J Y Verbakel1, C Richardson2, T Elias3, J Bowen4, R Hassanzadeh5, B Shine6, I Smith7, G Hayward1, A Van den Bruel1, S T Pendlebury8, D Lasserson9. 1. MD, PhD, Nuffield Department of Primary Care Health Sciences, University of Oxford, Oxford, United Kingdom. 2. MBBS, Department of Infectious Diseases, Royal Free Hospital, London, UK. 3. MBBS MSc, Departments of acute general medicine and geratology, Oxford University Hospitals NHS Foundation Trust. 4. MBBS, Departments of acute general medicine and geratology, Oxford University Hospitals NHS Foundation Trust. 5. MBBS, Department of Primary Care and Public Health, Imperial College London, UK. 6. MB, ChB, MD, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford, UK. 7. BSc, Department of Clinical Biochemistry, Oxford University Hospitals NHS Trust, Oxford, UK. 8. FRCP, DPhil, Departments of acute general medicine and geratology, Oxford University Hospitals NHS Foundation Trust. 9. MA MBBS (Hons) MD FRCP Edin MRCGP, Nuffield Department of Medicine, Oxford University, Oxford, UK.
Abstract
OBJECTIVE: To ensure clinicians can rely on point-of-care testing results, we assessed agreement between point-of-care tests for creatinine, urea, sodium, potassium, calcium, Hb, INR, CRP and subsequent corresponding laboratory tests. PARTICIPANTS: Community-dwelling adults referred to a community-based acute ambulatory care unit. INTERVENTIONS: The Abbott i-STATTM (Hb, clinical chemistry, INR) and the AfinionTM Analyser (CRP) and corresponding laboratory analyses. OUTCOMES: Agreement (Bland-Altman) and bias (Passing-Bablok regression). RESULTS: Among 462 adults we found an absolute mean difference between point-of-care and central laboratory analyses of 6.4g/L (95%LOA -7.9 to +20.6) for haemoglobin, -0.5mmol/L (95%LOA -4.5 to +3.5) for sodium, 0.2mmol/L (95%LOA -0.6 to +0.9) for potassium, 0.0mmol/L (95%LOA -0.3 to +0.3) for calcium, 9.0 μmol/L (95%LOA -18.5 to +36.4) for creatinine, 0.0mmol/L (95%LOA -2.7 to +2.6) for urea, -0.2 (95%LOA -2.4 to +2.0) for INR, -5.0 mg/L (95%LOA -24.4 to +14.4) for CRP. CONCLUSIONS: There was acceptable agreement and bias for these analytes, except for haemoglobin and creatinine.
OBJECTIVE: To ensure clinicians can rely on point-of-care testing results, we assessed agreement between point-of-care tests for creatinine, urea, sodium, potassium, calcium, Hb, INR, CRP and subsequent corresponding laboratory tests. PARTICIPANTS: Community-dwelling adults referred to a community-based acute ambulatory care unit. INTERVENTIONS: The Abbott i-STATTM (Hb, clinical chemistry, INR) and the AfinionTM Analyser (CRP) and corresponding laboratory analyses. OUTCOMES: Agreement (Bland-Altman) and bias (Passing-Bablok regression). RESULTS: Among 462 adults we found an absolute mean difference between point-of-care and central laboratory analyses of 6.4g/L (95%LOA -7.9 to +20.6) for haemoglobin, -0.5mmol/L (95%LOA -4.5 to +3.5) for sodium, 0.2mmol/L (95%LOA -0.6 to +0.9) for potassium, 0.0mmol/L (95%LOA -0.3 to +0.3) for calcium, 9.0 μmol/L (95%LOA -18.5 to +36.4) for creatinine, 0.0mmol/L (95%LOA -2.7 to +2.6) for urea, -0.2 (95%LOA -2.4 to +2.0) for INR, -5.0 mg/L (95%LOA -24.4 to +14.4) for CRP. CONCLUSIONS: There was acceptable agreement and bias for these analytes, except for haemoglobin and creatinine.