Comparison of Erythrocyte Sedimentation Rate Results of Test-1 and Automatic Westergren Device with Reference Westergren Method
Abstract
Aim: International Council of Standardization in Hematology (ICSH) suggests Westergren method as a reference method in erythrocyte sedimentation rate (ESR) measurement. There are lots of modified methods and devices which use different sample types recently. We investigated to compare the devices which are present in our hospital; Test-1 device that uses samples with EDTA and the device which is compatible with automatic Westergren method that uses infrared technique and studies with citrated samples; by using the reference method that is Westergren method.
Method: From a total of 80 patients for ESR test, blood samples were taken at the same time into the tubes with K2EDTA and sodium citrate on 7 separate days; and after these blood samples arrived at our laboratory in 2 hours, they were studied with reference Westergren method and in Test-1 and automatic Westergren devices. These two methods were statistically compared with each other and also with the reference method by using concordance correlation coefficient and Passing-Bablok regression analysis method.
Results: ESR result values were dispersed in the interval of 1-78 mm/hour, while R2 values in the correlation of reference Westergren method with Test-1 and automatic Westergren devices were found as 0,86 (%95 Cl 0,801 to 0,913) and 0,978 (%95 Cl 0,967 to 0,985), respectively. R2 value in the correlation between two devices was found as 0,898 (%95 0,846 to 0,933). In the Passing Bablok analysis, in the regression analysis of devices with reference method, intercept for Test-1 device was found as -0,5 (%95 Cl -2,42- 0) and the slope was 1,09 (%95 Cl 1-1,21) (y=-0,5+1,09x). Intercept for automatic Westergren device was found as -0,25 (%95 Cl -1,26-0) and the slope was 1,03 (%95 Cl 1-1,08) (y=0,25+1,03x). Intercept for comparison of these two systems was found as -0,14(%95 Cl –1,01-0) and the slope was 1,02 (%95 Cl 1-1,17) (y=-0,14+1,02x). There was no significant difference between the groups with student t-test (p>0,05).
Conclusion: Test-1 method and automated Westergren method devices can be used reliably in the ESR measurement in routine laboratory as compared with reference Westergren method. At high ESR values Test-1 device has deviations from the reference method. We suggest that the evaluation of results of high sedimentation values be made carefully and for high ESR values comprehensive studies be supported by further research.
References
Jou JM, Lewis SM, Briggs C, Lee SH, De La Salle B, McFadden S. International Council for Standardization in Haematology. ICSH review of the measurement of the erythocyte sedimentation rate. Int J Lab Hematol 2011;33:125-32.
Brigden ML. Clinical utility of the erythrocyte sedimentation rate. Am Fam Physician 1999;60:1443-50.
Samir P Desai. Clinician’s Guide to Laboratory Medicine. 3rd edition.2004. Part VIII: Rheumatology.
Bochen K, Krasowka A, Milaniuk S, Kulczyńska M, Prystupa A, Dzida G. Erytrocyte sedimentation rate an old marker with new applications. Journal of Pre-clinical and Clinical Research 2011;5:50-5
Keopke J. Welcome innovation in erythrocyte sedimentation testing. Am J Clin Pathol 2002;118:11-2
ICSH recommendations for measurement of erythrocyte sedimentation rate. International Council for Standardization in Haematology (Expert Panel on Blood Rheology) J Clin Pathol 1993;46:198-203.
Plebani M, Piva E. Erythrocyte sedimentation rate: use of fresh blood for quality control. Am J Clin Pathol 2002;117:621-6.
Atas A, Cakmak A, Soran M, Karazeybek H. Comparative study between the Ves-matic and microerythrocyte sedimentation rate method. J Clin Lab Anal 2008;22:70-2.
Plebani M, De Toni S, Sanzari MC, Bernard D, Stockrelter E. The TEST 1 automated system: a new method for measuring the erythrocyte sedimentation rate. Am J Clin Pathol 1998;110;334-40
Passing H, Bablok W. A new biometrical procedure for testing the equality of measurements from two different analytical methods. Application of lineer regression procedures for method comparison studies in clinical chemistry. Part I. J Clin Chem Clin Biochem 1983;21:709-20
Aktaş M, Erçetin N, Çimen B, Kanık A, Eskandari G, Atik U. Westergren metodu ve Test-1 Cihazı ile Ölçülen Eritrosit Sedimentasyon Hızı Sonuçlarının Karşılaştırılması. Türk Klinik Biyokimya Dergisi 2004;2:29-33
Arıkan S, Akalın N. Comparison of the erythrocyte sedimentation rate measured by the Micro Test 1 sedimentation analyzer and the conventional Westergren method. Ann Saudi Med 2007;27:362-5.
Malin R, Wirta V, Hiltunen PT, Lehtimaki T. Erythrocyte Sedimentation Rate by the Test-1 Analyzer. Clinical Chemistry 2000:46:882-3.
Hardeman MR, Levitus M, Pelliccia A, Bouman AA. Test 1 analyser for determination of ESR. 1. Practical evaluation and comparison with the Westergren technique. Scand J Clin Lab Invest 2010;70:21-5.
Happe MR, Battafarano DF, Dooley DP, Rennie TA, Murphy FT, Casey TJ et al. Validation of the Diesse Mini-Ves erythrocyte sedimentation rate (ESR) analyzer using the Westergren ESR method in patients with systemic inflammatory conditions. Am J Clin Pathol 2002;118:14-7.
