Our healthcare ecosystem is changing. Technological advancements, COVID-19 and an increasingly eco-conscious population are just a few of the driving factors that are helping reshape today’s diagnostic landscape, for tomorrow. But what does this change mean and how is it transforming the way we collect and analyse biodata at scale?
Collaborative research carried out by Thriva and Inuvi was recently published by the British Journal of Biomedical Science. The study aimed to determine whether remote capillary sampling practices could offer an acceptable alternative to traditional venous phlebotomy for the measurement of serum creatinine concentration. One of the key markers in monitoring renal function, this analyte is important for the early diagnosis and prevention of chronic kidney disease (CKD) and for tracking kidney function in diabetes.
The first of its kind, the published study explores the advantages of capillary blood testing (CBT) and how these significantly outweigh some of the more traditional venous methods of collection that can be costly, time-consuming and inconvenient for both patients and healthcare providers alike.
Traditional diagnostics are ripe for disruption
Blood testing is the cornerstone of our national healthcare screening process. But advancements in technology have meant that collecting samples via traditional venipuncture is no longer the only option available. In the wake of the COVID-19 pandemic, we’re seeing the proverbial needle shift towards more patient-centric, remote collection methods that remove many limitations and/or inconveniences associated with their venous counterparts.
Phlebotomy often requires patients to travel to physical clinical locations to have their samples collected by a medically trained professional. Regular outpatient visits like this can be onerous and expensive and for many, a venous draw can also be quite an invasive and uncomfortable experience.
This is further compounded by an increasingly overstretched public health service where waiting times for diagnostic appointments can be lengthy due to staff shortages and lack of resourcing. Combined, these factors can act as a deterrent for patients whose testing frequencies are negatively impacted by the process of booking and attending an in-person appointment.
By contrast, remote sampling has gained significant momentum in the wake of the pandemic and it is now changing how we detect, monitor, and prevent diseases. A less invasive experience, remote sampling can be conducted from the comfort of one’s own home. This significantly increases accessibility, comfort and convenience whilst also reducing costs associated with travel to and from outpatient appointments.
A study carried out by the Office of National Statistics estimated that the average time a patient spends travelling to an in-person healthcare appointment from a work location is 27.69 minutes. Double this figure for a return journey and you quickly have a significant time commitment that not everyone is willing or able to accept.
Remote sampling has the potential to eliminate this requirement entirely, promoting a more environmentally friendly approach to testing and monitoring. It also contributes towards the government's decarbonisation goals reducing traffic on the roads and medical waste.
Why is this recent study so significant?
It’s a stark reality that up to 10% of the UK’s adult population is affected by CKD and there are suggestions that it’s prevalence is increasing. The need for expansive screening and monitoring programmes has never been more acute which sits awkwardly against the backdrop of recent strike action causing a concerning backlog of primary and secondary care appointments.
The New Opportunities for Early Renal Intervention by Computerised Assessment (NEOERICA) project has alarmingly projected that out of the 10% currently afflicted by CKD, only 1.6% had a documented renal diagnosis logged against their patient record. If and when diagnosed, CKD requires regular testing of serum creatinine so that patients can keep track of their glomerular filtration rate (GFR). This is a crucial indicator of the disease’s progression. These appointments have historically always been in-person which is time-consuming for the patient and requires frequent access to phlebotomy and analytical laboratory services.
This study has, therefore, been instrumental in validating why the traditionalist approach to clinical blood sampling and health monitoring should no longer be the only pathway to care. Instead healthcare providers should place greater emphasis on patient experience, accessibility and optionality.
What did the study entail?
The study involved forty-nine ‘generally well’ patients requiring creatinine testing who each provided two venous and two capillary samples. A professional phlebotomist conducted the venous draws, whilst the self-collected samples were undertaken by participants themselves using Thriva's standard collection guidelines.
Within six hours of collection, one set of venous and capillary samples were centrifuged at 2000g for ten minutes. They were then analysed by the lab on the same day. The second set of samples were stored at an ambient temperature (ranging from 16 - 22 degrees) for a period of three days prior to centrifugation and analysis.
Additionally, a third sample set was obtained, stored and tested across a broader temperature range to evaluate the stability of creatinine in unspun blood over an extended time period. This was intended to simulate carriage through the domestic postal/courier network.
It was imperative that the study confirmed not only the comparability between venous and capillary samples but also the analyte’s stability over routine transport times and temperatures. The results indicated a very good agreement between capillary and venous serum creatinine concentrations across all variables tested.
The silver bullet: does this study change how we collect and analyse health data?
New and novel sampling methods are exciting. They’re making it easier for patients to collect their samples at a convenient location of their choice and at a time of their choosing. This flexibility is hugely empowering as it could enable earlier detection and more efficient monitoring of not only CKD but other chronic conditions across the care spectrum.
You can download the full study here to learn more.