title: Opinion paper on utility of point-of-care biomarkers in the emergency department pathways decision making.
abstract: Overcrowding of the emergency department (ED) is rapidly becoming a global challenge and a major source of concern for emergency physicians. The evaluation of cardiac biomarkers is critical for confirming diagnoses and expediting treatment decisions to reduce overcrowding, however, physicians currently face the dilemma of choosing between slow and accurate central-based laboratory tests, or faster but imprecise assays. With improvements in technology, point-of-care testing (POCT) systems facilitate the efficient and high-throughput evaluation of biomarkers, such as troponin (cTn), brain natriuretic peptide (BNP) and neutrophil gelatinase-associated lipocalin (NGAL). In this context, POCT may help ED physicians to confirm a diagnosis of conditions, such as acute coronary syndrome, heart failure or kidney damage. Compared with classic laboratory methods, the use of cTn, BNP, and NGAL POCT has shown comparable sensitivity, specificity and failure rate, but with the potential to provide prompt and accurate diagnosis, shorten hospital stay, and alleviate the burden on the ED. Despite this potential, the full advantages of rapid delivery results will only be reached if POCT is implemented within hospital standardized procedures and ED staff receive appropriate training.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Di Somma
authors.forename: Giorgio
authors.initials: G
authors.lastname: Zampini
authors.forename: Francesco
authors.initials: F
authors.lastname: Vetrone
authors.forename: Karina M
authors.initials: KM
authors.lastname: Soto-Ruiz
authors.forename: Laura
authors.initials: L
authors.lastname: Magrini
authors.forename: Patrizia
authors.initials: P
authors.lastname: Cardelli
authors.forename: Claudio
authors.initials: C
authors.lastname: Ronco
authors.forename: Alan
authors.initials: A
authors.lastname: Maisel
authors.forename: Frank W
authors.initials: FW
authors.lastname: Peacock
mesh_terms: D000209:Acute-Phase Proteins; D015415:Biomarkers / Q000097:blood; D003657:Decision Making; D004636:Emergency Service, Hospital; D006801:Humans; D000071068:Lipocalin-2; D054834:Lipocalins / Q000097:blood; D020097:Natriuretic Peptide, Brain / Q000097:blood; D019095:Point-of-Care Systems / Q000706:statistics & numerical data*; D011518:Proto-Oncogene Proteins / Q000097:blood; D014336:Troponin / Q000097:blood
chemical_list: D000209:Acute-Phase Proteins; D015415:Biomarkers; C489506:LCN2 protein, human; D000071068:Lipocalin-2; D054834:Lipocalins; D011518:Proto-Oncogene Proteins; D014336:Troponin; D020097:Natriuretic Peptide, Brain