UK NEQAS

Rapid growth in the use of Point of Care Testing (POCT), also known as near-patient testing (NPT), has occurred in many areas of diagnostic analysis.

Tests that were once an offshoot of laboratory analysis have expanded to occupy a substantial proportion of diagnostic testing, not only for the monitoring of, for example, glucose levels in diabetes and prothrombin time / international normalised ratio (PT/INR) in oral anticoagulant control, but also in standalone diagnostic tests, including molecular and genetic testing.

With the spread of POCT, there has also been a parallel increase in the provision of External Quality Assessment (EQA) for POCT.

UK NEQAS offers the following EQA programmes for Point of Care Testing (POCT):

UK NEQAS Blood Coagulation

• Activated Clotting Time (ACT): This test is typically used to monitor heparin therapy, especially high doses used during as well as pre-and post-surgical procedures.
  
• D-Dimer: Following formation of a blood clot, fibrinolytic activity results in degradation products, including cross-linked ‘D’ fragments of fibrin (D-Dimer). Results below a cut-off level when used with a clinical pre-test probability score can be used to exclude the condition venous thromboembolism (VTE).
• INR Testing: (CoaguChek XS series, CoaguChek Pro II, Xprecia Stride, i-STAT, LumiraDx): Warfarin is an anticoagulant given to patients to prevent a thrombotic event. The INR test is used to monitor the anticoagulation levels of patients on warfarin therapy.
• Thromboelastometry and Thromboelastography: Viscoelastic methods for monitoring haemostasis, where the rheological conditions of blood samples under test are measured and recorded, analysing the process of clot formation, stabilisation and subsequent degradation.

UK NEQAS Blood Transfusion Laboratory Practice

• D-Typing: To determine whether anti-D Ig prophylaxis is required following termination of pregnancy, to prevent sensitisation to the D antigen.

UK NEQAS Cardiac Markers

• B-Type Natriuretic Peptide (BNP): To help detect, diagnose, and evaluate the severity of congestive heart failure (CHF).
• Cardiac Troponin I: To determine if a patient has had heart muscle damage of which heart attack is one cause; to determine if angina is worsening.
• Cardiac Troponin T: To determine if a patient has had heart muscle damage of which heart attack is one cause; to determine if angina is worsening.
• CKMB: Is a legacy test which can be used to distinguish between skeletal muscle and heart muscle damage; sometimes to determine if a patient has had a heart attack.
• Myoglobin: To determine whether muscle has been injured or to help diagnose conditions associated with muscle damage.
• NT-pro BNP: To help detect, diagnose, and evaluate the severity of congestive heart failure (CHF).

UK NEQAS Clinical Chemistry (Birmingham Quality)

• Clinical Chemistry: A range of tests to fulfil the needs of Health Check and Community-based testing.  Historically this was centred around Cholesterol but now includes many other mainstream chemistry tests including those for kidney and liver function.  The testing repertoire, in terms of scope and frequency we offer, is only limited to what the end users require.
• Glycated Haemoglobins: We have whole-blood based material to assist in the diagnosis and monitoring of diabetes. As for all our programmes, the graphically rich reports are designed for non-laboratory staff and are easy to use.
• Urine Dipsticks: Urine Dipsticks (Urinalysis) measure multiple constituents such as pH, glucose, protein, bilirubin, blood, ketones, nitrites and leucocytes to assess kidney and urinary tract infections, diabetes and liver function.

UK NEQAS Edinburgh Peptide Hormones

• Pregnancy Testing: The determination of Urinary hCG confirms or excludes pregnancy.

UK NEQAS Haematology

• Haemoglobin Only: To monitor the performance of participants using point of care, single parameter instruments for the measurement of haemoglobin concentration.

UK NEQAS Immunology, Immunochemistry & Allergy (IIA)

• C-Reactive Protein (CRP): To identify the presence of inflammation and to reduce antibiotic prescribing in patients without a clinical diagnosis of pneumonia.

UK NEQAS Microbiology

• Cryptococcal Antigen: Detection of the presence or absence of Cryptococcal antigens in serum.
• Fungal Biomarkers: Detection of the presence or absence of galactomannan or glycoprotein antigens in serum.
• HIV: To provide EQA for laboratory and non-laboratory settings that use POCT devices to screen for HIV. Participants are required to determine the presence (reactive) or absence (negative) of HIV 1 and HIV 2 Ab by POCT devices.
• Molecular Detection of Respiratory Viruses: To test the presence of respiratory viruses by molecular methods in each freeze-dried specimen. Scoring is based on the detection of Respiratory syncytial virus, Influenza A (H1, H3) and Influenza B in the first 3 specimens. The fourth specimen can contain any of the following respiratory viruses: adenoviruses, human enteroviruses, rhinoviruses, human metapneumovirus, human parechoviruses, bocavirus, human coronaviruses and human parainfluenza viruses.
• Respiratory Rapid RSV: To determine the status of Respiratory syncytial virus (RSV) by POCT device or molecular methods in each of the simulated nasopharangeal specimen. The specimens are in a liquid format.
• Urinary Antigens: Detection of the presence or absence of the urinary antigens: Legionella pneumophila and pneumococcal antigens.
• Viral Gastroenteritis (also suitable for antigen testing): Participants are requested to determine the presence or absence of (1) Norovirus (2) Rotavirus and (3) enteric Adenovirus 40 and 41 by NAAT, antigen detection or any POCT method.

UK NEQAS Parasitology

• Malaria Rapid: To test for Malaria (in the UK this is performed by Laboratories).