Point of care testing is appropriate for National Health Service health check

Area of Science:

• Cardiovascular Disease Research
• Health Inequalities
• Biometric Analysis

Background:

• Initiated by the Department of Health to reduce cardiovascular disease (CVD) health inequalities.
• Collaborative vascular screening program involving HEART UK, Royal Free Hampstead NHS Trust, and Hindu Temples in North London.
• Targeted ethnic minority populations, specifically those of South Asian origin.

Purpose of the Study:

• To evaluate the accuracy of point-of-care testing (POCT) for cardiovascular disease risk assessment in South Asian individuals.
• To compare POCT lipid and glucose measurements with laboratory analysis.
• To assess the agreement of calculated CVD risk using various risk engines with POCT data.

Main Methods:

• Screening of 215 men and 191 women of South Asian origin.
• Measurement of lipid profiles and glucose using the Cholestech LDX analyser (POCT).
• Comparison of POCT results with laboratory venous sample analysis using Bland-Altman plots and kappa analysis for risk calculators (JBS2, QRISK2, ETHRISK, Framingham).

Main Results:

• The Cholestech LDX analyser showed concentration-dependent bias for high-density lipoprotein cholesterol (HDL-C) and total cholesterol at lower concentrations.
• Excellent agreement was observed in calculated cardiovascular disease risk across multiple risk engines (κ = 0.86–0.94).
• The study identified a high-risk population, with 9.7–19.4% having a ≥ 20% 10-year vascular event probability.

Conclusions:

• Point-of-care testing (POCT) demonstrates adequate accuracy for cardiovascular disease risk assessment in the NHS Health Check program.
• Minimal mismatch between POCT and laboratory values was found, irrespective of the risk calculator used.
• POCT is a viable tool for screening South Asian populations, contributing to efforts to reduce health inequalities.