Critical evaluation of connectivity-based point of care testing systems of glucose in a hospital environment
| Autor: | Katelijne Floré, Joris R. Delanghe, Tom Fiers |
|---|---|
| Rok vydání: | 2008 |
| Předmět: |
Blood Glucose
Quality Control medicine.medical_specialty Point-of-Care Systems Point-of-care testing Clinical Biochemistry Hematocrit Total error Glucose Oxidase Glucose dehydrogenase Control data Statistics Humans Medicine Intensive care medicine medicine.diagnostic_test business.industry Blood Glucose Self-Monitoring Calibration Error Biochemistry (medical) Glucose Measurement Glucose 1-Dehydrogenase General Medicine Laboratories Hospital business Biological variability |
| Zdroj: | Clinical Chemistry and Laboratory Medicine. 46 |
| ISSN: | 1437-4331 1434-6621 |
| Popis: | Background: In recent years a number of point of care testing (POCT) glucometers were introduced on the market. We investigated the analytical variability (lot-to-lot variation, calibration error, inter-instrument and inter-operator variability) of glucose POCT systems in a university hospital environment and compared these results with the analytical needs required for tight glucose monitoring. Methods: The reference hexokinase method was compared to different POCT systems based on glucose oxidase (blood gas instruments) or glucose dehydrogenase (handheld glucometers). Based upon daily internal quality control data, total errors were calculated for the various glucose methods and the analytical variability of the glucometers was estimated. Results: The total error of the glucometers exceeded by far the desirable analytical specifications (based on a biological variability model). Lot-to-lot variation, inter-instrument variation and inter-operator variability contributed approximately equally to total variance. As in a hospital environment, distribution of hematocrit values is broad, converting blood glucose into plasma values using a fixed factor further increases variance. The percentage of outliers exceeded the ISO 15197 criteria in a broad glucose concentration range. Conclusions: Total analytical variation of handheld glucometers is larger than expected. Clinicians should be aware that the variability of glucose measurements obtained by blood gas instruments is lower than results obtained with handheld glucometers on capillary blood. |
| Databáze: | OpenAIRE |
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