M , Mehta R , Murray PT , Pickkers P , Plebani M , Prowle J , Ricci Z , Rimmelé T , Rosner M , Shaw AD , Kellum JA , Ronco C . 2020 . Recommendations on acute kidney injury biomarkers from the acute disease quality initiative consensus conference: a consensus statement . JAMA Netw Open 3 : e2019209 . 10.1001/jamanetworkopen.2020.19209 PubMedWeb of Science®Google Scholar Willeit P , Welsh P , Evans JDW , Tschiderer L , Boachie C , Jukema JW , Ford I , Trompet S , Stott DJ , Kearney PM , Mooijaart SP , Kiechl S , Di Angelantonio E , Sattar N . 2017 . High-sensitivity cardiac troponin concentration and risk of first-ever cardiovascular outcomes in 154,052 participants . J Am Coll Cardiol 70 : 558 – 568 . 10.1016/j.jacc.2017.05.062 PubMedWeb of Science®Google Scholar Edwards HD , Sabio H , Shihabi ZK . 2009 . Rapid quantitation of hemoglobin S in sickle cell patients using the Variant II Turbo analyzer . Ann Clin Lab Sci 39 : 32 – 37 . CASPubMedGoogle Scholar Stone J. 2016 . High-throughput serum 25-hydroxy vitamin D testing with automated sample preparation . Methods Mol Biol 1378 : 301 – 320 . 10.1007/978-1-4939-3182-8_32 CASPubMedGoogle Scholar Benton SC , Tetteh GK , Needham SJ , Mücke J , Sheppard L , Alderson S , Ruppen C , Curti M , Redondo M , Milan AM . 2020 . Evaluation of the 25-hydroxy vitamin D assay on a fully automated liquid chromatography mass spectrometry system, the Thermo Scientific Cascadion SM clinical analyzer with the Cascadion 25-hydroxy vitamin D assay in a routine clinical laboratory . Clin Chem Lab Med 58 : 1010 – 1017 . 10.1515/cclm-2019-0834 CASPubMedWeb of Science®Google Scholar Thomson RB Jr , McElvania E . 2019 . Total laboratory automation. What is gained, what is lost and who can afford it? Clin Lab Med 39 : 371 – 389 . 10.1016/j.cll.2019.05.002 PubMedGoogle Scholar Mutters NT , Hodiamont CJ , de Jong MD , Overmeijer HP , van den Boogaard M , Visser CE . 2014 . Performance of Kiestra total laboratory automation combined with MS in clinical microbiology practice . Ann Lab Med 34 : 111 – 117 . 10.3343/alm.2014.34.2.111 PubMedWeb of Science®Google Scholar De Socio GV , Di Donato F , Paggi R , Gabrielli C , Belati A , Rizza G , Savoia M , Repetto A , Cenci E , Mencacci A . 2018 . Laboratory automation reduces time to report of positive blood cultures and improves management of patients with bloodstream infection . Eur J Clin Microbiol Infect Dis 37 : 2313 – 2322 . 10.1007/s10096-018-3377-5 PubMedGoogle Scholar Burckhardt I , Last K , Zimmermann S . 2019 . Shorter incubation times for detecting multi-drug resistant bacteria in patient samples: defining early imaging time points using growth kinetics and total laboratory automation . Ann Lab Med 39 : 43 – 49 . 10.3343/alm.2019.39.1.43 PubMedGoogle Scholar Heaton P , Patel R . 2018 . Mass spectrometry applications in infectious disease and pathogens identification , p 93 – 114 . In N Rifai , AR Horvath , CT Wittwer (ed), Principles and Applications of Clinical Mass Spectrometry . Elsevier , Amsterdam, Netherlands . 10.1016/B978-0-12-816063-3.00004-9 Google Scholar Sogawa K , Watanabe M , Sato K , Segawa S , Ishii C , Miyabe A , Murata S , Saito T , Nomura F . 2011 . Use of the MALDI BioTyper system with MALDI-TOF mass spectrometry for rapid identification of microorganisms . Anal Bioanal Chem 400 : 1905 – 1911 . 10.1007/s00216-011-4877-7 CASPubMedWeb of Science®Google Scholar Ward C , Stocker K , Begum J , Wade P , Ebrahimsa U , Goldenberg SD . 2015 . Performance evaluation of the Verigene® (Nanosphere) and FilmArray® (BioFire®) molecular assays for identification of causative organisms in bacterial bloodstream infections . Eur J Clin Microbiol Infect Dis 34 : 487 – 496 . 10.1007/s10096-014-2252-2 CASPubMedWeb of Science®Google Scholar Chong BSW , Kennedy KJ . 2021 . Comparison of a commercial real-time PCR panel to routine laboratory methods for the diagnosis of meningitis-encephalitis . Pathology 53 : 635 – 638 . 10.1016/j.pathol.2020.09.029 CASPubMedGoogle Scholar Leber AL , Everhart K , Daly JA , Hopper A , Harrington A , Schreckenberger P , McKinley K , Jones M , Holmberg K , Kensinger B . 2018 . Multicenter evaluation of BioFire FilmArray Respiratory Panel 2 for detection of viruses and bacteria in nasopharyngeal swab samples . J Clin Microbiol 56 : e01945 – 17 . 10.1128/JCM.01945-17 CASPubMedWeb of Science®Google Scholar Buss SN , Leber A , Chapin K , Fey PD , Bankowski MJ , Jones MK , Rogatcheva M , Kanack KJ , Bourzac KM . 2015 . Multicenter evaluation of the BioFire FilmArray gastrointestinal panel for etiologic diagnosis of infectious gastroenteritis . J Clin Microbiol 53 : 915 – 925 . 10.1128/JCM.02674-14 PubMedWeb of Science®Google Scholar Leli C , Di Matteo L , Gotta F , Vay D , Calcagno L , Callegari T , Cassinari M , Cattana E , Ciriello MM , Copponi V , Sacchi MC , Zambon D , Guaschino R , Rocchetti A . 2019 . Diagnostic accuracy of a commercial multiplex PCR for the diagnosis of meningitis and encephalitis in an Italian general hospital . Infez Med 27 : 141 – 148 . PubMedGoogle Scholar Collins S , MacIntyre C , Hewer I . 2016 . Thromboelastography: clinical application, interpretation, and transfusion management . AANA J 84 : 129 – 134 . PubMedGoogle Scholar Faraoni D , DiNardo JA . 2021 . Viscoelastic hemostatic assays: update on technology and clinical applications . Am J Hematol 96 : 1331 – 1337 . 10.1002/ajh.26285 PubMedWeb of Science®Google Scholar Shander A , Goobie SM , Warner MA , Aapro M , Bisbe E , Perez-Calatayud AA , Callum J , Cushing MM , Dyer WB , Erhard J , Faraoni D , Farmer S , Fedorova T , Frank SM , Froessler B , Gombotz H , Gross I , Guinn NR , Haas T , Hamdorf J , Isbister JP , Javidroozi M , Ji H , Kim YW , Kor DJ , Kurz J , Lasocki S , Leahy MF , Lee CK , Lee JJ , Louw V , Meier J , Mezzacasa A , Munoz M , Ozawa S , Pavesi M , Shander N , Spahn DR , Spiess BD , Thomson J , Trentino K , Zenger C , Hofmann A , International Foundation of Patient Blood Management (IFPBM) and Society for the Advancement of Blood Management (SABM) Work Group . 2020 . Essential role of patient blood management in a pandemic: a call for action . Anesth Analg 131 : 74 – 85 . 10.1213/ANE.0000000000004844 CASPubMedWeb of Science®Google Scholar Woo JS , Suslow P , Thorsen R , Ma R , Bakhtary S , Moayeri M , Nambiar A . 2019 . Development and implementation of real-time web-based dashboards in a multisite transfusion service . J Pathol Inform 10 : 3 . 10.4103/jpi.jpi_36_18 PubMedGoogle Scholar Dusseljee-Peute LW , Van der Togt R , Jansen B , Jaspers MW . 2019 . The value of radio frequency identification in quality management of the blood transfusion chain in an academic hospital setting . JMIR Med Inform 7 : e9510 . 10.2196/medinform.9510 PubMedWeb of Science®Google Scholar Briggs L , Davis R , Gutierrez A , Kopetsky M , Young K , Veeramani R . 2009 . RFID in the blood supply chain—increasing productivity, quality and patient safety . J Healthc Inf Manag 23 : 54 – 63 . PubMedGoogle Scholar Chen J , Gorman M , O'Reilly B , Chen Y . 2016 . Analytical evaluation of the epoc® point-of-care blood analysis system in cardiopulmonary bypass patients . Clin Biochem 49 : 708 – 712 . 10.1016/j.clinbiochem.2015.12.015 PubMedGoogle Scholar Johannis W , Bietenbeck A , Malchau G , Streichert T . 2020 . Point-of-care testing (POCT) and IT security concepts . J Lab Med. 44 : 107 – 111 . 10.1515/labmed-2019-0199 Google Scholar Bercovitz RS . 2018 . An introduction to point-of-care testing in extracorporeal circulation and LVADs . Hematology (Am Soc Hematol Educ Program) 2018 : 516 – 521 . 10.1182/asheducation-2018.1.516 PubMedGoogle Scholar Wool GD . 2019 . Benefits and pitfalls of point-of-care coagulation testing for anticoagulant management: an ACLPS critical review . Am J Clin Pathol 151 : 1 – 17 . 10.1093/ajcp/aqy087 CASPubMedWeb of Science®Google Scholar Van Keer S , Peeters E , Vanden Broeck D , De Sutter P , Donders G , Doyen J , Tjalma WAA , Weyers S , Vorsters A , Arbyn M . 2021 . Clinical and analytical evaluation of the RealTime High Risk HPV assay in Colli-Pee collected first-void urine using the VALHUDES protocol . Gynecol Oncol 162 : 575 – 583 . 10.1016/j.ygyno.2021.06.010 PubMedWeb of Science®Google Scholar Arienzo A , Cellitti V , Ferrante V , Losito F , Stalio O , Murgia L , Marino R , Cristofano F , Orrù M , Visca P , Di Somma S , Silvestri L , Ziparo V , Antonini G . 2020 . A new point-of-care test for the rapid detection of urinary tract infections . Eur J Clin Microbiol Infect Dis 39 : 325 – 332 . 10.1007/s10096-019-03728-3 PubMedGoogle Scholar Weddell S , Jones GL , Duffy S , Hogg C , Johnson S , Ledger W . 2019 . Home ovulation test use and stress during subfertility evaluation: subarm of a randomized controlled trial . Womens Health (Lond Engl) 15 :1745506519838363. 10.1177/1745506519838363 Google Scholar Ning Y , Lu F , Liu Y , Yang S , Wang F , Ji X , He Z . 2021 . Glow-type chemiluminescent hydrogels for point-of-care testing (POCT) of cholesterol . Analyst (Lond) 146 : 4775 – 4780 . 10.1039/D1AN00676B CASPubMedWeb of Science®Google Scholar Scherer JN , Schuch JB , Rabelo-da-Ponte FD , Silvestrin R , Ornell R , Sousa T , Limberger RP , Pechansky F . 2020 . Analytical reliability of four oral fluid point-of-collection testing devices for drug detection in drivers . Forensic Sci Int 315 : 110434 . 10.1016/j.forsciint.2020.110434 CASPubMedGoogle Scholar Wildi K , Boeddinghaus J , Nestelberger T , Lopez-Ayala P , Yufera Sanchez A , Okamura B , Shrestha S , Rohner J , Miró Ò , Martinez-Nadal G , Martin-Sanchez FJ , Koechlin L , Twerenbold R , Christ M , Kawecki D , Rubini Giménez M , Keller DI , Mueller C , for the APACE Investigators . 2022 . 0/2 h-algorithm for rapid triage of suspected myocardial infarction using a novel high-sensitivity cardiac troponin I assay . Clin Chem 68 : 303 – 312 . 10.1093/clinchem/hvab203 Google Scholar Biberthaler P , Musaelyan K , Krieg S , Meyer B , Stimmer H , Zapf J , von Matthey F , Chandran R , Marino JA , Beligere G , Hoffmann M , Zhang H , Datwyler SA , McQuiston B . 2021 . Evaluation of acute glial fibrillary acidic protein and ubiquitin c-terminal hydrolase-L1 plasma levels in traumatic brain injury patients with and without intracranial lesions . Neurotrauma Rep 2 : 617 – 625 . 10.1089/neur.2021.0048 PubMedGoogle Scholar Bernardini S , Pieri M , Ciotti M . 2021 . How could POCT be a useful tool for migrant and refugee health? EJIFCC 32 : 200 – 208 . PubMedGoogle Scholar James AS , Alawneh JI . 2020 . COVID-19 infection diagnosis: potential impact of isothermal amplification technology to reduce community transmission of SARS-CoV-2 . Diagnostics (Basel) 10 : 399 . 10.3390/diagnostics10060399 CASPubMedWeb of Science®Google Scholar Shalaby A , Laharwani H , Bates JT , Kyle PB . 2021 . Efficacy of POC antibody assays after COVID-19 infection and potential utility for "immunity passports." Lab Med 53 : 262 – 265 . 10.1093/labmed/lmab093 Google Scholar Morris SR , Bristow CC , Wierzbicki MR , Sarno M , Asbel L , French A , Gaydos CA , Hazan L , Mena L , Madhivanan P , Philip S , Schwartz S , Brown C , Styers D , Waymer T , Klausner JD . 2021 . Performance of a single-use, rapid, point-of-care PCR device for the detection of Neisseria gonorrhoeae, Chlamydia trachomatis, and Trichomonas vaginalis: a cross-sectional study . Lancet Infect Dis 21 : 668 – 676 . 10.1016/S1473-3099(20)30734-9 CASPubMedWeb of Science®Google Scholar Laha S , Chakraborty J , Das S , Manna SK , Biswas S , Chatterjee R . 2020 . Characterizations of SARS-CoV-2 mutational profile, spike protein stability and viral transmission . Infect Genet Evol 85 : 104445 . 10.1016/j.meegid.2020.104445 CASPubMedWeb of Science®Google Scholar Oude Munnink BB , Nieuwenjuijse DF , Stein M , O'Toole A , Haverkate M , Mollers M , Kamga SK , Schapendonk C , Pronk M , Lexmond P , van der Linden A , Bestebroer T , Chestakova I , Overmars RJ , van Nieuwkoop S , Molenkamp R , van der Eijk AA , Geurtsvan Kessel C , Vennema H , Meijer A , Rambaut A , van Dissel J , Sikkema RS , Timen A , Koopmans M , Dutch-Covid-19 response team . 2020 . Rapid SARS-CoV-2 whole-genome sequencing and analysis for informed public health decision-making in the Netherlands . Nat Med 26 : 1405 – 1410 . 10.1038/s41591-020-0997-y CASPubMedWeb of Science®Google Scholar Paul D , Pyne N , Paul S . 2021 . Mutation profile of SARS-CoV-2 spike protein and identification of potential multiple epitopes within spike protein for vaccine development against SARS-CoV-2 . Virusdisease 32 : 703 – 726 . 10.1007/s13337-021-00747-7 CASPubMedGoogle Scholar Loeffelholz MJ , Alland D , Butler-Wu SM , Pandey U , Perno CF , Nava A , Carroll KC , Mostafa H , Davies E , McEwan A , Rakeman JL , Fowler RC , Pawlotsky JM , Fourati S , Banik S , Banada PP , Swaminathan S , Chakravorty S , Kwiatkowski RW , Chu VC , Kop J , Gaur R , Sin MLY , Nguyen D , Singh S , Zhang N , Persing DH . 2020 . Multicenter evaluation of the Cepheid Xpert Xpress SARS-CoV-2 test . J Clin Microbiol 58 : e00926-20 . 10.1128/JCM.00926-20 PubMedWeb of Science®Google Scholar Gerlier C , Pilmis B , Ganansia O , Le Monnier A , Nguyen Van JC . 2021 . Clinical and operational impact of rapid point-of-care SARS-CoV-2 detection in an emergency department . Am J Emerg Med 50 : 713 – 718 . 10.1016/j.ajem.2021.09.062 PubMedWeb of Science®Google Scholar Kumar S , Ghildayal NS , Shah RN . 2011 . Examining quality and efficiency of the U.S. healthcare system . Int J Health Care Qual Assur 24 : 366 – 388 . 10.1108/09526861111139197 PubMedGoogle Scholar Singer CF . 2021 . Genetic testing in breast cancer: new standards of care . Breast Care (Basel) 16 : 193 – 195 . 10.1159/000516788 PubMedGoogle Scholar Prodan Žitnik I , Černe D , Mancini I , Simi L , Pazzagli M , Di Resta C , Podgornik H , Repič Lampret B , Trebušak Podkrajšek K , Sipeky C , van Schaik R , Brandslund I , Vermeersch P , Schwab M , Marc J , EFLM/ESPT working group of Personalised Laboratory Medicine . 2018 . Personalized laboratory medicine: a patient-centered future approach . Clin Chem Lab Med 56 : 1981 – 1991 . 10.1515/cclm-2018-0181 CASPubMedGoogle Scholar Serir N , Pilat S , Pouget R , Errouane B . 2022 . [ Telemedicine and emergency medicine ]. Rev Med Suisse 18 : 1507 – 1511 . PubMedGoogle Scholar Di Cerbo A , Quagliano N , Napolitano A , Pezzuto F , Iannitti T , Di Cerbo A . 2021 . Comparison between an emerging point-of-care tool for TSH evaluation and a centralized laboratory-based method in a cohort of patients in southern Italy . Diagnostics (Basel) 11 : 1590 . 10.3390/diagnostics11091590 CASPubMedGoogle Scholar Oehme R , Sandholzer-Yilmaz AS , Heise M , Frese T , Fankhaenel T . 2022 . Utilization of point-of-care tests among general practitioners, a cross-sectional study . BMC Prim Care 23 : 41 . 10.1186/s12875-022-01643-9 PubMedGoogle Scholar Hathway JM , Miller-Wilson LA , Sharma A , Jensen IS , Yao W , Raza S , Parks PD , Weinstein MC. 2021 . The impact of increasing multitarget stool DNA use among colorectal cancer screeners in a self-insured US employer population . J Mark Access Health Policy 9 : 1948670 . 10.1080/20016689.2021.1948670 PubMedGoogle Scholar Cheriyedath S . 2021 . What is lab-on-a-chip? AZO Life Sciences . https://www.azolifesciences.com/article/What-is-Lab-on-a-Chip.aspx . Accessed 15 August 2022. Google Scholar Dietrich TR . 25 June 2020 . Microfluidics technology's growing importance in healthcare and the search for fast-acting Covid-19 test kits . NS eMedical Devices. https://www.nsmedicaldevices.com/analysis/microfluidics-healthcare-covid-19-test-kits/ . Accessed 15 August 2022. Google Scholar Nulty AK , Chen A , Thompson AL . 2022 . The Ava bracelet for collection of fertility and pregnancy data in free-living conditions: an exploratory and validity acceptability study . Digit Health 8 :20552076221084461. PubMedGoogle Scholar Agarwal DK , Nandwana V , Henrich SE , Josyula VPVN , Thaxton CS , Qi C , Simons LM , Hultquist JF , Ozer EA , Shekhawat GS , Dravid VP . 2022 . Highly sensitive and ultra-rapid antigen-based detection of SARS-CoV-2 using nanomechanical sensor platform . Biosens Bioelectron 195 : 113647 . 10.1016/j.bios.2021.113647 CASPubMedWeb of Science®Google Scholar Paria D , Kwok KS , Raj P , Zheng P , Gracias DH , Barman I . 2022 . Label-free spectroscopic SARS-CoV-2 detection on versatile nanoimprinted substrates . Nano Lett 22 : 3620 – 3627 . 10.1021/acs.nanolett.1c04722 CASPubMedWeb of Science®Google Scholar Clinical Laboratory Management, Third Edition ReferencesRelatedInformation