Congress report: 6th German POCT symposium, September 25–26, 2024, Bremen

Introduction

The POCT section of the German Society for Clinical Chemistry and Laboratory Medicine (DGKL) organized the 6th German POCT Symposium on the subject of “Innovative solutions for a quality-assured near-patient laboratory diagnostics” as a satellite congress of the 19th Annual Congress of the DGKL 2024 in Bremen. The new event format resulted from the reorganization of the congress following the end of the “Munich POCT Symposium” series. The Congress presidents Astrid Petersmann and Peter B. Luppa organized a total of eight sessions in the Congress Center Bremen which members of the POCT section mostly chaired.

The conference highlighted and discussed relevant innovations in the highly dynamic field of the near-patient diagnostics [1]. During the conference, the presenters and the attendees also examined numerous clinical issues from emergency and intensive care medicine, the diagnosis of infectious diseases, and the application of continuous glucose monitoring. The POCT Symposium was also dedicated to modern cross-sectional technologies, new IT concepts, innovative POCT applications, innovations in quality assurance, pre-analytics, and the critical aspects of new regulatory requirements (Figure 1).

Figure 1:

The symposium’s icon.

The Scientific Committee was formed by Martin Christmann, Hildesheim; Ramona Dolscheid-Pommerich, Bonn; Guido Freckmann, Ulm; Ralf Junker, Kiel; Christian Karnutsch, Karlsruhe; Peter B. Luppa, Munich; Johannes Lotz, Mainz; Alexander von Meyer, Munich; Matthias Nauck, Greifswald; Dirk Peetz, Berlin; Astrid Petersmann, Oldenburg; Christina Rode-Schubert, Heidelberg; Dirk Roggenbuck, Blankenfelde-Mahlow; Michael Spannagl, Munich; Thomas Streichert, Cologne; Hans Günter Wahl, Lüdenscheid.

The total number of attendees reached approx. 250. The congress languages were primarily German, but also English. Besides the eight sessions, three lunch symposia were organized by the IVD companies Siemens Healthineers, Werfen, and Nova Biomedical. A poster session accompanied the 30 oral presentations on the second congress day. Additionally, IVD companies showed the latest POCT analysis devices in the industrial exhibition of the DGKL main congress, which started the second day of the congress.

The oral presentations within the eight sessions and the three lunch symposia

Session 1, “IT concepts for POCT”, chaired by Astrid Petersmann, Oldenburg, and Thomas Streichert, Cologne, depicted IT aspects important for the routine handling of stationary and ambulatory POCT services.

Petra Olbort-Herzog and Bernhard Buckel, both Heidelberg, started the session by presenting “The POCT network at the Heidelberg University hospital – large and diverse, but the work is in detail”. Both speakers reported on the POCT coordination unit at the Heidelberg University Hospital. The coordination is responsible for three clinical locations: a University Hospital (2,000 beds), an external thorax clinic (310 beds), and a district hospital (280 beds). There is a central POCT system with an administration (paper-based) of approx. 6,000 active POCT users. There is also a principal administration of all QC data and a remote control of all stationary devices. All POCT devices are connected via LAN, each clinic has its own medical network. There is a central DHCP without intermediate adapters (USB, etc.) and a partial cloud connection (QC batches, software updates). Rolf Bikker, Bernburg, continued with the topic “Harmonization and centralization of a cross-clinic POCT ecosystem by use of Aqure”. The presenter explained that his home IT infrastructure connects several healthcare sites with different diagnostic requirements. The applied POCT middleware is Aqure, which runs best with Radiometer devices. The connection of third-party devices to this middleware must be checked in advance. Aqure can also be used for supra-regional POCT structures. However, a close exchange with all stakeholders is essential for such an organization. As one of the following steps, the implementation of an e-learning module is planned [2]. Finally, Nico Vogt from Ludwigsburg spoke about “POCT software applications in the RKH Gesundheit”. Like the last speaker, he presented the POCT network for the “RKH Gesundheit”, a regional hospital holding and services with sites in Karlsruhe, Ludwigsburg, Bruchsal, and Enzkreis. The two middleware software systems, POCcelerator and POCTopus, are in operation to connect a broad range of different POCT methods and devices. The presenter described his experience with this IT solution.

Session 2, “Innovative POCT applications”, was chaired by Ralf Junker, Kiel, and Matthias Nauck, Greifswald.

This session started with the stimulating presentation of Dana Cialla-May, Jena, dealing with “Surface-enhanced Raman spectroscopy (SERS) for medical diagnostic applications”. SERS combines exceptional molecular specificity with ultra-trace sensitivity by use of nanostructured sensor surfaces and holds significant potential in medical diagnostics [3]. However, the practical implementation of SERS in real-world scenarios is often hindered by the complexity of the biological matrix, which can obscure target signals due to interfering components such as large biomolecules or other matrix elements. SERS is being integrated with innovative sample preparation techniques to address this challenge. These techniques include methods to remove matrix elements, such as large proteins, or the development of specialized sensor layers designed to selectively attract and concentrate target analytes onto the metallic surface. Such strategies enhance the efficiency and reliability of SERS in complex sample environments, paving the way for broader applications in medical diagnostics.

This talk was followed by the presentation of Raphael Twerenbold, Hamburg, about “Cardiovascular risk assessment in rural areas”. The author gave an impressive clinically-oriented talk. A reliable diagnosis of suspected myocardial infarction is still only possible in the emergency room. However, the newly developed high-sensitive troponin POCT methods already have identical analytical performance compared to the methods in the central laboratory and can thus have the potential to facilitate patient care in other settings. The combination of POCT and AI [4] can help to improve patient management by: i. Tripling of the direct rule-out cases in the emergency department, ii: Simple and safe triage in the outpatient setting; iii. More accurate pre-hospital risk stratification in the ambulance car is possible; iv. Potential avoidance of unnecessary healthcare costs. The last presentation was given by Urs Daniel Lichtenauer, talking about “Digitalization in care – synergies at the point of care”. Using the example of chronic disease diabetes mellitus, he explained the situation in German hospitals: 30 % of the hospitalized patients have diabetes, of which 25 % require acute treatment. The current training programs for nursing staff are very complex, and dose adjustment algorithms are non-specific, but can improve BG control. HIS systems usually do not allow adequate blood glucose management (BGM). Thus, POCT systems alone do not lead to an improvement in blood sugar control. It is crucial to improve the BGM process: i. trouble-free networking with POCT and HIS systems. This networking is a prerequisite for digital solutions. ii. First, all-in-one POCT/software combinations are currently coming onto the market. iii. Intelligent algorithms for blood glucose optimization (currently under development) can make a decisive contribution to better BGM for patients in the hospital.

The lunch symposium of the first conference day was organized by Siemens Healthineers and dedicated to “Manufacturer-independent POC management solutions to increase efficiency – Quo Vadis?”. Under the chair of Vladimir Kovalev, Eschborn, the speaker, Christian Sommer, Berlin, presented a comprehensive market survey on IT middleware solutions for POCT devices. He also introduced the “Atellica Connect POC Insights” as a future Siemens Healthineers project. This session was particularly interesting for POCT coordinators and led to a lively discussion about practical experiences in POCT networks inside, outside and between hospitals.

The first day continued in the afternoon with Session 3, “POCT for emergency medicine and in the ICU”, chaired by Michael Spannagl, Munich, and Dirk Peetz, Berlin.

Evangelos Giannitsis, Heidelberg, started with the important topic presentation: “Cardiac Marker in the Emergency Department (ED)”. An increasing number of POCT devices fulfill the analytical criteria of a highly sensitive troponin (hs-cTn) assay. Some even have validated protocols for triage using ESC 0/1 h. These developments open up new options for areas with no or limited access to a hs-cTn test delivered by a central laboratory, e.g., surgeries, rural areas, and individual smaller hospitals [5]. Improvements are also possible in pre-hospital care, in particular, for a better “routing” of high-risk patients. However, hs-cTn tests are more expensive and labor-intensive to use in the ED, if hs-cTn is available in the central laboratory and the TAT is <60 min. It is therefore not advisable to use it. In addition, there is currently no convincing data for the use of POCT in this setting compared to central laboratory-based measurement, as time delays in the overall process in the ED depend only to a small extent on the cTn result, e.g., other laboratory, crowding, exit blocks, waiting times for additional diagnostics (X-ray, echo), discharge or transfer letter, etc. The second speaker, Patrick Möhnle, Munich, talked about “Bleeding management: are (hemostaseologic) POCT procedures helpful?”. In his lively presentation, the speaker introduced the components of modern bleeding management (perioperative coagulation diagnostics): It consists of viscoelastic POCT procedures, defined, algorithm-supported therapy targets, and targeted substitution with fibrinogen, PPSB, thrombocytes, etc. Nowadays, there are new indications for hemostaseologic POCT diagnostics: i. Monitoring of fibrinolysis; ii. Tracking of a medication with direct oral anticoagulants (DOACs); iii. Surveillance of the patient’s platelet function; and iv. Diagnosis of hypercoagulability. The session was concluded with a presentation by Christian Waydhas, Essen, who reported about a “Position paper of DGKL and DIVI: Requirements for laboratory medicine in intensive care and emergency medicine”. Even without clear scientific evidence, there is a broad medical consensus on the urgency of the various laboratory tests in emergency and intensive care medicine. The timely determination of lab tests in patients with acute life- or organ-threatening diseases is essential for diagnosis, initiation of therapy, and outcome. Thus, the position paper defined the time requirements for providing laboratory results under practical circumstances [6]. The recommendation includes three levels of urgency: emergency 1, with a turnaround time (TAT) of no more than 15 min; emergency 2, with a TAT of a maximum of 60 min; urgent case, with a TAT within 4 h. The recommendation allows the organizational and technical regulations for individual hospitals to be aligned with the urgency of the test provision to the intensive care team based on the medical requirements.

Session 4 was entitled: “Nucleic-acid-testing (NAT) procedures in the near-patient diagnosis of infectious diseases”, and chaired by Peter B. Luppa, Munich and Martin Christmann, Hildesheim.

Philipp Thelen, Oldenburg, first presented the talk “Molecular POCT in the emergency room – here to stay?”. The question about NAT POCT “here to stay?” can be answered with yes, because this new near-patient testing is much faster compared with the routine lab service. Additionally, small handheld devices on site are convenient to operate and cover a broad spectrum of pathogens. However, some draw-backs should be considered: Costs are only manageable with constant basic throughput. In addition, it must be ensured that NAT-POCT has immediate therapeutic consequences and that quality management is regulated by the central laboratory. Then, Ioana Diana Olaru, Münster, gave insights on “Advancing health-care equity and access: point-of-care tests for low- and middle-income countries”. Half of the global population has little to no access to diagnostics! Diagnostics are central and fundamental to quality health care. This notion is under-recognized, leading to underfunding and inadequate resources at all levels. The level of primary health care is the diagnostic so-called last mile and particularly affects poor, rural, and marginalized communities globally; appropriate access is essential for equity and social justice. Therefore, improved access to POCT in low-or-middle-income countries (LMIC) is urgently needed. Major advances have already been achieved with tests for HIV, malaria, and TB in the last decade. Nevertheless, infections are prevalent causes of presentation to primary care in LMIC. Antimicrobials are very frequently prescribed and lead to high rates of antibiotic resistance. Adequate tests that can aid in prescribing decisions for common infections in LMIC should be developed for enteric fever, respiratory infections, and febrile illness. The third presentation, entitled “Rapid isothermal detection of Clostridioides difficile toxin genes”, was given by Frank Hufert, Brandenburg. Nosocomial-associated diarrhea due to C. difficile infection (CDI) is diagnosed after sample precultivation by the detection of the toxins in enzyme immunoassays or via toxin gene nucleic acid amplification. Rapid and direct CDI diagnosis is important for targeted treatment to prevent severe cases and recurrence and to improve hygiene management. Based on isothermal recombinase polymerase amplification (RPA) the working group of F. Hufert developed assays which target toxin genes A and B. A single-plex and a one-tube duplex assay format were used. The assays yielded results within 15 min. Analytical sensitivity was determined using DNA standards obtained from 20 different C. difficile strains with different toxinotypes. The sensitivity of the assays ranged from 119 to 1,411 genome copies and specificity was almost 100 % [7]. The sensitivity and specificity were independent from the assay format applied. A set up in a 3D-printed microchamber format yielded the same results. Therefore, it is possible to implement the assays in a lab-on-a-chip system to be used for diagnosing CDI at the point of need.

The first day’s final Session 5, “Continuous Glucose Monitoring (CGM) – is standardization necessary?”, was chaired by Guido Freckmann, Ulm and Hans Günther Wahl, Berlin.

Guido Freckmann started the session with the presentation: “New market developments in CGM”. The use of CGM is rapidly increasing, and new players from Asia are entering the market. CGM systems are no longer used only as stand-alone devices but also as part of automated insulin delivery systems. However, the comparability of different CGM systems is still limited, which might influence therapeutic decisions depending on the system used. Thus, a standardization is needed [8]. Subsequently, Rolf Hinzmann, Lampertheim, talked about “Why different CGM systems display different measured values”. The performance evaluation of a CGM system investigates two things: the analytical performance of the CGM sensor and that of the algorithm to predict blood glucose from ISF glucose. When comparing CGM measurement values to blood glucose values, currently, the only way to assess the accuracy performance of CGM systems is by Comparator Data Characteristics, and the comparison method has a significant impact on CGM system accuracy results. It is essential to bear in mind that performance evaluations are currently not standardized. The “working group CGM” of the IFCC is currently working on the task of standardizing CGM system performance evaluation procedures. Results are coming soon. Finally, Manuel Eichenlaub, Ulm, thought about how “How CGM systems could be standardized”. The IFCC working group on CGM aims at establishing standards for CGM performance evaluations. Critical points are the characteristics of the comparator data, including the distribution of glucose concentrations and rates of change. Additionally, the comparison measurement procedure describing the sample type, the method, and traceability need to be defined. The performance results will become comparable by defining mandatory requirements, and CGM readings may be aligned.

The second congress day continued with Session 6, “Cross-sectional technologies for POCT”, chaired by Christian Karnutsch, Karlsruhe and Peter B. Luppa, Munich.

The first presentation was given by Susanne Weber, Munich, entitled “Biosensing Nano-Devices from DNA Origami”. The programmable nature of DNA base pairing enables the generation of diverse DNA origami nanostructures with defined geometries and modifications. Possible applications of such nanostructures range from nano-scale to signal-amplifying detection systems and drug-releasing systems. In addition to various rigid 2D and 3D structures (e.g., nanoantennas), flexible 3D structures (e.g., DNA origami cages or hinges) have also been developed in the past. The presentation describes the development of a diagnostic test system for the rapid detection of ADAMTS-13 protease activity in diagnosing life-threatening thrombotic thrombocytopenic purpura (TTP). The test system is based on DNA origami hinge nanostructures [9] combined with protein chemistry and utilizes highly efficient fluorescence resonance energy transfer as an analytical read-out of ADAMTS-13 activity. The second speaker, Antje Bäumner, Regensburg, discussed “Nanomaterials for POCT applications”. In her presentation, she bridged the gap between the need for innovation from the origin of POCT to their use in digital healthcare in rural areas. She put forward the hypothesis that the later, stringent criteria must already be considered in basic research and that sensitivity and specificity should not be the only driving factors behind test developments. She demonstrated this by using examples from her nanomaterial research, in which liposomes and nanofibers are developed for both sample preparation and detection [10]. Liposomes were presented for novel, homogeneous assays and for the functional analysis of the complement system. Nanofibers were developed as novel transducers in electrochemical LFAs. Finally, Christian Karnutsch, Karlsruhe, presented his photonic BANSAI technology: “BANSAI: A novel analytical system for clinical chemistry analyses at the point of care”. With the Biomedical ANalysis System with lAser lIght, a novel photometer system is introduced that should enable clinical chemical analyses directly at the POC. The photometer demonstrates the ease of integrating organic distributed feedback (DFB) lasers as light source and leads toward optofluidic on-chip absorption spectrometers. An optically pumped organic second-order DFB laser was constructed on a transparent substrate, including a transparent encapsulation layer [11]. This configuration enabled access to both emission directions of the surface-emitting laser. Very short light pulses (duration 3 ns) allow a highly dynamic and precise absorbance measurement. In doing so, most of the standard clinical chemistry assays will be measured with the same instrument.

The captivating scientific program continued with Session 7, “Preanalytic aspects at the Point of Care”, chaired by Alexander von Meyer, Munich, and Astrid Petersmann, Oldenburg. The first speaker was Gunnar Brandhorst, Oldenburg, with a survey presentation on “Relevance of hemolysis detection in blood gas analysis”. Hemolysis is a frequent and relevant problem in blood gas analysis (BGA). The prevalence of hemolytic BGA samples is 1–12 %, depending on the cut-off applied (e.g., 50 mg/dl Hb) and the type of ward (ICU or ED or regular) and clinical specialty. Visually, hemolyzed samples are not recognizable when performing the analysis in whole blood. Thus, an automated hemolysis check, integrated in the BGA devices, should be carried out for all BGA samples in the future [12]. An IVD company is now (2024) offering such a FDA approved system. Other external POCT systems for quantifying hemolysis in whole blood before the BGA procedure are also available on the market. The following presentation with the provocative title “Who’s who? - Does patient and user identification follow a script?”, was given by Christian Schäfer, Greifswald. For a good POCT “movie script” the speaker pointed out that the POCT coordination should pay particular attention to the following points: Management, training, monitoring, taking personnel and users with you, and instant reply to feedback. For a good integration of networked POCT into the clinical processes, he recommended short interaction times, freedom for adaptations, and reduction of errors and sources of error. Sustainability has recently become an important aspect when dealing with POCT diagnostic kits. Therefore, Dirk Kuhlmeier, Leipzig, devoted himself to the topic “POCT goes green – Approaches to the development and production of bio-based and sustainable diagnostic tests”. POCT produces disposable plastic materials that contribute significantly to the total amount of medical waste. Petroleum-based plastics remain in the environment unless they are specifically disposed of in waste incineration plants. Alternative bioplastics, such as polylactic acid (PLA) made from starch, cellulose components, or microbially produced polymers like polyhydroxyalkanoates (PHA), offer more environmentally friendly options.

In the final Session 8, “Quality assurance of POCT – Legal regulations for POCT – new IVDR”, chaired by Ralf Junker, Kiel and Matthias Nauck, Greifswald, three presentations were dedicated to this critical topic.

The first speaker was Matthias Nauck, Greifswald, with his talk “Rili-BAEK 2023”. The Rili-BAEK determines quality standards for measurements in patient care irrespective of the device used. Consequently tests carried out at the point of care have to comply with Rili-BAEK. Among many other aspects this update of the Rili-BAEK addresses preanalytical requirements and introduces a new table B1-1, a main aim laid down in the introduction. Additionally, requirements for internal quality controls e.g. for glucose were adapted, and external quality controls for POCT-devices in doctors’ practices are now recommended [13]. The next presentation, “POCT glucose measurement systems and the updated Rili-BAEK” was given by Stefan Pleus, Ulm. The talk was dedicated to the new quality assessment rules for determining glucose provided by the updated Rili-BAEK. Here is a change in the tolerance limits for the internal quality control from ±11 % to ±5 % and for the external quality control from ±15 % to ±8 %. Retrospective analyses show that the quality of unit-use POCT systems for measuring glucose in biological fluids would not be sufficient in many cases. Manufacturers may need to improve the quality of this for further use in healthcare. Astrid Petersmann, Oldenburg, presented the final talk, entitled with “POCT best practices from peer review laboratory medicine”. Medical peer reviews according to the German Medical Association are well established in many medical disciplines, e.g. Intensive Care or Transfusion Medicine, and have recently been established in Laboratory Medicine through the initiative of INQUAM (Institute for Quality Management in Medical Laboratories e.V.). Trained peer teams include all professions of laboratories including technical personnel. While being part of the visited laboratory on one occasion, participants may be the visiting peer the next time. Based on a self-evaluation and a structured site visit, the visiting peers prepare a report and give advice. First Peer Reviews performed across Germany included POCT and helped to identify best practices such as homogenous devices for a given measurand or efficient exchange concepts for defect devices enabling elimination of costly service lines within health care institution.

There were two lunch symposia on the second conference day. The first one, “Future-oriented diagnostics for point-of-care tests and blood gas analysis”, was organized by Nova Biomedical GmbH and chaired by Anne Deutsch, Waltham MA (USA). Roman Iakoubov, Munich, first talked about “Blood ketones in focus: New facets of ketoacidosis”. The presentation focused on ketones role in physiological and pathophysiological conditions, particularly a life-threatening condition of diabetic ketoacidosis (DKA) and demonstrated the conditions causing a typical DKA. Particularly interesting are cases of atypical DKA. E.g., DKA due to sodium-glucose transport protein-2 inhibitors for treatment of diabetes mellitus, or immune-checkpoint inhibitors-associated DKA. Early ketone detection in capillary blood samples, ideally using POCT, is crucial and enables a rapid treatment including rehydration and insulin therapy. Close monitoring for electrolyte fluctuations, acidosis and ketones is mandatory. The rising incidence of DKA underlines the importance of early detection in emergency care settings. Then, Anne Deutsch, Waltham, presented “Ionized Magnesium, BUN/Creatinine and Estimated Plasma Volume (ePV) – BGA parameters with additional benefits”. The author provides explanations for these parameters that can be monitored in modern blood gas analyzers: Nephrological disease as a major cause of mortality accounts currently up to 18 % in Europe. 20 % -30 of those affected are not diagnosed as such. The corresponding risks are progression to end-stage renal disease or contraindicated medications. This risk can be reduced by monitoring the BUN/Crea ratio. Ionized magnesium is the physiologically active form of magnesium, although there is no consistent correlation between ionized and total magnesium. Studies show that up to 40 % of hypomagnesemia is overlooked in hospitalized patients when only total magnesium is measured. Volume status monitoring in critically ill patients is essential. Volume overload correlates closely with increased mortality. The measurement of ePV is an important diagnostic tool in this context.

The second lunch symposium was organized by Werfen GmbH and dedicated to “Detection of hemolysis in the blood gas analysis (BGA) – Wish or reality?”. First Hugo Stiegler, Bochum, talked about “Hemolysis from the laboratory’s point of view: everything under control or not?”. Preanalytical errors caused by hemolyzed blood samples are a common challenge in laboratory medicine. He dedicated his talk mainly to the current procedures in European laboratories regarding the detection and management of hemolyzed samples. These procedures are heterogeneous and in need of improvement. Thus, he pointed out that a novel in-line hemolysis detection for BGA devices marks a breakthrough for correct whole-blood potassium results [14]. Then, Michael Bernhard, from the central emergency department of the university hospital of Düsseldorf gave a clinically oriented presentation on “Detection of hemolysis in the BGA – Ignorance can also be a burden”. A sophisticated detection of hemolysis in BGA samples would be essential for the ED since it would reduce unnecessary BGA checks and unnecessary laboratory parameters. This hemolysis detection mode would also mean less uncertainty and less need for clarification. Finally, the company’s representative, Gert Blankenstein, Bedford, USA, presented the novel technique for the real-time detection of hemolytic sampes in his talk “Detection of hemolysis in the BGA – Wish or reality?”. The GEM Premier 7,000 from Werfen with iQM3 hemolysis detection using the innovative novel acustofluidic technique offers automatic hemolysis detection in whole blood samples as part of the analytical process. The device demonstrates excellent agreement with established laboratory detection methods for hemolysis. It provides an integrated technological solution to ensure the quality of potassium results from whole blood at the point of care.

The POCT Symposium program was finalized by the DGKL poster session #13 “POCT, mobile medical labs”, chaired by Peter B. Luppa, Munich and Andreas Fischer, Göttingen. Short oral presentations were given by: Ramona Dolscheid-Pommerich, Bonn: “Reliability of co-oximetry versus SLS hemoglobin determination in elderly patients at University Hospital Bonn”; Malte Hilsch, Holzheim and Veronika Pleskova, Dresden: “Revolutionizing Urine Analysis: AI-Powered Digital Holographic Microscopy in a Handheld Device”; Simon Michaelis, Leoben: “Fecal calprotectin, analyzed by use of an app-based home test in comparison to a routine lab test”; Manuel Krone, Würzburg: “SARS-CoV-2 Antigen Rapid Detection Tests: test performance during the COVID-19 pandemic and the impact of COVID-19 vaccination”; Claudia Seide, Berlin: “Establishment of a novel POCT breakdown concept. Better active than passive!”; Jennifer Meinel, Berlin: “Labeling pathological BGA values for greater patient safety – What options does POCT offer?”; Robby Markwart, Jena: “Utilization of laboratory point-of-care testing in the outpatient sector: An analysis of reimbursement data from Thuringia, Germany”.

Final remarks

At the end of the conference, which offered the participants many new impressions and valuable information, both congress presidents and the local organizing team thanked all speakers, discussion speakers, and participants for their commitment and perseverance. Special thanks were also due to the patrons DGKL, DVTA, DIW-MTA, VDGH, RfB, and INSTAND e.V., the sponsors for their generous support, and the congress organization company m:con, Mannheim, for the organizational realization of the event. The members from the POCT section are confident that the German POCT symposium will be continued successfully in two years.