+ Site Statistics
+ Search Articles
+ Subscribe to Site Feeds
Most Shared
PDF Full Text
+ PDF Full Text
Request PDF Full Text
+ Follow Us
Follow on Facebook
Follow on Twitter
Follow on LinkedIn
+ Translate
+ Recently Requested

Evaluation of point-of-care glucose testing accuracy using locally-smoothed median absolute difference curves

Evaluation of point-of-care glucose testing accuracy using locally-smoothed median absolute difference curves

Clinica Chimica Acta; International Journal of Clinical Chemistry 389(1-2): 31-39

We introduce locally-smoothed (LS) median absolute difference (MAD) curves for the evaluation of hospital point-of-care (POC) glucose testing accuracy. Arterial blood samples (613) were obtained from a university hospital blood gas laboratory. Four hospital glucose meter systems (GMS) were tested against the YSI 2300 glucose analyzer for paired reference observations. We made statistical comparisons using conventional methods (e.g., linear regression, mean absolute differences). Difference plots with superimposed ISO 15197 tolerance bands showed bias, scatter, heteroscedasticity, and erroneous results well. LS MAD curves readily revealed GMS accuracy patterns. Performance in hypoglycemic and hyperglycemic ranges erratically exceeded the recommended LS MAD error tolerance limit (5 mg/dl). Some systems showed acceptable (within LS MAD tolerance) or nearly acceptable performance in and around a tight glycemic control (TGC) interval of 80-110 mg/dl. Performance patterns varied in this interval, creating potential for discrepant therapeutic decisions. Erroneous results demonstrated by ISO 15197-difference plots must be carefully considered. LS MAD curves draw on the unique human ability to recognize patterns quickly and discriminate accuracy visually. Performance standards should incorporate LS MAD curves and the recommended error tolerance limit of 5 mg/dl for hospital bedside glucose testing. Each GMS must be considered individually when assessing overall performance for therapeutic decision making in TGC.

(PDF emailed within 0-6 h: $19.90)

Accession: 020998202

Download citation: RISBibTeXText

PMID: 18157943

DOI: 10.1016/j.cca.2007.11.019

Related references

Mapping point-of-care performance using locally-smoothed median and maximum absolute difference curves. Clinical Chemistry and Laboratory Medicine 49(10): 1637-1646, 2012

Accuracy and precision of point-of-care testing for glucose and prothrombin time at the critical care units. Clinica Chimica Acta 307(1-2): 119-123, 2001

The effect of hematocrit on the accuracy of six glucose meter systems for point-of-care testing. Clinical Chemistry 45(6 PART 2): A32, June, 1999

System accuracy evaluation of systems for point-of-care testing of blood glucose: a comparison of a patient-use system with six professional-use systems. Clinical Chemistry and Laboratory Medicine 52(7): 1079-1086, 2015

The Quantitative Relationship Between ISO 15197 Accuracy Criteria and Mean Absolute Relative Difference (MARD) in the Evaluation of Analytical Performance of Self-Monitoring of Blood Glucose (SMBG) Systems. Journal of Diabetes Science and Technology 10(5): 1182-1187, 2017

Accuracy evaluation of point-of-care glucose analyzers in the Saudi market. Saudi Medical Journal 33(1): 91-92, 2012

Comparison of Point of Care (POC) Testing of Glucose by B Braun Glucometer and Hemocue Glucose 201+ Analyser Versus Centralised Testing in Neonatal Intensive Care Unit (NICU). Journal of Clinical and Diagnostic Research 8(7): Pc10-Pc13, 2014

Evaluation of the accuracy of three glucose monitoring systems in blood glucose testing Comparison of alternate site testing versus classical fingertip testing. Diabetologia 45(Supplement 2): A 277, August, 2002

Health Economic Evaluation of a Strict Glucose Control Guideline Implemented Using Point-of-Care Testing in Three Intensive Care Units in The Netherlands. Applied Health Economics and Health Policy 13(4): 399-407, 2016

Drug interference with glucose measurements on six handheld glucose meters and a portable glucose analyzer for point-of-care testing in critical care. Clinical Chemistry 45(6 PART 2): A31, June, 1999

Evaluation of the SureStepPro Blood Glucose Analyzer for point-of-care testing in neonates. Clinical Chemistry 44(6 PART 2): A66, June, 1998

Accuracy and clinical correlation of international normalized ratio testing by three point-of-care testing devices versus traditional laboratory testing. Pharmacotherapy 20(3): 347, March, 2000

Evaluation of the hemocue blood glucose data management analyzer for point-of-care testing. Clinical Chemistry 44(6 PART 2): A66, June, 1998

Analytical evaluation of the Accu-Chek Advantage monitor for point-of-care glucose testing. Clinical Chemistry 42(6 PART 2): S160, 1996

Critical evaluation of connectivity-based point of care testing systems of glucose in a hospital environment. Clinical Chemistry and Laboratory Medicine 46(12): 1763-1768, 2008