Comparability of Point-of-Care versus Central Laboratory Hemoglobin Determination in Emergency Patients at a Supra-Maximal Care Hospital

Background Point-of-care-testing (POCT) of haemoglobin Alc (HbA1c) is popular due to its fast turnaround of results in the outpatient setting. The aim of this project was to evaluate the performance of a new HbA1c POCT analyser, the Bio-Rad in2it, and compare it with the Siemens DCA 2000, Bio-Rad Variant II and Roche Tina-quant HbA1c Gen 2 assay on the cobas c501. Methods Imprecision of the four methods were compared by computing total imprecision from within-run and between-run data. A total of 80 samples were also compared and analysed by Deming regression and Altman–Bland difference test. Results Study of total imprecision of the in2it at HBA1c levels of 6.0% and 10.4% produced a coefficient of variation (%CV) of 3.8% and 3.7%, respectively. These results were more favourable as compared with the DCA 2000 but did not match the low imprecision of the central laboratory methods, the Bio-Rad Variant II and the Roche cobas c501. Comparison between the in2it and the central laboratory analysers, Bio-Rad variant II and cobas c501, revealed positive bias of 12% and 10%, respectively, supported by corresponding Deming regression equation slopes of +1.18 and +1.14. Comparison between the DCA 2000 and the central laboratory analysers revealed a bias that became increasingly positive with rising HbA1c concentrations with Deming regression analysis also revealing proportional and constant differences. Conclusions The in2it is a suitable POCT analyser for HbA1c but its less than ideal precision performance and differences with the central laboratory analysers must be communicated to and noted by the users.

Download Full-text

Impact from point-of-care devices on emergency department patient processing times compared with central laboratory testing of blood samples: a randomised controlled trial and cost-effectiveness analysis

Emergency Medicine Journal ◽

10.1136/emermed-2013-202632 ◽

2013 ◽

Vol 31 (9) ◽

pp. 714-719 ◽

Cited By ~ 36

Author(s):

Stephen Edward Asha ◽

Adam Chiu Fat Chan ◽

Elizabeth Walter ◽

Patrick J Kelly ◽

Rachael L Morton ◽

...

Keyword(s):

Emergency Department ◽

Laboratory Testing ◽

Point Of Care ◽

Controlled Trial ◽

Emergency Department Patient ◽

Central Laboratory ◽

Blood Samples ◽

Processing Times ◽

Effectiveness Analysis ◽

Randomised Controlled

Download Full-text

Correlation of COVID-19 antigen test and CBNAAT results at a single tertiary care hospital in North India: an experience

International Journal of Community Medicine and Public Health ◽

10.18203/2394-6040.ijcmph20211768 ◽

2021 ◽

Vol 8 (5) ◽

pp. 2427

Author(s):

Surbhi Gupta ◽

Anju Shukla ◽

Poonam Singh ◽

Areena H. Siddiqui

Keyword(s):

Tertiary Care Hospital ◽

Point Of Care ◽

Tertiary Care ◽

Uttar Pradesh ◽

Nucleic Acid Amplification ◽

North India ◽

Care Hospital ◽

Antigen Test ◽

Discordant Group ◽

Antigen Tests

Background: Nucleic acid amplification test (NAAT) is considered gold standard in the molecular diagnosis of CoV-2 infection but since it is costly, labor intensive and needs technical expertise, rapid chromatographic immunoassay for the qualitative detection of specific antigens to SARS CoV-2 have been devised. Objectives of this study was to compare the results of Antigen test and NAAT for CoV-2 infection carried out during the months of July and August 2020 by single tertiary care hospital in Lucknow, Uttar Pradesh and to determine the utility of rapid antigen test in the SARS CoV-2 diagnosis.Methods: All the patients who came to our hospital seeking admission during July 2020 and August 2020 were included in the study. A total of 1000 patients were included in this study.Results: Out of a total 1000 cases which were included in the study, 769 cases (76.9%) were found to be SARS CoV-2 negative by both antigen and CBNAAT, 100 cases (10.0%) were SARS CoV-2 positive by both antigen and CBNAAT tests. But in 131 cases (13.1%), antigen was not able to pick up the disease. It was also found that the Cycle Threshold (Ct) value for the discordant group was higher (Mean E= 28, Mean N2=33) when compared to the group where antigen was positive.Conclusions: The present study establishes the role of rapid antigen tests in contributing to the quick, point of care diagnosis of SARS CoV-2. These assays are safe, simple, and fast and can be used in local clinics and hospitals. These tests are very important for real-time patient management and infection control decision.

Download Full-text

Comparison of Point-of-Care versus Central Laboratory Measurement of Electrolyte Concentration in Intensive Care Patient

Indian Journal of Anaesthesia and Analgesia ◽

10.21088/ijaa.2349.8471.4417.10 ◽

2017 ◽

Vol 4 (4 (Part-1)) ◽

pp. 974-978

Author(s):

Syamasundar Ayya ◽

◽

Geeta Kanithi ◽

R. Gopinath ◽

◽

...

Keyword(s):

Intensive Care ◽

Intensive Care Patient ◽

Electrolyte Concentration ◽

Point Of Care ◽

Care Patient ◽

Laboratory Measurement ◽

Central Laboratory

Download Full-text

Point-of-care versus central testing of hemoglobin during large volume blood transfusion

BMC Anesthesiology ◽

10.1186/s12871-019-0916-2 ◽

2019 ◽

Vol 19 (1) ◽

Author(s):

Justin Herman ◽

Brian Park ◽

Bharat Awsare ◽

Frances West ◽

Denine Crittendon ◽

...

Keyword(s):

Massive Transfusion ◽

Clinical Laboratory ◽

Complete Blood Count ◽

Point Of Care ◽

Tertiary Care ◽

Absolute Difference ◽

Care Hospital ◽

Specific Patient ◽

Paired Samples ◽

Clinically Significant

Abstract Background Point-of-care (POC) hemoglobin testing has the potential to revolutionize massive transfusion strategies. No prior studies have compared POC and central laboratory testing of hemoglobin in patients undergoing massive transfusions. Methods We retrospectively compared the results of our point-of-care hemoglobin test (EPOC®) to our core laboratory complete blood count (CBC) hemoglobin test (Sysmex XE-5000™) in patients undergoing massive transfusion protocols (MTP) for hemorrhage. One hundred seventy paired samples from 90 patients for whom MTP was activated were collected at a single, tertiary care hospital between 10/2011 and 10/2017. Patients had both an EPOC® and CBC hemoglobin performed within 30 min of each other during the MTP. We assessed the accuracy of EPOC® hemoglobin testing using two variables: interchangeability and clinically significant differences from the CBC. The Clinical Laboratory Improvement Amendments (CLIA) proficiency testing criteria defined interchangeability for measurements. Clinically significant differences between the tests were defined by an expert panel. We examined whether these relationships changed as a function of the hemoglobin measured by the EPOC® and specific patient characteristics. Results Fifty one percent (86 of 170) of paired samples’ hemoglobin results had an absolute difference of ≤7 and 73% (124 of 170) fell within ±1 g/dL of each other. The mean difference between EPOC® and CBC hemoglobin had a bias of − 0.268 g/dL (p = 0.002). When the EPOC® hemoglobin was < 7 g/dL, 30% of the hemoglobin values were within ±7, and 57% were within ±1 g/dL. When the measured EPOC® hemoglobin was ≥7 g/dL, 55% of the EPOC® and CBC hemoglobin values were within ±7, and 76% were within ±1 g/dL. EPOC® and CBC hemoglobin values that were within ±1 g/dL varied by patient population: 77% for cardiac surgery, 58% for general surgery, and 72% for non-surgical patients. Conclusions The EPOC® device had minor negative bias, was not interchangeable with the CBC hemoglobin, and was less reliable when the EPOC® value was < 7 g/dL. Clinicians must consider speed versus accuracy, and should check a CBC within 30 min as confirmation when the EPOC® hemoglobin is < 7 g/dL until further prospective trials are performed in this population.

Download Full-text