The evaluation of Accu-Chek Inform II® and Hexokinase Method in Emergency Departments for Glucose Measurement
AbstractObjective: Glycemic control has a critical role especially in surgical and medical intensive care units and emergency departments (ED), so point-of-care (POC) glucose monitoring has become increasingly important. The aim of our study was to compare the glucose levels of emergency patients, measured with the Accu-Chek Inform II® and hexokinase reference method.Methods: One-hundred-four patients’ glucose levels were studied with hexokinase method in Abbott Architect C16000 device and Accu-Chek Inform II®. The results were analyzed with Error Grid method. Agreement between the systems was assessed using Bland- Altman and Passing-Bablok regression analysis.Results: Among 104 patients, the mean participant age was 43.6 ± 15.7 years. Mean glucose levels measured with Accu-Chek Inform II® glucose and reference method were 180.67mg/dL ± 12.57 and 194.26mg/dL ± 14.55, respectively. There was no statistically significant difference between the groups (P>0.05). These two systems’ R2 value was found to be 0.967 (95% CI, 0.952-0,977). The regression equation was Y=9,46+0.88213X. The error grid analysis showed that 98% of the results fell in the Zone A (89%) and Zone B (9%). Two percent of the results was located in Zone C.Conclusion: The performance of the Accu-Chek Inform II® System was found to be reliable according to currently used reference methods in central laboratories.
Lockyer MG, Fu K, Edwards RM et al. Evaluation of the Nova StatStrip glucometer in a pediatric hospital setting. Clin Biochem. 2014 Jan 20. pii: S0009-9120(14)00007-1. doi: 10.1016/j.clinbiochem.2014.01.004.
Ghys T, Goedhuys W, Spincemaille K, Gorus F, Gerlo E. Plasma-equivalent glucose at the point-of-care: evaluation of Roche Accu-Chek Inform and Abbott Precision PCx glucose meters. Clin Chim Acta. 2007;386:63-8.
Yuoh C, Tarek Elghetany M, Petersen JR, Mohammad A, Okorodudu AO Accuracy and precision of point-of-care testing for glucose and prothrombin time at the critical care units. Clin Chim Acta. 2001;307:119-23.
Karon BS, Gandhi GY, Nuttall GA et al. Accuracy of roche accu-chek inform whole blood capillary, arterial, and venous glucose values in patients receiving intensive intravenous insulin therapy after cardiac surgery.Am J Clin Pathol. 2007;127:919-26.
D'Orazio P, Burnett RW, Fogh-Andersen N et al. Approved IFCC recommendation on reporting results for blood glucose (abbreviated). International Federation of Clinical Chemistry Scientific Division Working Group on Selective Electrodes and Point of Care Testing. Clin Chem. 2005;51:1573-6.
Solnica B, Naskalski JW, Sieradzki J.Analytical performance of glucometers used for routine glucose self-monitoring of diabetic patients. Clin Chim Acta. 2003;331:29-35.
Arabadjief D, Nichols JH. Assessing glucose meter accuracy. Curr Med Res Opin. 2006 ;22:2167-74.
Tholen D.W, Kallner A, Kenndy J. W, Krouwer J.S, Meier K. EP5-A2 Evaluation of Precission Performance of Quantitative Measurment Methods;Approved Guideline- Second Edition Volume 24 Number 25
Clarke WL, Cox D, Gonder-Frederick LA, Carter W, Pohl SL Evaluating clinical accuracy of systems for self monitoring of blood glucose. Diabetes Care 1987;10:622–8.
Cox DJ, Gonder-Frederick LA, Kovatchev BP, Julian DM, Clarke WL. Understanding error grid analysis. Diabetes Care 1997;20:911–2.
Harrison B, Markes R, Bradley P, Ismail IA. A comparison of statistical techniques to evaluate the performance of the Glucometer Elite blood glucose meter. Clin Biochem. 1996 ;29:521-7.
Bland JM, Altman DG. Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1986;1:307-10.
Karon BS, Gandhi GY, Nuttall GA et al. Accuracy of roche accu-chek inform whole blood capillary, arterial, and venous glucose values in patients receiving intensive intravenous insulin therapy after cardiac surgery. Am J Clin Pathol. 2007;127:919-26.
Tsao LY, Chang MY, Hsiao CC. The accuracy of a glucose-oxidase-based point-of-care glucometer in premature infants. Arch Dis Child Fetal Neonatal Ed. 2013 ;98:F545-8.
Kanji S, Buffie J, Hutton B et al. Reliability of point of care testing for glucose measurement in critically ill adults. Crit Care Med. 2005;33:2778-85.
R Boyd, B Leigh, P Stuart Capillary versus venous bedside blood glucose estimations. Emerg Med J 2005;22:177–179.
Sylvain HF, Pokorny ME, English SM et al. Accuracy of fingerstick glucose values in shock patients. Am J Crit Care. 1995 ;4:44-8.
Brunner GA, Ellmerer M, Sendlhofer G et al. Validation of home blood glucose meters with respect to clinical and analytical approaches. Diabetes Care 1998;21:585-90.
Chan JC, Wong RY, Cheung CK et al. Accuracy, precision and user-acceptability of self blood glucose monitoring machines. Diabetes Res Clin Pract 1997;36:91- 104.
Kost GJ1, Tran NK, Abad VJ, Louie RF. Evaluation of point-of-care glucose testing accuracy using locally-smoothed median absolute difference curves. Clin Chim Acta. 2008 ;389:31-9.
Pfützner A, Hengesbach C, Demircik F, Schipper C, Forst T, Musholt PB. Performance of blood glucose meters in compliance with current and future clinical ISO15197 accuracy criteria. Curr Med Res Opin. 2014;30:185-90
All opinions and reports within the articles that are published in the Gazi Medical Journal are the personal opinions of author(s). Gazi University, Editors and the publisher do not accept any responsibility for these articles. The journal is printed on acid-free paper.