Entering a New Era of Diagnosis

Looking at the development of diagnostics from prehistorical days up to know and even further visioning into the future the shamans of the old days were slowly replaced by the early “all-round” doctor having first simple diagnostical and surgery possibilities, changing to nowadays specialized physicians doing the diagnoses based on analytical results provided by decentralized specialized labs. Future visions present doctors offices harboring small instruments that allow the physicians to do analyses directly as fast and as minimally or even non-invasive as possible advantageously combined with a connection to a smart health care database providing anamnesis and providing possible therapeutical measures. Already in the 1960s’ science fiction series Star Trek the spaceship crew used very small instruments for fast, non-invasive diagnosis and treatment. Although, such analyzers are future vision actual developments lead to less and less complex and small systems. Using micro- and nano-technologies manifold approaches addressing so-called “Lab-on-a-chip (LoC)” or “micro total analysis systems (μTAS)” where described during the last two decades. Huge progress can be seen in miniaturization not only of electronics but also of mechanics. While presently, table-top systems reach the market handheld systems providing complete analysis from sample taking to result are rare. Presently, often complex sample preparation methods have to be performed to reach the sensitivity and robustness needed for reliable results. In addition, specific disease markers are still missing that give clear conclusions about health status. In this field, intensive research is going on identifying new better and more specific markers for fast and easy reliable determination of diseases, infections, predispositions and more. Having markers available where each marker gives a non-misleading conclusion that a person will have or already has a certain disease, being able to determine these markers directly from the sample without complex sample preparation steps and having instruments available being preferably portable and applicable by non-specialists such a vision is getting closer. The actually developed miniaturized instruments are an important step towards the envisioned future systems demonstrating the basic proof of concept and thereby heralding a new era of diagnosis.