Evaluation of the agreement between a point‐of‐care lactate meter and a handheld laboratory analyzer in cats treated in emergency practice

2019 ◽  
Vol 30 (1) ◽  
pp. 50-53 ◽  
Author(s):  
Mark J. Acierno ◽  
Aubrey Hirsch ◽  
Andrea Dedeaux
Keyword(s):  
Point Of Care ◽  
Laboratory Analyzer

Assessment of a Veterinary Dipstick for Determination of Urine Protein/Creatinine Ratio in Canines

2014 ◽  
Vol 50 (5) ◽  
pp. e11-e14 ◽  
Author(s):  
Christina Mamone ◽  
Mark Mitchell ◽  
Hugues Beaufrere ◽  
Mark Acierno
Keyword(s):  
Point Of Care ◽  
Clinical Pathology ◽  
Ordinal Scale ◽  
Creatinine Ratio ◽  
Urine Protein ◽  
Pathology Laboratory ◽  
The Individual ◽  
Glomerular Barrier ◽  
Laboratory Analyzer

The urine protein/creatinine ratio (UPC) is a widely used screening test of glomerular barrier function. It usually requires sending urine samples to a distant laboratory, which is costly and time consuming. A point-of-care urine dipstick that could accurately measure UPC would increase test utility and utilization. The objective of this study was to determine if there was good correlation and agreement between UPC as measured by a dipstick and a laboratory analyzer. Thirty-one canines undergoing UPC measurement as part of a diagnostic workup were included in the study. A total of 2 mL of urine was collected via cystocentesis. Urine was applied to the dipstick then presented to two blinded reviewers to analyze. The remaining urine was submitted to a clinical pathology laboratory for analysis. UPC data from the dipsticks and the analyzer was converted into an ordinal scale. Correlation and agreement between the individual reviews and the analyzer was calculated. Agreement between reviewers was substantial; however, correlation and agreement between the individual reviews and the analyzer was low. On the basis of this information, use of this veterinary urinary dipstick to determine UPC cannot be recommended at this time.

scholarly journals Potential Inaccuracies in Chloride Measurements in Patients with Severe Metabolic Acidosis

2012 ◽  
Vol 2012 ◽  
pp. 1-7 ◽  
Author(s):  
Tetsuya Makiishi ◽  
Naomasa Nishimura ◽  
Keiko Yoshioka ◽  
Shinya Yamamoto ◽  
Ryuichi Mitsuhashi ◽  
...  
Keyword(s):  
Point Of Care ◽  
Blood Gas ◽  
Central Laboratory ◽  
Gas Analyzer ◽  
Severe Metabolic Acidosis ◽  
Acid Base ◽  
Factors Associated ◽  
Acid Base Status ◽  
Blood Gas Analyzer ◽  
Laboratory Analyzer

Background. To address the cause(s) of the significant differences in chloride (Cl-) concentrations between point-of-care blood gas analyzers and central laboratory analyzers.Methods. Cl-concentrations measured simultaneously by a blood gas analyzer (ABL800 FLEX) and a central laboratory analyzer (Hitachi7600) were collected in patients with severe acidemia (pH<7.20) (n=32) and were examined for correlations between differences in Cl-and factors associated with the acid-base status. Cl-concentrations were measured with both analyzers for samples with different concentrations of lactate, inorganic phosphate, or bicarbonate (HCO3   −).Results. The differences in Cl-concentrations were correlated withHCO3   −concentrations (r=0.72,P<0.0001) and anion gap (r=0.69,P<0.0001). Only the addition ofHCO3   −proportionately increased Cl-levels measured by a Hitachi7600, but it did not affect those measured by an ABL800FLEX.Conclusion. Cl-measurements with some analyzers may be influenced byHCO3   −concentrations, which could result in the observed discrepancies.

The Variability of Results Between Point-of-Care Testing Glucose Meters and the Central Laboratory Analyzer

2006 ◽  
Vol 130 (10) ◽  
pp. 1527-1532
Author(s):  
Adil I. Khan ◽  
Yolanda Vasquez ◽  
Jacquelyn Gray ◽  
Frank H. Wians Jr ◽  
Martin H. Kroll
Keyword(s):  
Whole Blood ◽  
Point Of Care ◽  
Clinical Results ◽  
Central Laboratory ◽  
Point Of Care Testing ◽  
Blood Samples ◽  
Glucose Meter ◽  
Whole Blood Samples ◽  
Blood Specimens ◽  
Laboratory Analyzer

Abstract Context.—Point-of-care testing glucose meters are strongly recommended in the management of diabetes and are increasingly being used for making therapeutically important decisions. Thus, it is essential that their results correlate well with those of laboratory analyzers. Objectives.—To test the reliability of point-of-care testing glucose meters. Design.—Two studies were performed: (1), an in-house study comparing accuracy of point-of-care testing glucose meters with a reference analyzer using fresh whole blood specimens (2), a real-time comparison of (a) 2 successive glucose meter readings and (b) glucose meter reading to central laboratory analyzer reading. Setting.—(1), Seven glucose meters from 4 manufacturers were compared with the Yellow Springs YSI 2300 blood glucose analyzer using whole blood without preservative. (2), (a) Whole blood samples were read within 5 minutes of each other using Accu-Chek meters and (b) between a glucose meter and a Hitachi laboratory analyzer. Results.—(1) Within the Accu-Chek group of glucose meters, fresh, preservative-free whole blood samples showed the lowest bias. (2) At the hypoglycemic level, successive glucose meter readings agreed well, but there was considerable disagreement between glucose meter and central laboratory values. Because laboratory analyzers are of proven accuracy, they are used as the reference. In the glucose meter–central laboratory analyzer correlation, for both hypoglycemic and hyperglycemic values, readings in which the differences were greater than 10% occurred more than 61% of the time. In the hypoglycemic range, differences greater than 20% occurred 57% of the time. Conclusions.—One should scrutinize point-of-care testing glucose meter readings at the hypoglycemic and hyperglycemic levels and whenever possible to corroborate these clinical results with central laboratory analyzers.

scholarly journals Performance of the microINR Point-of-Care System Used by Self-Testing Patients: A Multicenter Clinical Trial

TH Open ◽  
2021 ◽  
Vol 05 (04) ◽  
pp. e577-e584
Author(s):  
Majed A. Refaai ◽  
Alan K. Jacobson ◽  
Jack C. Rosenfeld ◽  
Robert R. Orr
Keyword(s):  
Point Of Care ◽  
Venous Blood ◽  
International Normalized Ratio ◽  
System A ◽  
Medical Centers ◽  
Accuracy And Precision ◽  
Self Testing ◽  
Point Of Care System ◽  
Anticoagulated Patients ◽  
Laboratory Analyzer

Abstract Introduction Anticoagulation monitoring is a major practical and clinical challenge. We assessed the performance of the microINR system in patient self-testing (PST). Methods This study was performed at four US medical centers. After the training visit of warfarin anticoagulated patients (n = 117) on microINR system, PST was performed at home and in two visits to the medical centers. At the medical centers, both PST and healthcare professionals (HCPs) performed duplicate tests with the microINR System. A venous blood sample for the laboratory testing was also extracted. Accuracy and precision were assessed. Results The comparison between microINR PST results and microINR HCP results revealed an equivalence with a slope of 1.00 (95% confidence interval [CI]: 1.00–1.00), and an intercept of 0.00 (95% CI: 0.00–0.00). When compared with the laboratory analyzer, microINR PST results also showed good correlation with a slope of 0.94 (95% CI: 0.86–1.04) and an intercept of 0.14 (95% CI: -0.09–0.34). Predicted bias values at international normalized ratio (INR) 2.0, 3.5, and 4.5 were 0% against HCP and ≤2.5% against the laboratory. Analytical agreement with both HCP and laboratory was 100% according to ISO17593 and 99.1 and 100% according to CLSI POCT14 with HCP and laboratory, respectively. Clinical agreement with HCP regarding 2.0–4.0 as INR therapeutic range was 98% (within range). The precision (coefficient of variation) of microINR system used by PST was comparable to HCP. Conclusion The microINR results when used by self-testing patients show satisfactory concordance to both HCP results and laboratory analyzer. The microINR system is adequate for self-testing use.

scholarly journals Prospective Comparison of Point-of-Care Device and Standard Analyzer for Monitoring of International Normalized Ratio in Outpatient Oral Anticoagulant Clinic

2018 ◽  
Vol 24 (7) ◽  
pp. 1153-1158 ◽  
Author(s):  
Bushra Moiz ◽  
Anila Rashid ◽  
Muhammad Hasan ◽  
Lena Jafri ◽  
Ahmed Raheem
Keyword(s):  
Point Of Care ◽  
Hospital Setting ◽  
International Normalized Ratio ◽  
Mean Difference ◽  
Altman Plot ◽  
Prospective Comparison ◽  
Self Testing ◽  
The Mean ◽  
Coaguchek Xs ◽  
Laboratory Analyzer

Point-of-care testing (POCT) coagulometers are increasingly being used in the hospital setting and patients’ self-testing. We determined the agreement of prothrombin time international normalized ratio (INR) results by POCT coagulometer and laboratory instrument through a comparative analysis and investigated whether the results of POCT coagulometer can reliably be used without being confirmed by standard laboratory analyzer. A total of 200 INR measurements by POCT coagulometer (CoaguChek XS Pro) and laboratory analyzer (Sysmex CS2000i) were compared using Passing-Bablok regression analysis and Bland-Altman plot. Agreement of the INR measurement was further analyzed in relation to dosing decision. The correlation of INR measurements between CoaguChek XS Pro and Sysmex CS2000i was excellent (correlation coefficient = 0.973). The overall mean difference was 0.21 INR ± 0.32 (range: 1.7-0.44). The mean difference was found to get increased as INR results increased and was 0.09 in the subtherapeutic range (≤1.9 INR), 0.29 INR in the therapeutic range (2.0-3.0 INR), while 0.4 INR in the supratherapeutic range (>3.0 INR). The overall agreement was excellent (κ = 0.916) and overall 11 (5.5%) of 200 INR measurements showed a difference in dosing decision between the 2 instruments. The positive bias of POC-INR is evident in the supratherapeutic range which could affect the dosing decision requiring confirmation with the laboratory INR measurement.

“Aspirin - resistance”? A few critical considerations on definition, terminology, diagnosis, clinical value, natural course of atherosclerotic disease, and therapeutic consequences

VASA ◽  
2011 ◽  
Vol 40 (6) ◽  
pp. 429-438 ◽  
Author(s):  
Berent ◽  
Sinzinger
Keyword(s):  
Platelet Function ◽  
Point Of Care ◽  
Aspirin Resistance ◽  
Point Of View ◽  
Evidence Based ◽  
Platelet Function Tests ◽  
Clinical Value ◽  
Vascular Events ◽  
Therapeutic Consequences ◽  
Function Tests

Based upon various platelet function tests and the fact that patients experience vascular events despite taking acetylsalicylic acid (ASA or aspirin), it has been suggested that patients may become resistant to the action of this pharmacological compound. However, the term “aspirin resistance” was created almost two decades ago but is still not defined. Platelet function tests are not standardized, providing conflicting information and cut-off values are arbitrarily set. Intertest comparison reveals low agreement. Even point of care tests have been introduced before appropriate validation. Inflammation may activate platelets, co-medication(s) may interfere significantly with aspirin action on platelets. Platelet function and Cox-inhibition are only some of the effects of aspirin on haemostatic regulation. One single test is not reliable to identify an altered response. Therefore, it may be more appropriate to speak about “treatment failure” to aspirin therapy than using the term “aspirin resistance”. There is no evidence based justification from either the laboratory or the clinical point of view for platelet function testing in patients taking aspirin as well as from an economic standpoint. Until evidence based data from controlled studies will be available the term “aspirin resistance” should not be further used. A more robust monitoring of factors resulting in cardiovascular events such as inflammation is recommended.

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