The Journal of mHealth Vol 1 Issue 3 (June 2014) - Page 44

Lab Quality Testing in the Palm of Your Hand Continued from page 41 The system operates using cartridges pre-loaded with reagents and probes specific to a disease, such that the operator can insert different cartridges for different conditions into Q-POC™ allowing the device to be used to test for many different diseases. The operation is equally as simple: input the sample into the cartridge, insert the cartridge into the device and press go. In 10 -15 minutes a result will be presented on-screen. The company uses their proprietary Q-FILTER™ technology to capture cellular debris in a lysed sample, allowing the DNA to continue flowing through the fluidic channel in solution. This simple methodology rapidly purifies DNA for amplification. Lyophilised reagents, stored on-chip, are rehydrated by the sample as it passes through the fluidic channel. These heat and time stable reagents provide the disposable test cartridge with a shelf life of 18 months. On-board reagents also allow fully automated sample to result testing, with no further hands on involvement. The Device then employs a nanowire biosensor microarray to detect 10's to 1000's of features. Thousands of uniform, reproducible nanowires are arrayed on a mass producible, low cost computer chip. The nanowires are printed with DNA probes associated with disease or drug resistance. When the amplified DNA flows over the biosensor, target sequences hybridize to the probes. As DNA is naturally negatively charged, this causes a change in charge density at the surface of the nanowire, which in turn causes a change in resistance in the nanowires. The nanowires are individually calibrated and monitored in realtime with the signal processed by an on-board application specific integrated circuit (ASIC) and analysed by algorithms to give a diagnostic result. QuantuMDx are currently working on a number of projects to deploy their technology as a means of tackling disease around the world. The company is in the process of developing Q-TB™, a rapid and cheap test that will analyse sputum samples at the patient's side and diagnose multi-drug resistant TB (MDR-TB) within 15 minutes enabling immediate personalised prescription of the most effective TB drug treatment. The three year £2m project will integrate QuantuMDx's state of the art DNA analysis device with a novel sputum disruption technology and a comprehensive TB biomarker panel developed by St George's, University of London. The project is particularly strong as it also embraces the expertise of various global academic TB Groups and several TB focused charities and NGOs who are currently working in the field to help eradicate the disease and who understand, first hand, what is needed for a rapid TB diagnostic. Advanced portable point-of-care laboratory devices are also being developed for bedside testing in hospital environments. Philips Healthcare recently announced the completion of its first field study for its Minicare handheld cardiac Troponin-I blood test, demonstrating the platform’s potential to produce lab-equivalent results with finger prick samples within minutes. The Minicare cTn-I system is designed to help physicians, nurses and paramedics identify patients at high risk for acute cardiac events right at the bedside or in pre-hospital settings. Only about 15 percent of patients presenting in emergency departments with chest pain suffer from acute myocardial infarction (AMI). At the same time, early diagnosis and treatment are critical to improving outcomes around acute cardiac events, and today’s standard lab tests, logistics and reporting can take up to 90 minutes to enable decision-making. With a quick finger prick cTn-I blood test, Philips Minicare is being designed to measure AMI indicators almost immediately, wherever the patient is located. This has the potential to enable doctors to identify high-risk patients earlier, reducing the time from diagnosis to treatment or quickly discharging patients not requiring emergency care. Waiting on conclusive blood test results can cause anxiety for patients and delay a physicians' decision for treatment. Almost 70% of diagnostic decisions are currently based on information provided by blood assays, but it often takes an hour or more to get the results from a central laboratory. In life threatening conditions like AMI, every minute counts. The Minicare Platform is being developed to provide blood test results, within minutes, at the point of care, such as critical care treatment centres, ambulances and in the future in GP clinics as well as at home. The state of the art device will enable doctors, nurses and health professionals alike to perform complex testing that will guide prescription of targeted drug treatments. Disease specific testing devices are starting to emerge across a whole range of treatment pathways, allowing patients to conduct testing in their own homes without the need to travel to doctors surgeries or hospital. These devices are generally connected, allowing data to be easily shared across the whole spectrum of care stakeholders. Proving patients with accurate bedside testing also allows them to more easily manage their own condition. In a similar deployment the company is also working on a malaria diagnostic to allow health workers to tackle drug resistance. With no need for clean water or stable electricity, QuantuMDx's handheld lab will offer a technology leap to developing nations, giving even the most rural communities access to life saving diagnostics. One particular innovation that has been designed with a consumer focus on point-of-care-testing comes from US company CUE. Their POC mobile connected testing platform has been specifically targeted at the consumer health-tracking audience, allowing health conscious consumers to go beyond simply activity and vital sign monitoring, to tracking health at the molecular level. 42 June 2014