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Devices are no substitute for a professionally run laboratory

I am the medical director of a hospital laboratory and a past president of the Massachusetts Society of Pathologists. I feel I should make some cautionary statements about point-of-care laboratory testing (“Blood tests in minutes, not days or weeks,” Business, Sept. 30).

First, the turnaround time of testing in conventional labs is not nearly as long as the article would imply. Only the most complex, esoteric testing takes more than a few days; most routine tests are completed the day the blood specimen is obtained.

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More important, lab testing in hospital and freestanding labs is performed by highly trained technologists under the supervision of board-certified pathologists. Many of the tests are run on sophisticated automated equipment, which gives an impression of simplicity — much like the point-of-care systems — that can be misleading. Things do go wrong, and it takes highly qualified testing personnel to recognize that something is wrong, and to know how to fix it.

Labs such as the one I supervise are subject to rigorous quality controls to assure the accuracy of results, as well as periodic unannounced inspections.

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No responsible person would suggest that pathologists or lab techs should, say, administer chemotherapy or perform surgery. Conversely, I don’t think it’s appropriate to have nonlaboratorians performing complex lab tests, no matter how simple the device makes it seem.

I don’t think these point-of-care devices should replace the professionally run lab. They certainly may have a place in field work, where the usual labs are not easily available, but they are not a substitute for highly trained technicians and doctors.

Dr. Donald G. Ross

North Andover

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