Types of POCTs - RT2

Point of Care Test kits (POCT) - Level 1 Certification

There are many different types of POCTs (rapid drug testing kits) on the market. The housing of each product determines how the donor specimen is collected and how the POCT is used. The housing also determines what type of specimen is required by the donor. In some cases the POCT housing can impact accuracy and reliability.

 

Every POCT falls into one of five primary categories; pipette/cassette, dip card, integrated cup, direct collect oral fluid, and swab transfer oral fluid. 

Urine POCT

Pipette/Cassette

PROS: 

The most cost-effective & accurate format.

CONS:

Requires the use of a pipette (eye dropper) and offers close contact with human urine. 

HOW IT WORKS

Urine is drawn into a plastic, disposable pipette and transferred to the cassette by placing 3-4 drops of urine in each strip well.

Dip Card

 

PROS: 

Easier to use than a pipette POCT with a low unit price.

CONS:

Requires additional collection cup and offers close contact with human urine. 

HOW IT WORKS

The exposed assay strips are dipped directly into an open specimen cup for several seconds. A cap is placed over the strips to minimize dripping.

Integrated Cup

PROS: 

Runs it self and comes with everything necessary.

CONS:

Is the most expensive format of the urine testing POCTs. Can fog up, making it harder to interpret.

HOW IT WORKS

Urine is placed directly into the cup by the donor and the lid is secured. The POCT runs automatically, Some require a key or physical activation.

Saliva/oral fluid POCT

Direct Collect/Swab

PROS: 

No bathroom required. Harder to adulterate.

CONS:

Easy to disrupt process, slow, high-failure rate, unable to detect THC in real world use. 

HOW IT WORKS

Swab mouth for 3-5 minutes or until swab is saturated. Some direct collect run immediately while others require a the insertion of the cap to activate.

Transfer/Swab

PROS: 

No bathroom required. Harder to adulterate.

CONS:

Easy to disrupt process, slow, high-failure rate, unable to detect THC in real world use. 

HOW IT WORKS

Swab mouth for 3-5 minutes or until swab is saturated.  Insert swab collector into POCT housing and close lid. Compression forces sample across POCT strips.

Urine vs Oral POCT

Which is right for your testing program?

There are huge differences between POCT urine and POCT oral fluid testing. There is a lot of mis-information about POCT oral fluid testing. There are advantages and disadvantages to both specimen formats. Only you can decide which is best for your testing program.  

Accuracy - Urine POCT has an advantage

In this category, urine has the advantage. Although the technology used is very similar, urine POCTs will identify more positive donors than oral fluid POCTs. If Accuracy is important, you may want to consider using Urine POCTs.

Defeat-ability​ - Oral POCT has an advantage

In this category, oral POCT has the advantage. Because the collection is performed in the view of the collector, Oral POCT is harder to cheat. If thwarting donors trying to cheat is important, you may want to consider using Oral POCTs.

Performance - Urine POCT has an advantage

Performance is judged on how often a test produces a valid, easy to read result. On average, Urine POCTs generate valid, easy to read results almost every time a specimen is collected. It is rare to have a quality urine POCT fail to run properly.  Oral POCTs do not have this same performance characteristic. Most well trained collectors see at least a 1-2 % device failure rate. Some collectors ask donors to spit directly into the Oral POCT housing before inserting the swab. This can reduce the failure rates and speed up the testing process, but it can also cause false negatives and/or false positives. If performance is important, you may want to consider using Urine POCTs.

Detection limits - Urine POCT has an advantage

There is no competition here, if detection time is important, a urine POCT would be a better option. If detection limits are important, you should consider using urine POCTs.

Cost - Urine POCT has an advantage

The average price for a Urine POCT is lower than an Oral POCT containing the same assays. Over time, this may normalize as Oral POCTs continue to grow in popularity. But if price is important, you may want to consider urine POCTs. 

Confirming Non-Negative results - Urine POCT has an advantage

Urine POCTs win this big. Urine POCTs are easier to collect enough sample for secondary testing and offers far more options (and lower price) when laboratory confirmations are required. If lab confirmations are important, you may want to consider using urine POCTs.

Summary

 

If you are looking for a program that does not require a bathroom and is less sensitive to drugs (fewer positive results), oral POCTs might be a good fit.

 

If accuracy and reliability at a lower cost is important, then a urine POCT program might be a good fit.

END OF POCT TYPES