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Licensed Unlicensed Requires Authentication Published by De Gruyter November 6, 2019

Measurement accuracy of two professional-use systems for point-of-care testing of blood glucose

  • Annette Baumstark , Nina Jendrike , Ulrike Kamecke , Christina Liebing , Stefan Pleus ORCID logo EMAIL logo and Guido Freckmann ORCID logo

Abstract

Background

The professional-use systems HemoCue® Glucose 201+ (HC201+) and HemoCue® Glucose 201 RT (HC201RT) are widely used for point-of-care testing (POCT) of blood glucose (BG). HC201RT utilizes unit-use microcuvettes which can be stored at room temperature, whereas HC201+ microcuvettes have to be stored at <8 °C. In this study, system accuracy of HC201+ and HC201RT was evaluated using capillary and venous blood samples.

Methods

For each system, two reagent system lots were evaluated within a period of 2 years based on testing procedures of ISO 15197:2013, a standard applicable for self-monitoring of blood glucose (SMBG) systems. For each reagent system lot, the investigation was performed by using 100 capillary and 95 to 99 venous blood samples. Comparison measurements were performed with a hexokinase laboratory method. Accuracy criteria of ISO 15197:2013 and POCT12-A3 were applied. In addition, bias was analyzed according to Bland and Altman, and error grid analysis was performed.

Results

When measuring capillary samples, both systems fulfilled accuracy requirements of ISO 15197:2013 and POCT12-A3 with the investigated reagent system lots. When measuring venous samples, only HC201+ fulfilled these requirements. Bias between HC201+ and reference measurements was more consistent over venous and capillary samples and microcuvette lots than for HC201RT. Error grid analysis showed that clinical actions might have been different depending on which system was used.

Conclusions

In this study, HC201+ showed a high level of accuracy irrespective of the sample type (capillary or venous). In contrast, HC201RT measurement results were markedly affected by the type of sample.


Corresponding author: Stefan Pleus, MSc, Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Lise-Meitner-Str. 8/2, Ulm, Germany, Phone: +49 731 509900, Fax: +49 731 5099022

Acknowledgments

We would like to thank the study personnel who conducted the study.

  1. Author contributions: All the authors have accepted responsibility for the entire content of this submitted manuscript and approved submission.

  2. Research funding: None declared.

  3. Employment or leadership: All authors were employees of Institut für Diabetes-Technologie, Forschungs- und Entwicklungsgesellschaft mbH an der Universität Ulm, Ulm, Germany (IDT) at the time the study was conducted.

  4. Honorarium: GF is general manager of the IDT, which carries out clinical studies on the evaluation of BG meters and medical devices for diabetes therapy on its own initiative and on behalf of various companies. GF/IDT have received speakers’ honoraria or consulting fees from Abbott, Ascensia, Dexcom, LifeScan, Menarini Diagnostics, Metronom Health, Novo Nordisk, Roche, Sanofi, Sensile and Ypsomed.

  5. Competing interests: The funding organization(s) played no role in the study design; in the collection, analysis, and interpretation of data; in the writing of the report; or in the decision to submit the report for publication.

References

1. Kleinwechter H. POCT zur Diabetes-Diagnostik mit Blutglukose – Pro. Diabetologie 2012;7:387–9.10.1055/s-0032-1325425Search in Google Scholar

2. Kerner W. POCT zur Diabetes-Diagnostik mit Blutglukose – Kontra. Diabetologie 2012;7:390–1.10.1055/s-0032-1325424Search in Google Scholar

3. Klein FK, Groten T, Schleußner E, Wolf G, Battefeld W. Analytic issues in the diagnosis of GDM – comparison of 6 analytical methods for plasma glucose. Diabetologie 2016;11:155–62.10.1055/s-0041-109980Search in Google Scholar

4. Rajadhyaksha A, Rodriguez M, Nichols JH. Evaluation of the HemoCue Glucose 201 room temperature microcuvettes. Point Care 2008;7:12–5.10.1097/POC.0b013e3181634e16Search in Google Scholar

5. Segerhag E, Gyberg V, Ioannides K, Jennings C, Ryden L, Stagmo M, et al. Accuracy of a simplified glucose measurement device – the HemoCue Glucose 201RT. Diabetes Technol Ther 2015;17:755–8.10.1089/dia.2014.0354Search in Google Scholar PubMed

6. Kos S, van Meerkerk A, van der Linden J, Stiphout T, Wulkan R. Validation of a new generation POCT glucose device with emphasis on aspects important for glycemic control in the hospital care. Clin Chem Lab Med 2012;50:1573–80.10.1515/cclm-2011-0900Search in Google Scholar PubMed

7. Shahim B, Kjellstrom B, Gyberg V, Jennings C, Smetana S, Ryden L. The accuracy of point-of-care equipment for glucose measurement in screening for dysglycemia in patients with coronary artery disease. Diabetes Technol Ther 2018;20:596–602.10.1089/dia.2018.0157Search in Google Scholar PubMed

8. Bundesärztekammer. Richtlinie der Bundesärztekammer zur Qualitätssicherung laboratoriumsmedizinischer Untersuchungen. Dtsch Arztebl 2014;111:1583–618.Search in Google Scholar

9. Revision of the “Guideline of the German Medical Association on Quality Assurance in Medical Laboratory Examinations – Rili-BAEK” (unauthorized translation). J Lab Med 2015;39:26–69.10.1515/labmed-2014-0046Search in Google Scholar

10. Clinical and Laboratory Standards Institute. Point-of-care blood glucose testing in acute and chronic care facilities; approved guideline – third edition. CLSI document POCT12-A3. Wayne, PA; 2013Search in Google Scholar

11. International Organization for Standardization. In vitro diagnostic test systems – requirements for blood-glucose monitoring systems for self-testing in managing diabetes mellitus. ISO 15197:2013.Search in Google Scholar

12. 510(k) substantial equivalence determination – Decision summary – Assay and instrument combination template (2006). US Food and Drug Administration. Available at: https://www.accessdata.fda.gov/cdrh_docs/reviews/K060765.pdf. Accessed: 18 Apr 2018.Search in Google Scholar

13. RELA – IFCC external quality assessment scheme for reference laboratories in laboratory medicine. Referenzinstitut für Bioanalytik. Available at: www.dgkl-rfb.de. Accessed: 18 Apr 2018.Search in Google Scholar

14. International Organization for Standardization. In vitro diagnostic test systems – requirements for blood-glucose monitoring systems for self-testing in managing diabetes mellitus (ISO 15197:2013). EN ISO 15197:2015.Search in Google Scholar

15. Freckmann G, Schmid C, Baumstark A, Pleus S, Link M, Haug C. Partial pressure of oxygen in capillary blood samples from the fingertip. J Diabetes Sci Technol 2013;7:1648–9.10.1177/193229681300700627Search in Google Scholar PubMed PubMed Central

16. Parkes JL, Slatin SL, Pardo S, Ginsberg BH. A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose. Diabetes Care 2000;23:1143–8.10.2337/diacare.23.8.1143Search in Google Scholar PubMed

17. Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;327:307–10.10.1016/j.ijnurstu.2009.10.001Search in Google Scholar

18. Neumaier M, Luppa PB, Koschinsky T, Siegel E, Freckmann G, Heinemann L. Aktualisierte Anforderungen an die Messqualität und Qualitätssicherung (QS) von Point-of-care-testing(POCT)-Blutglukose-Messsystemen mit Unit-use-Reagenzien, die für die Erstdiagnostik eines manifesten Diabetes in der Schwangerschaft oder eines Gestationsdiabets mellitus (GDM) gemäß der GDM-Leitlinie der Deutschen Diabetes Gesellschaft (DDG) geeignet sind. Diabetologie 2015;10:197–9.10.1055/s-0035-1553518Search in Google Scholar

19. Baumstark A, Pleus S, Schmid C, Link M, Haug C, Freckmann G. Lot-to-lot variability of test strips and accuracy assessment of systems for self-monitoring of blood glucose according to ISO 15197. J Diabetes Sci Technol 2012;6:1076–86.10.1177/193229681200600511Search in Google Scholar PubMed PubMed Central

20. Kristensen GB, Christensen NG, Thue G, Sandberg S. Between-lot variation in external quality assessment of glucose: clinical importance and effect on participant performance evaluation. Clin Chem 2005;51:1632–6.10.1373/clinchem.2005.049080Search in Google Scholar PubMed

21. Freckmann G, Schmid C, Pleus S, Baumstark A, Link M, Stolberg E, et al. 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. Clin Chem Lab Med 2014;52:1079–86.10.1515/cclm-2013-0976Search in Google Scholar PubMed

22. Kleinwechter HJ, Schäfer-Graf U, Bührer C, Hoesli I, Kainer F, Kautzky-Willer A, et al. Gestationsdiabetes mellitus (GDM). Evidenzbasierte Leitlinie zu Diagnostik, Therapie u. Nachsorge der Deutschen Diabetes-Gesellschaft und der Deutschen Gesellschaft für Gynäkologie und Geburtshilfe (DGGG). 2011. Available at: http://www.deutsche-diabetes-gesellschaft.de/fileadmin/Redakteur/Leitlinien/Evidenzbasierte_Leitlinien/Gestationsdiabetes_EbLL_Endfassung_2011_08_11_.pdf. Accessed: 19 Apr 2018.Search in Google Scholar

23. Bukve T, Sandberg S, Vie WS, Solvik U, Christensen NG, Stavelin A. Commutability of a whole-blood external quality assessment material for point-of-care c-reactive protein, glucose, and hemoglobin testing. Clin Chem 2019;65:791–7.10.1373/clinchem.2018.300202Search in Google Scholar PubMed

24. Reddy VR, M ES, Gowda YC, Suhail SM. 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). J Clin Diagn Res 2014;8:PC10–3.Search in Google Scholar

25. Ignell C, Berntorp K. Evaluation of the relationship between capillary and venous plasma glucose concentrations obtained by the Hemocue glucose 201+ system during an oral glucose tolerance test. Scand J Clin Lab Invest 2011;71:670–5.10.3109/00365513.2011.619703Search in Google Scholar PubMed

Received: 2019-06-04
Accepted: 2019-10-01
Published Online: 2019-11-06
Published in Print: 2020-02-25

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