scholarly journals Reproducibility and validity of portable haemoglobinometer for the diagnosis of anaemia in children under the age of 5 years

2020 ◽  
Vol 9 ◽  
Author(s):  
Alessandra da Silva Pereira ◽  
Inês Rugani Ribeiro de Castro ◽  
Flávia Fioruci Bezerra ◽  
José Firmino Nogueira Neto ◽  
Ana Carolina Feldenheimer da Silva
Keyword(s):  
Venous Blood ◽  
Intraclass Correlation ◽  
Age Groups ◽  
Capillary Blood ◽  
Test Method ◽  
Automated System ◽  
Accuracy Rate ◽  
Predictive Values ◽  
Sensitivity Specificity ◽  
Good Agreement

Abstract Portable haemoglobinometers have been used in order to estimate the prevalence of anaemia in diverse settings. However, few studies have been conducted to evaluate their performance in children of different age groups in distinct epidemiological contexts. To evaluate the reproducibility and reliability of a portable haemoglobinometer for the diagnosis of anaemia in children <5 years Hb was measured in the venous blood of 351 children <5 years by an automated system (standard method) and in three capillary blood samples, using a portable haemoglobinometer (HemoCue®; test method). The reproducibility of the device and of the test method was evaluated using the intraclass correlation coefficient (ICC) (Hb in its continuous form), κ and prevalence-adjusted bias-adjusted κ (PABAK) (categorised variable: anaemia: yes/no). For test method validation, Bland–Altman analyses were performed and sensitivity, specificity, accuracy rate, positive predictive value (PPV) and negative predictive values (NPV) were calculated. The haemoglobinometer presented good device reproducibility (ICC = 0·79) and reasonable method reproducibility (puncture, collection and reading) (ICC = 0·71). Superficial and fair agreement (κ) and good agreement (PABAK) were observed among the diagnoses obtained through the test method. The prevalence of anaemia was 19·1 and 19·7 % using the standard and the test method, respectively, with no statistically significant differences. The test method presented higher specificity (87·7 %) and NPV (88·3 %) than sensitivity (50·7 %) and PPV (49·3 %), and intermediary accuracy rate (57·8 %). HemoCue® showed good device reproducibility and reasonable method reproducibility, as well as good performance in estimating the prevalence of anaemia. Nevertheless, it showed a fair reliability and low individual diagnostic accuracy.

scholarly journals Reliability of Capillary Complete Blood Count in Children With Acute Gastroenteritis

2021 ◽  
Vol 9 ◽  
Author(s):  
Hanna Wielińska-Wiśniewska ◽  
Jan K. Nowak ◽  
Michał Da̧browski ◽  
Paula Szydłowska ◽  
Mariusz Szczepanik ◽  
...  
Keyword(s):  
Acute Gastroenteritis ◽  
Blood Count ◽  
Complete Blood Count ◽  
Characteristic Curve ◽  
Venous Blood ◽  
Intraclass Correlation ◽  
Capillary Blood ◽  
Cross Sectional ◽  
Predictive Values ◽  
The Mean

Background: To assess the reliability of complete blood count (CBC) in the capillary blood of children with acute gastroenteritis (AGE), with a focus on leukocytes.Methods: This was a retrospective cross-sectional study. Complete blood count was compared between the capillary and venous blood in children admitted to a pediatric gastroenterology department with primary diagnosis of AGE (ICD-10 A09, A08.0, A08.2). Capillary blood was obtained in the emergency room and venous blood was sampled in the ward shortly thereafter during peripheral intravenous line placement.Results: One hundred and forty children were included. The mean (±SD) age and weight of patients were 3.0 ± 2.9 years and 16 ± 9 kg; 26% had leukocytosis. The mean difference between obtaining results of capillary and venous blood tests was 2 ± 1 h. Area under the receiver operating characteristic curve (AUC) for the identification of leukocytosis using the capillary blood was 0.98 (95% CI 0.96–1.0). The sensitivity and specificity were 86 and 98%, respectively (accuracy 95%). The positive and negative predictive values were 94 and 95%, respectively. The intraclass correlation coefficient revealed high concordance between capillary and venous CBC measurements (leukocyte count 0.94, hemoglobin 0.88, erythrocyte count 0.77, hematocrit 0.79, platelet count 0.90). Matched pairs comparisons revealed marginally higher erythrocytes (difference of medians: 0.2 T/L), hemoglobin (0.3 g/dL), hematocrit (1.0%), and platelets (9 G/L) in the capillary blood.Conclusion: Capillary CBC is useful in detecting leukocytosis in children with AGE.

scholarly journals COVID-19 Seroprevalence among Healthcare Workers of a Large COVID-19 Hospital in Rome Reveals Strengths and Limits of Two Different Serological Tests

2021 ◽  
Vol 18 (5) ◽  
pp. 2650
Author(s):  
Giuseppe Vetrugno ◽  
Daniele Ignazio La Milia ◽  
Floriana D’Ambrosio ◽  
Marcello Di Pumpo ◽  
Roberta Pastorino ◽  
...  
Keyword(s):  
Blood Test ◽  
Healthcare Workers ◽  
Point Of Care ◽  
Venous Blood ◽  
Administrative Staff ◽  
Serological Tests ◽  
Predictive Values ◽  
Work From Home ◽  
Significant Difference ◽  
Sensitivity Specificity

Healthcare workers are at the forefront against COVID-19, worldwide. Since Fondazione Policlinico Universitario A. Gemelli (FPG) IRCCS was enlisted as a COVID-19 hospital, the healthcare workers deployed to COVID-19 wards were separated from those with limited/no exposure, whereas the administrative staff were designated to work from home. Between 4 June and 3 July 2020, an investigation was conducted to evaluate the seroprevalence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) immunoglobulin (IgG) antibodies among the employees of the FPG using point-of-care (POC) and venous blood tests. Sensitivity, specificity, and predictive values were determined with reverse-transcription polymerase chain reaction on nasal/oropharyngeal swabs as the diagnostic gold standard. The participants enrolled amounted to 4777. Seroprevalence was 3.66% using the POC test and 1.19% using the venous blood test, with a significant difference (p < 0.05). The POC test sensitivity and specificity were, respectively, 63.64% (95% confidence interval (CI): 62.20% to 65.04%) and 96.64% (95% CI: 96.05% to 97.13%), while those of the venous blood test were, respectively, 78.79% (95% CI: 77.58% to 79.94%) and 99.36% (95% CI: 99.07% to 99.55%). Among the low-risk populations, the POC test’s predictive values were 58.33% (positive) and 98.23% (negative), whereas those of the venous blood test were 92.86% (positive) and 98.53% (negative). According to our study, these serological tests cannot be a valid alternative to diagnose COVID-19 infection in progress.

Evaluation of the Capillary Microhematocrit as a Screening Test for Anemia in Pediatric Office Practice

PEDIATRICS ◽  
1986 ◽  
Vol 78 (2) ◽  
pp. 206-209
Author(s):  
Paul C. Young ◽  
Barbara Hamill ◽  
Richard C. Wasserman ◽  
Joseph D. Dickerman
Keyword(s):  
Lower Limit ◽  
Screening Test ◽  
Pediatric Patients ◽  
Capillary Blood ◽  
White Children ◽  
Predictive Values ◽  
Special Skill ◽  
Capillary Sample ◽  
Sensitivity Specificity ◽  
Lower Limit Of Normal

The capillary microhematocrit test is widely used to screen pediatric patients for anemia. Recently, it has been suggested that this method produces spuriously elevated values compared with venous hematocrits measured by a Coulter electronic counter and might consequently fail to detect children who are truly anemic. To address this issue we studied 66 white children 9 months to 14 years of age whose capillary hematocrits were either below, equal to, or one or two points above the lower limit of normal for age. Venous specimens were obtained simultaneously with the capillary sample; hemoglobin, hematocrit, and mean corpuscular volume results were obtained using a Coulter electronic counter. Using published standards of venous hemoglobin, we determined the sensitivity, specificity, and predictive values of the capillary microhematocrit in this population of patients with low or borderline values. Twenty of the 66 patients had venous hemoglobin values less than the lower limit of normal. The sensitivity of the microhematocrit was 90.0%; the specificity was 43.5%. The predictive values for a normal (negative) hematocrit was 90.1%; the predictive value for a low (positive) hematocrit was 40.9%. We conclude that the microhematocrit method using capillary blood will miss very few patients with significantly low venous hemoglobin values and is thus an acceptable screening test for anemia. Because it does not require expensive equipment or special skill to obtain the specimen or perform the test, it is ideal for physicians' offices or nonhospital-based clinics.

scholarly journals Capillary blood tests may overestimate ketosis: triangulation between three different measures of β-hydroxybutyrate

2020 ◽  
Vol 318 (2) ◽  
pp. E184-E188 ◽  
Author(s):  
Jakob Norgren ◽  
Shireen Sindi ◽  
Anna Sandebring-Matton ◽  
Ingemar Kåreholt ◽  
Ulrika Akenine ◽  
...  
Keyword(s):  
Regression Models ◽  
Ketone Body ◽  
Point Of Care ◽  
Venous Blood ◽  
Capillary Blood ◽  
Dietary Interventions ◽  
Healthy Older Adults ◽  
Time Points ◽  
Blood Tests ◽  
Good Agreement

The ketone body β-hydroxybutyrate (BHB), assessed by a point-of-care meter in venous whole blood (BHBv), was used as the main outcome in a study on nutritional ketosis in healthy older adults. Two other BHB measures were also used in the study for validation and exploratory purposes, and here we report findings on correlation and agreement between those three methods. Ketosis in the range of 0–1.5 mmol/L was induced in 15 healthy volunteers by intake of medium-chain fatty acids after a 12-h fast. BHBv was assessed at 12 time points for 4 h. The same point-of-care meter was also used to test capillary blood (BHBc) at three time points, and a laboratory test determined total ketones (TK) in plasma (BHBp + acetoacetate) at four time points. A total of 180 cases included simultaneous data on BHBv, BHBc, BHBp, and TK. TK correlated with BHBp (Pearson’s r = 0.99), BHBv ( r = 0.91), and BHBc ( r = 0.91), all P < 0.0001. BHBv and BHBp had good agreement in absolute values. However, the slope between BHBc and BHBv, measured with the same device, was in the range of 0.64–0.78 in different regression models, indicating substantially higher BHB concentrations in capillary versus venous blood. We conclude that all three methods are valid to detect relative changes in ketosis, but our results highlight the importance of method considerations and the possible need to adjust cutoffs, e.g., in the management of ketoacidosis and in the evaluation and comparison of dietary interventions.

scholarly journals Criterion validity of a Wechsler-III scale short form in a sample of Brazilian Elderly

2010 ◽  
Vol 4 (3) ◽  
pp. 207-213
Author(s):  
Eliane Ferreira Carvalho Banhato ◽  
Isabel Cristina Gonçalves Leite ◽  
Danielle Viveiros Guedes ◽  
Alfredo Chaoubah
Keyword(s):  
Short Form ◽  
Age Groups ◽  
The Elderly ◽  
Total Sample ◽  
Criterion Validity ◽  
Predictive Values ◽  
Clock Drawing Test ◽  
Sensitivity Specificity ◽  
Age Range ◽  
And Control

Abstract Although a normative process, changes in cognitive functioning vary among older adults. The differential diagnosis between normal and pathological aging must be made early using psychometrically adequate measures. Objectives: To assess the evidence of criterion validity of a Short Form (SF) of the Wechsler-III Scale containing eight subtests (SF8) by determining its sensitivity, specificity, positive and negative predictive values and cut-off points for Brazilian elderly from different age groups. Methods: 168 individuals, aged 60 years or above, living in the community or in an institution, were assigned to case and control groups, and investigated according to age range. Measures included a sociodemographic questionnaire, the Mini-Mental State Examination (MMSE), Verbal Fluency Test, Clock-Drawing Test and the SF8. Results: More than two thirds of the sample was women (73.8%), mean age was 74.5 years (SD=8.9), mean education was 6.2 years (SD=4.8) and 40.5% were widows/widowers. In the total sample, the best cut-off point for the SF8 was 142 while cut offs among individuals aged 60 to 69 years, 70 to 79 years, and more than 80 years were 160, 129 and 129, respectively. Conclusions: The results demonstrated the importance of different cut-off points for different age ranges. Sensitivity and specificity values of the SF8 were sufficiently high to warrant the use of the SF8 as an instrument to identify cognitive impairment in the elderly.

scholarly journals Agreement between fingertip-capillary and antecubital-venous appetite-related peptides

2014 ◽  
Vol 3 (4) ◽  
pp. 233-242 ◽  
Author(s):  
Benjamin Paul Green ◽  
Javier Thomas Gonzalez ◽  
Kevin Thomas ◽  
Emma Stevenson ◽  
Penny Louise Sheena Rumbold
Keyword(s):  
Venous Blood ◽  
Capillary Blood ◽  
Blood Sampling ◽  
Systematic Bias ◽  
Deming Regression ◽  
Methodological Approaches ◽  
Capillary Blood Sampling ◽  
Venous Blood Sampling ◽  
Good Agreement

This study examined the agreement between fingertip-capillary and antecubital-venous measures of appetite-related peptides. Simultaneous fingertip-capillary and antecubital-venous blood samples were collected from 19 participants. The samples were obtained at baseline, 30, 60, 90, and 120 min following breakfast for the determination of plasma GLP17–36, glucagon, insulin and leptin. Between-day reproducibility of fingertip-capillary-derived estimates was assessed in 18 participants. Deming regression, limits of agreement (LOA) and typical error as a coefficient of variation (CV) were used to quantify agreement (CVa) and reproducibility (CVr). Deming regression revealed no systematic bias for any of the analytes studied, but for insulin there was evidence of a proportional difference at higher concentrations. Measures of GLP17–36 (CVa=24.0%, LOA ±2.5 pg m/l per h), leptin (CVa=9.0%, LOA ×/÷1.19) and glucagon (CVa=21.0%, LOA, ±31.5 pg m/l per h) revealed good agreement between methodological approaches. Fingertip-capillary glucagon was highly reproducible between days (CVr=8.2%). GLP17–36 and leptin demonstrated modest reproducibility (CVr=22.7 and 25.0% respectively). For insulin, agreement (CVa=36.0%, LOA ×/÷1.79) and reproducibility were poor (CVr=36.0%). Collectively, the data demonstrate that fingertip-capillary blood sampling provides a comparable and reproducible alternative to antecubital-venous blood sampling for the quantification of glucagon, and to a lesser extent for GLP17–36 and leptin. Caution should be exercised when utilising fingertip-capillary blood sampling for insulin quantification, and consequently should not be employed interchangeably with antecubital-venous blood sampling.

scholarly journals LUTS-V: A New Simplified Score for Assessing Lower Urinary Tract Symptoms in Men

2020 ◽  
Author(s):  
Caroline Santos Silva ◽  
Ueslei Menezes de Araujo ◽  
Mateus Andrade Alvaia ◽  
Kátia Santana Freitas ◽  
Cristiano Mendes Gomes ◽  
...  
Keyword(s):  
Diagnostic Accuracy ◽  
Roc Curve ◽  
Predictive Value ◽  
Altman Analysis ◽  
Predictive Values ◽  
Bland Altman Analysis ◽  
Discriminating Power ◽  
Urinary Tract Symptoms ◽  
Sensitivity Specificity ◽  
Good Agreement

ABSTRACTOBJECTIVETo validate a new simplified score for the assessment of men with LUTS (LUTS-V).METHODSWe made adjustments to the VPSS, resulting in a new simplified instrument (LUTS visual score – LUTS-V). In a pilot study, LUTS-V was administered to 50 men to identify interpretation issues. We used the International Prostate Symptom Score (IPSS) as the gold standard to validate the new tool in 306 men. The total IPSS and LUTS-V scores for each subject were evaluated and we used Bland-Altman analysis and Pearson’s correlation plot to assess the agreement between the scores. A ROC curve was utilized to determine the diagnostic accuracy of LUTS-V and its diagnostic properties were described in terms of sensitivity, specificity, positive and negative predictive values.RESULTSMedian age was 59 [52-67] years and, according to the IPSS, 26 (8.7%) patients had severe symptoms, while 99 (33%) had moderate symptoms, and 175 (58.3%) had mild symptoms. We found a positive correlation between the IPSS and LUTS-V (r = 0.72; p < 0.0001). Bland-Altman analysis showed good agreement between the two questionnaires. We found LUTS-V to have a diagnostic accuracy to detect more severe cases of 83% (95% CI: [78-87%]; p < 0.001), as estimated by the area under the ROC curve. The cut-off value of ≥ 4 points was the best threshold, with a sensitivity of 74% and a specificity of 78%, which resulted in a negative predictive value of 81% and a positive predictive value of 71% in this scenario. Median completion time was 0.51 [0.41-1.07] min for LUTS-V and 2.5 [2.2-3.4] min for the IPSS (p < 0.0001). In addition, 91.5% of patients completed the questionnaires with no help, while the other 8.5% were interviewed.CONCLUSIONLUTS-V is a simple, self-administered tool with a significant discriminating power to identify patients with moderate to severe symptoms.

scholarly journals Performance of the hematology analyzer XN-31 prototype in the detection of Plasmodium infections in an endemic region of Colombia

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Lina Zuluaga-Idárraga ◽  
Alexandra Rios ◽  
Verónica Sierra-Cifuentes ◽  
Edwar Garzón ◽  
Alberto Tobón-Castaño ◽  
...  
Keyword(s):  
Urban Areas ◽  
Venous Blood ◽  
Intraclass Correlation ◽  
Average Difference ◽  
Endemic Region ◽  
Past Infection ◽  
Predictive Values ◽  
Cell Counts ◽  
Hematology Analyzer ◽  
Limited Sensitivity

AbstractEarly and accurate diagnosis is critical in reducing the morbidity and mortality associated with malaria. Microscopy (MI) is the current diagnostic gold standard in the field; however, it requires expert personnel, is time-consuming, and has limited sensitivity. Although rapid diagnostic tests for antigen detection (RDTs) are an alternative to diagnosis, they also have limited sensitivity and produce false positive results in detecting recent past infection. The automated hematology analyzer XN-31 prototype (XN-31p) (Sysmex Corporation, Kobe, Japan) is able to identify plasmodium-infected erythrocytes, count parasitemia and perform complete blood-cell counts within one minute. The performance of the XN-31p in diagnosing malaria was evaluated and compared with real-time polymerase chain reaction (qPCR), MI and RDT in an endemic area of Colombia where Plasmodium falciparum and Plasmodium vivax are present. Acute febrile patients were enrolled from July 2018 to April 2019 in Quibdó, Colombia. Malaria diagnoses were obtained from MI and RDT in the field and later confirmed by qPCR. Venous blood samples in EDTA were processed with an XN-31p in the field. Sensitivity, specificity, positive/negative predictive values, and the likelihood ratios of positive and negative tests were calculated with respect to the results from qPCR, MI and RDT. The intraclass correlation coefficient (ICC) and Bland–Altman plot were used to evaluate the concordance in the parasitemia with respect to MI. A total of 1,754 subjects were enrolled. The mean age was 27.0 years (IQR 14–44); 89.6% were Afro-Colombians, 94.3% lived in urban areas and 0.91% were pregnant. With respect to qPCR, the XN-31p showed a sensitivity of 90% (95% CI 87.24–92.34) and a specificity of 99.83% (95% CI 99.38–99.98) in detecting Plasmodium spp.; both parameters were equivalent to those for MI and RDT. Using MI as the reference, the XN-31p showed a sensitivity of 98.09% (95% CI 96.51–99.08), a specificity of 99.83% (95% CI 99.4–99.98), an ICC of 0.85 (95% CI 0.83–0.87) and an average difference of − 3096 parasites/µL when compared with thick-smear MI and an ICC of 0.98 (95% CI 0.97–0.98) and an average difference of − 0.0013% when compared with thin-smear MI. The XN-31p offers a rapid and accurate alternative method for diagnosing malaria in clinical laboratories in areas where P. falciparum and P. vivax cocirculate.

scholarly journals Use of filter paper for sample collection and transport in steroid pharmacology

1997 ◽  
Vol 43 (8) ◽  
pp. 1408-1415 ◽  
Author(s):  
Christopher J Howe ◽  
David J Handelsman
Keyword(s):  
Filter Paper ◽  
Pharmacological Study ◽  
Venous Blood ◽  
Field Studies ◽  
Dried Blood Spots ◽  
Capillary Blood ◽  
Sample Collection ◽  
Blood Spots ◽  
Adverse Environmental Conditions ◽  
Good Agreement

Abstract Field studies of androgen pharmacology are complicated by the necessity to collect, process, and store blood samples in a central facility. We have assessed the feasibility of using capillary blood spots collected by fingerprick and dried on filter paper for pharmacokinetics and pharmacodynamic measurements with nandrolone and testosterone RIAs modified for extracts from capillary blood spots. Assays on punched spots of 7.9-mm diameter (14.9 μL of dried blood) permitted accurate quantification of testosterone down to 0.4 nmol/L from a single spot and nandrolone down to 0.9 nmol/L from two spots. Stability of the steroids in dried blood spots to adverse environmental conditions, notably increased temperatures, was investigated both in the laboratory and in field studies of dried spots sent through the postal system. Storage or postal transport under moderate conditions appeared to have no deleterious effects on apparent androgen concentrations. However, under extreme conditions of storage at 50 °C for a week or more, or transport to a very hot tropical location, a rise in the final concentration of nandrolone, and, to a lesser extent, testosterone when corrected for tracer recovery, was noticed. These effects were largely due to apparent susceptibility of tritiated tracer, but not unlabeled androgens, to thermal degradation. In a pilot pharmacological study involving intramuscular injection of 100 mg of nandrolone decanoate in 1 mL of arachis oil, nandrolone concentrations in concurrently collected plasma as well as venous and capillary blood spots showed good agreement. Testosterone concentrations in contemporaneously collected plasma and venous blood spots also showed very good agreement. We propose that these methods may allow patients and experimental subjects to self-collect samples at remote or field locations for convenient mailing to a central laboratory for androgen assay. Applications of this methodology are now under way.

scholarly journals Diagnosis of bacterial vaginosis: Comparison of Nugent and novel microscopic method

2020 ◽  
pp. 105-105
Author(s):  
Dane Nenadic ◽  
Snezana Ribis ◽  
Milos Pavlovic ◽  
Dejan Baskic
Keyword(s):  
Bacterial Vaginosis ◽  
Scoring System ◽  
Relative Number ◽  
High Sensitivity ◽  
Kappa Index ◽  
Predictive Values ◽  
Microscopy Method ◽  
Index Sensitivity ◽  
Sensitivity Specificity ◽  
Good Agreement

Background/Aim: Bacterial vaginosis (BV) is common cause of vaginal discomfort in women. The aim of this study was comparison of Nugent's scoring system and novel microscopy method, introduced in our laboratory and used in BV diagnosis. Methods: 705 pregnant and asymptomatic women between 24 and 28 weeks of pregnancy participated in this prospective study. Degree of agreement between methods was determined by kappa index. Sensitivity, specificity, positive and negative predictive value of novel microscopy method was compared to Nugent's score as standard. Results: Based on scoring system of both methods, Nugent and novel microscopy method, BV was diagnosed in 21%, and 25% of women, respectively. Despite the disparities among diagnostic criteria, which mainly concerned classification of intermediary samples, the degree of agreement between categories, determined by kappa index, was satisfactory: Nugent vs novel microscopy method (?=0,68; good agreement), and Nugent vs novel microscopy method without intermediary results (?=0,83; very good agreement). We also demonstrated that compared to Nugent, as golden standard, novel microscopy method had high sensitivity and specificity (ranging from 75%-99.3%), and positive and negative predictive values (ranging from 88.8%-99.5%). Conclusion: novel microscopy method in diagnosis of BV, corresponded well with Nugent's scoring system which allows it to be an alternative method in diagnosing of BV. Our method is based on relative number of bacterial morphotypes, either rod forms (? 1.5?m, lactobacilli) or non-rod forms (< 1.5?m, bacterial vaginosis associated bacteria) under 200x magnification, which extends the surface of examined preparation, but without prolongation of observer's working time. Furthermore, novel microscopy method appeared to be flexible and can be reorganized in the way to categorize findings into only two groups: normal and BV, which makes it comparable to dichotomous Amsel's clinical criterion.

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