With 4 days remaining until AACC 2019 we are going to dive into point of care, rapid tests and molecular diagnostics.

In our last post, I drilled down into the characteristics of companies in the diagnostic testing space that will be exhibiting at the AACC Expo starting next week. I showed how the areas of infectious disease testing, point of care testing, rapid tests, and molecular diagnostics have a lot of activity, and I showed which subcategories have overlap with infectious disease testing.

In this post, I’ll do the same with point of care testing, rapid tests, and molecular diagnostics. I’m using the data I scraped from the AACC exhibitor listing on their website using python and BeautifulSoup. To create the heatmap, I generated a co-occurrence matrix using the pandas and numpy libraries.

To review, here is a heatmap of the diagnostic testing subcategories for the companies exhibiting at AACC:

Co-Occurrence of Dx Testing Subcategories 2019

Co-Occurrence of Dx Testing Subcategories 2019

So, it appears that there is renewed intense focus on point of care (PoC) testing right now. The decentralization of patient care is an obvious driver accelerated by the patient/consumer desire for  convenience.

 What is the overlap with other subcategories? Let’s take a look:

Dx Sub-Categories POC 2019

Dx Sub-Categories POC 2019

I removed rapid tests from this graph because it overlaps almost completely with PoC testing. Not surprisingly, we see overlap with infectious disease testing and molecular diagnostics for the reasons we discussed in our last blog post.

 

The next group of subcategories that have high co-occurrence with point of care testing consist of the major applications for point of care testing, like HbA1c, glucose and other diabetic testing, cardiac testing, and infectious disease testing applications.

 

Let’s look at rapid tests, now (for this graph, I removed PoC testing given the large overlap):

Dx Subcategories  Rapid Tests 2019

Dx Subcategories Rapid Tests 2019

In the rapid test subcategory, which we assume consists largely of CLIA-waived tests, we see overlap with infectious disease again, specifically in the applications of HIV testing, influenza testing, hepatitis testing, and STD testing. After infectious disease testing, there are quite a number of other applications, including the point of care “classics”, drugs of abuse, pregnancy and fertility testing, and newer cardiovascular markers. 

Other applications where we may see increased activity for PoC testing in the near future may include asthma, immunology, or even pharmacogenomic testing.

Now let’s look at molecular diagnostics:

Dx Subcategories  Molecular Tests 2019

Dx Subcategories Molecular Tests 2019

As expected, there is overlap in molecular diagnostic testing with infectious disease testing, point of care testing, and rapid tests. Due to the nature of molecular diagnostics, it is not surprising there is overlap with multiplex testing and genetic testing. We can see the applications for molecular testing include HIV, viral testing, and cancer testing.

 

What are your thoughts? Do our observations make sense to you? Given the large amount of focus on rapid and point of care testing, what do you think the major challenges are in these areas, particularly with syndromic testing? What reimbursement issues are you seeing?

 

For a project we did for the point of care testing application of congestive heart failure, we found that many cardiologists at heart failure clinics love the ability to test brain natriuretic peptide during office visits. However, insurance companies would not reimburse for this PoC test and placed a requirement that phlebotomy be performed at a lab facility, rendering the clinical value of this PoC test, as imperfect as it is, useless.

 

In our next post, I’ll look at the turnover from 2018 to this year at the AACC Clinical Lab Expo. It’s probably more than you think.

 

Are you going to AACC? Let us know!

 

 Stephanie Kreml, MD, Senior Advisor

 

Stephanie Kreml