Comparability of hemoglobin A1c level measured in capillary versus venous blood sample applying two point-of-care instruments

IntroductionFever commonly leads to healthcare seeking and hospital admission in sub-Saharan Africa and Asia. There is only limited guidance for clinicians managing non-malarial fevers, which often results in inappropriate treatment for patients. Furthermore, there is little evidence for estimates of disease burden, or to guide empirical therapy, control measures, resource allocation, prioritisation of clinical diagnostics or antimicrobial stewardship. The Febrile Illness Evaluation in a Broad Range of Endemicities (FIEBRE) study seeks to address these information gaps.Methods and analysisFIEBRE investigates febrile illness in paediatric and adult outpatients and inpatients using standardised clinical, laboratory and social science protocols over a minimum 12-month period at five sites in sub-Saharan Africa and Southeastern and Southern Asia. Patients presenting with fever are enrolled and provide clinical data, pharyngeal swabs and a venous blood sample; selected participants also provide a urine sample. Laboratory assessments target infections that are treatable and/or preventable. Selected point-of-care tests, as well as blood and urine cultures and antimicrobial susceptibility testing, are performed on site. On day 28, patients provide a second venous blood sample for serology and information on clinical outcome. Further diagnostic assays are performed at international reference laboratories. Blood and pharyngeal samples from matched community controls enable calculation of AFs, and surveys of treatment seeking allow estimation of the incidence of common infections. Additional assays detect markers that may differentiate bacterial from non-bacterial causes of illness and/or prognosticate illness severity. Social science research on antimicrobial use will inform future recommendations for fever case management. Residual samples from participants are stored for future use.Ethics and disseminationEthics approval was obtained from all relevant institutional and national committees; written informed consent is obtained from all participants or parents/guardians. Final results will be shared with participating communities, and in open-access journals and other scientific fora. Study documents are available online (https://doi.org/10.17037/PUBS.04652739).

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Comparative study of DIPSI and IADPSG criteria for diagnosis of GDM

International Journal of Reproduction Contraception Obstetrics and Gynecology ◽

10.18203/2320-1770.ijrcog20180869 ◽

2018 ◽

Vol 7 (3) ◽

pp. 932

Author(s):

Swathy Srinivasan ◽

Rani P. Reddi

Keyword(s):

Pregnant Women ◽

Blood Sample ◽

Sensitivity And Specificity ◽

International Association ◽

Venous Blood ◽

P Value ◽

Kappa Statistics ◽

Venous Blood Sample ◽

Iadpsg Criteria ◽

Criteria For Diagnosis

GDM is defined as any degree of glucose intolerance with onset or first recognition during pregnancy. The prevalence of GDM varies, widely based on the diagnostic criteria used and the ethnic group studied. It is associated with adverse maternal and perinatal outcome. Incidence of GDM in India is 1-14%. There are several screening and diagnostic tests for GDM. It is important to diagnose early and treat to prevent these complications. The present study was done to compare Diabetes in Pregnancy Study Group India (DIPSI) with International Association of the Diabetes and Pregnancy Study Groups (IADPSG) criteria for diagnosis of GDM and to assess the validity of these methods.Methods: It was a cross sectional study done in 144 pregnant women who fulfilled the inclusion criteria. They underwent non - fasting OGTT with 75 grams glucose which was given irrespective of the last meal. A venous blood sample was drawn two hours after glucose administration. They were advised to come two to three days later and repeated with 75 grams OGTT after an overnight fast of atleast 8 hours. Venous blood sample was drawn at fasting, one hour and two hours after load with 75 grams of glucose. Plasma glucose was measured by using an autoanalyzer by glucose - oxidase peroxidase (GOD - POD) technique.Results: The epidemiological parameters like Age, BMI, Parity and Gestational age did not have any difference between two groups. 17.4% was diagnosed by DIPSI criteria and 15.3% was diagnosed by IADPSG criteria and 6.9% was diagnosed by both. Sensitivity and specificity of DIPSI was 45% and87% and sensitivity and specificity of IADPSG was 40% and89% respectively. According to kappa statistics, the p-value is 0.000.Conclusions: In present study it was concluded that screening is very essential in all pregnant women due to high prevalence of GDM in India. By comparing these two criteria, sensitivity of DIPSI was found better than IADPSG criteria in diagnosing GDM. Though IADPSG is universally accepted for diagnosis, DIPSI has still got a place in low resource countries as it is easy, cost effective and non fasting test.

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Hemoglobin A1c Point-of-Care Assays; A New World with a Lot of Consequences!

Journal of Diabetes Science and Technology ◽

10.1177/193229680900300303 ◽

2009 ◽

Vol 3 (3) ◽

pp. 418-423 ◽

Cited By ~ 20

Author(s):

Erna Lenters-Westra ◽

Robbert J. Slingerland

Keyword(s):

Nurse Practitioners ◽

Hemoglobin A1c ◽

Clinical Laboratory ◽

Point Of Care ◽

Care Center ◽

Venous Blood ◽

Coefficients Of Variation ◽

Rapid Result ◽

Performance Results ◽

Clinical Laboratory Improvement Amendments

Background: Point-of-care instruments for the measurement of hemoglobin A1c (HbA1c) may improve the glycemic control of people with diabetes by providing a rapid result if the performance of the instruments used is acceptable. A 0.5% HbA1c difference between successive results is considered a clinically relevant change. With this in mind, the In2it from Bio-Rad and the DCA Vantage from Siemens were evaluated according to Clinical and Laboratory Standards Institute (CLSI) protocols. Methods: The CLSI protocols EP-5 and EP-9 were applied to investigate precision, accuracy, and bias. The bias was compared with three certified secondary reference measurement procedures. Differences between capillary and venous blood were investigated by an end-user group consisting of nurse practitioners at a diabetes care center. Results: At HbA1c levels of 5.1 and 11.2%, total coefficients of variation (CV) for the In2it were 4.9 and 3.3%, respectively, and for the DCA Vantage were 1.7 to 1.8% and 3.7 to 5.5% depending on the lot number of the cartridges. Method comparisons showed significant lot number-dependent results for the In2it and the DCA Vantage compared with the three reference methods. No overall difference was observed between capillary and venous blood for both methods. Conclusion: Performance results of the In2it and the DCA Vantage showed variable and lot number-dependent results. To maintain the interlaboratory CV of 5% for HbA1c, the Clinical Laboratory Improvement Amendments rules for waived point-of-care instruments should be revised. An obligation for participating in external quality schemes and taking adequate action should be considered for POC instruments that perform poorly.

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Implementation of pre-labelled barcode tubes and the GeT-System in a general hospital for the exact documentation of the time of venous blood sample and improvement of sample quality

Clinical Chemistry and Laboratory Medicine (CCLM) ◽

10.1515/cclm-2020-1017 ◽

2020 ◽

Vol 0 (0) ◽

Author(s):

Gabriele Halwachs-Baumann ◽

Birgit Winninger

Keyword(s):

Blood Sample ◽

General Hospital ◽

Venous Blood ◽

Venous Blood Sample ◽

Sample Quality

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Point-of-care measurement of clozapine concentration using a finger-stick blood sample

Journal of Psychopharmacology ◽

10.1177/0269881121991567 ◽

2021 ◽

pp. 026988112199156

Author(s):

David Taylor ◽

Matthew Atkins ◽

Robert Harland ◽

Irina Baburina ◽

James H MacCabe ◽

...

Keyword(s):

Blood Sample ◽

Point Of Care ◽

Venous Blood ◽

Laboratory Method ◽

Capillary Blood ◽

Strong Positive Correlation ◽

Blood Samples ◽

Clozapine Concentration ◽

Capillary Sample ◽

Finger Stick

Background: The use of clozapine demands regular monitoring of clozapine plasma concentrations and of white blood cell parameters. The delay between sending blood samples for analysis and receiving the results hinders clinical care. Point-of-care testing (POCT) can provide drug assay results within a few minutes. Aim: This study aimed to investigate the utility of a novel point-of-care device that can measure clozapine concentrations using capillary blood samples collected via a finger stick. Method: During a five-week period starting in June 2019 eligible patients were asked to provide a finger-stick capillary sample in addition to their usual venous blood sample. Samples were analysed by the novel point-of-care device and by the standard laboratory method. Capillary blood samples were tested by the MyCare™ Insite POCT analyser, and a quantitative measurement of clozapine concentration was provided within six minutes. Results: A total of 309 patients agreed to measurements by the two methods. Analysis revealed clozapine concentrations in venous blood as determined by the laboratory method ranged from 20 to 1310 ng/mL and by POCT from 7 to 1425 ng/mL. There was a strong positive correlation ( R = 0.89) between the results from the venous and the capillary sample methods. The slope of the association between standard assay and MyCare™ Insite was 1.0 with an intercept of –21 ng/mL, indicating minimal bias. Conclusion: Clozapine concentrations can be accurately measured at the point of care using capillary blood samples collected via a finger stick. This approach may be more acceptable than venous sampling to patients and, with almost instant results available, more useful to clinicians.

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Comparison of the effect of three intramuscular sedation protocols on packed cell volume and total protein in cats

Journal of Feline Medicine and Surgery ◽

10.1177/1098612x211064702 ◽

2021 ◽

pp. 1098612X2110647

Author(s):

Alicia M Skelding ◽

Alexander Valverde

Keyword(s):

Clinical Study ◽

Blood Sample ◽

Cell Volume ◽

Total Protein ◽

Packed Cell Volume ◽

Venous Blood ◽

Blood Sampling ◽

Venous Blood Sample ◽

To Receive ◽

Venous Blood Sampling

Objectives The aim of this study was to evaluate the change in packed cell volume (PCV) and total protein following intramuscular preanesthetic sedation with one of three drug combinations in cats. Methods Thirty client-owned cats were enrolled in this prospective, randomized, blinded, clinical study. A venous blood sample was obtained prior to administration of any sedation and PCV, total protein, electrolytes (Na+, K+, Cl–, iCa2+), glucose and lactate were measured. Cats were randomly assigned to receive one of three intramuscular sedation protocols (n = 10 cats/protocol): methadone 0.2 mg/kg + acepromazine 0.02 mg/kg (MA), methadone 0.2 mg/kg + dexmedetomidine 5 µg/kg (MD) or methadone 0.2 mg/kg + midazolam 0.2 mg/kg + alfaxalone 2 mg/kg (MMA). Twenty-five minutes later, cats were assessed for level of sedation followed by another venous blood sampling to evaluate the same variables as above. Results There were no significant differences in demographics (age, weight, sex) between groups. Level of sedation was significantly higher in MMA cats. Within groups, after premedication, PCV and hemoglobin significantly decreased in all groups, total protein significantly decreased in the MA and MMA groups and glucose significantly increased in the MD group. For electrolytes, statistical changes were not clinically relevant; Cl– mean difference was significantly different between MA and MD; in the MD group Na+ and Cl– significantly decreased and in the MMA group Cl– significantly increased. Conclusions and relevance All three sedation protocols caused significant decreases in PCV and hemoglobin in healthy cats.

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Comparison of Full Blood Count Parameters Using Capillary and Venous Samples in Patients Presenting to the Emergency Department

ISRN Emergency Medicine ◽

10.5402/2012/508649 ◽

2012 ◽

Vol 2012 ◽

pp. 1-6 ◽

Cited By ~ 6

Author(s):

R. Ponampalam ◽

Stephanie Man Chung Fook Chong ◽

Sau Chew Tan

Keyword(s):

Emergency Department ◽

Blood Sample ◽

Blood Count ◽

Point Of Care ◽

White Cell Count ◽

Venous Blood ◽

Blood Parameters ◽

Full Blood Count ◽

Invasive Technique ◽

Paired Samples

Full blood count (FBC) analysis is a common investigation done in the emergency department (ED). The aim of this study was to determine the accuracy of bedside FBC analysis using capillary blood samples from a finger stab at point of care (POC) compared to a conventional venous blood sample analysis. A total of 314 consecutive patients presenting to the ED were recruited. After consenting, a sample of the patient’s venous (V) blood was obtained via venepuncture and sent to the haematology laboratory for analysis as standard practice. This was followed immediately by collection of a capillary (C) blood sample from a finger stab which was analysed at site using an automated FBC analyser at POC. Agreement between the paired samples for blood parameters including the total white cell count, hemoglobin, and platelet count was assessed by the statistical method of Bland and Altman using V sample as the gold standard. The results showed a statistically significant deviation between capillary and venous samples only for platelet counts (P<0.001) and haemoglobin (P<0.001). However, the magnitudes of this difference 7.3 × 109/L and 0.5 g/dL respectively, were not clinically significant. The study suggest that the analysis of capillary samples for FBC parameters is a reliable and acceptable alternative to conventional methods with the benefits of being a rapid, convenient, and minimally invasive technique.

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