Accuracy of Noninvasive and Invasive Point-of-Care Total Blood Hemoglobin Measurement in an Outpatient Setting

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.

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Cardiac safety of off-label COVID-19 drug therapy: a review and proposed monitoring protocol

European Heart Journal Acute Cardiovascular Care ◽

10.1177/2048872620922784 ◽

2020 ◽

Vol 9 (3) ◽

pp. 215-221 ◽

Cited By ~ 40

Author(s):

Niyada Naksuk ◽

Sorin Lazar ◽

Thoetchai (Bee) Peeraphatdit

Keyword(s):

Adverse Effects ◽

Qt Interval ◽

Point Of Care ◽

Cardiac Injury ◽

Torsade De Pointes ◽

Heart Association ◽

Outpatient Setting ◽

Off Label ◽

Care Protocol ◽

Investigational Drugs

More than 2,000,000 individuals worldwide have had coronavirus 2019 disease infection (COVID-19), yet there is no effective medical therapy. Multiple off-label and investigational drugs, such as chloroquine and hydroxychloroquine, have gained broad interest due to positive pre-clinical data and are currently used for treatment of COVID-19. However, some of these medications have potential cardiac adverse effects. This is important because up to one-third of patients with COVID-19 have cardiac injury, which can further increase the risk of cardiomyopathy and arrhythmias. Adverse effects of chloroquine and hydroxychloroquine on cardiac function and conduction are broad and can be fatal. Both drugs have an anti-arrhythmic property and are proarrhythmic. The American Heart Association has listed chloroquine and hydroxychloroquine as agents which can cause direct myocardial toxicity. Similarly, other investigational drugs such as favipiravir and lopinavir/ritonavir can prolong QT interval and cause Torsade de Pointes. Many antibiotics commonly used for the treatment of patients with COVID-19, for instance azithromycin, can also prolong QT interval. This review summarizes evidenced-based data regarding potential cardiac adverse effects due to off-label and investigational drugs including chloroquine and hydroxychloroquine, antiviral therapy, monoclonal antibodies, as well as common antibiotics used for the treatment of COVID-19. The article focuses on practical points and offers a point-of-care protocol for providers who are taking care of patients with COVID-19 in an inpatient and outpatient setting. The proposed protocol is taking into consideration that resources during the pandemic are limited.

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Improving the Quality of Our Clinical Work for Coumadin Anticoagulation Therapy with Electronic Medical Record (EMR) Based System Redesign

Blood ◽

10.1182/blood.v120.21.4714.4714 ◽

2012 ◽

Vol 120 (21) ◽

pp. 4714-4714

Author(s):

Linda Thomas-Hemak ◽

Lisa Thomas ◽

Qi Shi ◽

Jignesh Sheth ◽

Etikala Praveen ◽

...

Keyword(s):

Medical Record ◽

Electronic Medical Record ◽

Therapeutic Range ◽

Conflicts Of Interest ◽

Anticoagulation Therapy ◽

Clinical Work ◽

Clinical Decision ◽

Outpatient Setting ◽

Flow Sheet ◽

Total Blood

Abstract Abstract 4714 Introduction: Coumadin anticoagulation therapy is indicated in a variety of thromboembolic conditions. Close INR monitoring is required to maintain therapeutic range in order to decrease complications, emergency room visits, and medical costs associated with Coumadin therapy. To achieve this, tight quality control in primary health care systems is undeniably important. The purpose of this study is to assess the effects of a redesigned system for coumadin anticoagulation therapy in an outpatient setting. Our project includes: (1) Meaningful use of a new electronic medical record (EMR) based INR flow sheet; (2) Improved physician and staff efficiency using new EMR based protocol for INR tracking and clinical decision support, including drug interaction information, dose adjustment, per-procedure anticoagulation bridging, and an education/training program; (3) Improved patient education, including enhanced Coumadin educational materials. Vitamin K prescriptions will be given to the patients in the event of complications with coumadin. Method and Materials: INR data were collected from 55 patients receiving Coumadin therapy from 10/01/2009 to 10/31/2011 at an outpatient setting. Total blood tests for INR were 1679 samples. We summarized results from 55 patients twelve months before and after using our redesigned system. Result: Our data shows the new system helped to: (1) Increased the percentage of INRs (average) in the therapeutic range from 51.35% to 54.05% and the percentage of INRs (average) in extended therapeutic range (+/−0.2) from 63.78% to 70.43%; (2) Decreased the highest value from 15.4 to 10.2; (3)Decreased annual total number of INR checkups for all patients from 881 to 798; and (4)Decreased average number of INR checkups per month from 1.8 to 1.3 (average). Conclusion: Our clinical data shows that Our EMR based system redesign not only helps to increase efficiency and safety of Coumadin anticoagulation therapy, but also decreases the frequency of INR checks, thereby reducing medical expenditures. Disclosures: No relevant conflicts of interest to declare.

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STUDY TO COMPARE THE CORRELATION BETWEEN MOKSHIT DIGITAL HEMOGLOBINOMETER AND KT6400 HEMATOLOGY ANALYZER FOR HEMOGLOBIN MEASUREMENT

International Journal of Research in Informative Science Application & Techniques (IJRISAT) ◽

10.46828/ocpu/ijrisat/21541 ◽

2021 ◽

pp. 21541-21543

Keyword(s):

Point Of Care ◽

Gravimetric Method ◽

Health Concern ◽

Major Health ◽

Colour Scale ◽

Blood Banks ◽

Hematology Analyzer ◽

Automated Hematology Analyzer ◽

Method Point ◽

Hemoglobin Measurement

Anemia is a major health concern in India since many decades and is continue to rise. Therefore, Hemoglobin measurement is performed in various Pathology labs, Hospitals, Blood Banks etc. to detect Technology. Different method are used for Hemoglobin measurement like Automated Hematology Analyzer, copper sulphate gravimetric method, Hemoglobin colour scale, HICN method, point of care Hemoglobin meter etc.

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