Assessing the performance of handheld glucose testing for critical care.
نویسندگان
چکیده
BACKGROUND We assessed the performance of a point-of-care (POC) glucose meter system (GMS) with multitasking test strip by using the locally-smoothed (LS) median absolute difference (MAD) curve method in conjunction with a modified Bland-Altman difference plot and superimposed International Organization for Standardization (ISO) 15197 tolerance bands. We analyzed performance for tight glycemic control (TGC). METHODS A modified glucose oxidase enzyme with a multilayer-gold, multielectrode, four-well test strip (StatStriptrade mark, NOVA Biomedical, Waltham, MA) was used. There was no test strip calibration code. Pragmatic comparison was done of GMS results versus paired plasma glucose measurements from chemistry analyzers in clinical laboratories. Venous samples (n = 1,703) were analyzed at 35 hospitals that used 20 types of chemistry analyzers. Erroneous results were identified using the Bland-Altman plot and ISO 15197 criteria. Discrepant values were analyzed for the TGC interval of 80-110 mg/dL. RESULTS The GMS met ISO 15197 guidelines; 98.6% (410 of 416) of observations were within tolerance for glucose <75 mg/dL, and for > or =75 mg/dL, 100% were within tolerance. Paired differences (handheld minus reference) averaged -2.2 (SD 9.8) mg/dL; the median was -1 (range, -96 to 45) mg/dL. LS MAD curve analysis revealed satisfactory performance below 186 mg/dL; above 186 mg/dL, the recommended error tolerance limit (5 mg/dL) was not met. No discrepant values appeared. All points fell in Clarke Error Grid zone A. Linear regression showed y = 1.018x - 0.716 mg/dL, and r2 = 0.995. CONCLUSIONS LS MAD curves draw on human ability to discriminate performance visually. LS MAD curve and ISO 15197 performance were acceptable for TGC. POC and reference glucose calibration should be harmonized and standardized.
منابع مشابه
Assessing process performance with incapability index based on fuzzy critical value
Process capability indices are considered as an important concept in statistical quality control. They have been widely used in the manufacturing industry to provide numerical measures on process performance. Moreover, some incapability indices have been introduced to account the process performance. In this paper, we focus on the one proposed by Chen ~cite{Che:Stat}. In today's modern world, a...
متن کاملContinuous glucose sensors for glycaemic control in the ICU: have we arrived?
Dr Blixt and colleagues show in an elegant pilot study that the continuous measurement of glucose in venous blood by microdialysis in a central venous catheter is feasible in critically ill patients. The performance of this type of continuous glucose monitoring device equals the performance of the commonly used handheld blood glucose meters. But are we, as ICU physicians and nurses, now ready t...
متن کاملDoes routine repeat testing of critical laboratory values improve their accuracy?
Background: Routine repeat testing of critical laboratory values is very common these days to increase their accuracy and to avoid reporting false or infeasible results. We figure that repeat testing of critical laboratory values has any benefits or not. Methods : We examined 2233 repeated critical laboratory values in 13 different hematology and chemistry tests including: hemoglobin, white...
متن کاملHighly specific and rapid glycan based amperometric detection of influenza viruses† †Electronic supplementary information (ESI) available: Synthesis and characterization of all compounds and intermediates are provided. See DOI: 10.1039/c6sc03720h Click here for additional data file.
Rapid and precise detection of influenza viruses in a point of care setting is critical for applying appropriate countermeasures. Current methods such as nucleic acid or antibody based techniques are expensive or suffer from low sensitivity, respectively. We have developed an assay that uses glucose test strips and a handheld potentiostat to detect the influenza virus with high specificity. Inf...
متن کاملHighly specific and rapid glycan based amperometric detection of influenza viruses.
Rapid and precise detection of influenza viruses in a point of care setting is critical for applying appropriate countermeasures. Current methods such as nucleic acid or antibody based techniques are expensive or suffer from low sensitivity, respectively. We have developed an assay that uses glucose test strips and a handheld potentiostat to detect the influenza virus with high specificity. Inf...
متن کاملذخیره در منابع من
با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید
برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید
ثبت ناماگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید
ورودعنوان ژورنال:
- Diabetes technology & therapeutics
دوره 10 6 شماره
صفحات -
تاریخ انتشار 2008