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11th October 2021
Support for the development of this article was provided by Sight Diagnostics
There is a constant and delicate balance throughout the oncology care pathway between time, high-quality oncological care, efficiency as a cancer centre, and cost ratios. All these considerations are connected and kept in equilibrium by one routine step – complete blood counts (CBCs). Unfortunately, because oncology blood tests are frequent (48–72 hours before each chemotherapy cycle) and legacy haematology processes (drawing blood, transporting the sample, receiving results, accessing results, etc.) with a centralised laboratory can take hours, CBCs often cause a bottleneck in the oncology ecosystem. This domino effect causes delayed treatment, scheduling complications, vacant chairs, unproductive clinic operations, and patient safety concerns, leading to high operating costs for care providers, substandard patient experiences, and unsatisfactory treatment outcomes. These inefficiencies are at times even further intensified by broken lab equipment (especially in smaller oncology settings), limited lab operational hours (weekdays nine to five), and poor-quality point of care haematology analysers that struggle with abnormal samples, which all culminates in blood being sent out to hospital labs for testing. This results in additional travel time, no internal flagging system, and potentially outdated blood results.
According to Professor Richard Adams, Professor and Honorary Consultant Clinical Oncologist at Cardiff University and Velindre Cancer Centre, Cardiff, UK, when the oncology system’s workflow is slow or broken – and a patient arrives at a clinic and does not receive treatment – it not only negatively affects the intensity of the chemotherapy but also has a profound financial and operational impact on many stakeholders as well: “We’re looking at about 16 people in the network of things. And let’s then bring in the doctor, the specialist nurses, the communication with the patient, the uncertainty for the patient, the time the patient took to travel there, the likelihood that they came with somebody else, the likelihood that person took time off work. So, the knock-on effect becomes quite extensive if you have a delay for an individual patient in this sort of circle of events.”
Furthermore, Professor Adams stresses that a lot can change between when the blood tests are done and when the patient is scheduled to receive treatment. With borderline neutropenic patients especially, this often leads to clinicians making judgment calls on whether they suspect the trajectory of the neutrophils to be up or down, which can pose a significant risk in terms of ensuring the safety of the treatment: “That’s where we run into challenges in terms of optimising safety, and where something that gave us a very rapid turnaround would allow us potentially to continue to use a slot that otherwise goes vacant, keeps us efficient, keeps the intensity of the chemotherapy up, and also keeps the chemotherapy delivery safe for an individual.”
As Professor Adams highlights, reliable, non-compromising haematology analysers at the point of care can positively address many system inefficiencies. That is, if a point of care CBC analyser ticks the following criteria: can provide lab-grade accuracy within a quick turnaround time; is easy to set up and operate; requires minimal training and low maintenance; and can leverage a finger prick sampling method as well as a venous one (which requires a trained phlebotomist), it can transform the efficiency of the oncology care pathway.
From an operating costs perspective, by reconfiguring the oncology blood test workflow with an accurate point of care CBC analyser, it could not only reduce lab downtime, ‘out-of-hours’ samples, and backlogs, but also help reduce turnaround times, vacant chemotherapy chairs, patient travel costs, staff hours, and unnecessary expenditure – which may lead to cost savings for every stakeholder in the oncology ecosystem.
From a patient’s perspective, by incorporating an accurate and rapid point of care CBC analyser throughout the oncology journey, it could help optimise treatment safety, maintain the intensity of the chemotherapy, and provide patients with high-quality care physically and psychologically – all of which could contribute to a better patient experience and more satisfactory treatment outcomes.
Because oncology care depends on time-sensitive, yet accurate (especially at low ranges) CBC results, the Sight OLO haematology analyser streamlines the typical blood staining workflow while maintaining lab-grade accuracy. So, through leveraging innovations in physics, optics, sample preparation, and AI-based computer vision algorithms, the self-contained quantitative multi-parameter analyser and its disposable cartridge can deliver fast and accurate CBC results within minutes in point-of-care settings. To test OLO’s performance, Sight ran numerous studies to compare OLO to legacy analysers.
In a Sight report summarising the accumulated results from 17 clinical method comparison studies focusing on low counts for clinically significant CBC parameters, OLO also showed excellent performance in enumerating low ranges (Table 1 and Figs 1 and 2). The studies compared the performance and accuracy of OLO to comparative haematology analysers (for example, Sysmex XN and Beckman Coulter DxH models) at various institutes and clinical settings – including oncology departments – in different countries. Again, the high agreement between OLO and the comparative analysers demonstrated OLO’s compatibility to oncological contexts. And the versatility of technologies, locations, operators, and clinical settings confirmed the robustness and accuracy of OLO across different variables.
During one study conducted in November 2020 in an oncology day centre in Israel, Sight evaluated OLO’s accuracy for finger prick samples across OLO’s reportable range and the device’s workflow and turnaround time compatibility to the centre. The study’s 64 patient sample enrolment aimed to cover low ranges for specific measures, particularly relevant for oncologic patients’ medical decisions.
The results of the study showed very good correlations between the different sampling methods and analysers in a variety of oncology patients while covering a wide range of values. The finger prick results also demonstrated excellent accurate reporting of actionable results, with approximately 90% of the samples having no flags on main parameters. And an OLO and Beckman Coulter DxH800 (the centre’s current system) comparison revealed OLO decreased the average time from phlebotomy to CBC results by 45%.
Overall, the various studies demonstrate that the high rate of accurate results suggests that using OLO in an oncology setting could help make clinical decisions in real-time, improve workflow efficiencies, and provide reliable and accelerated care to patients.
This article is intended for global dissemination excluding audiences in the US.