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Clinica Chimica Acta
Volume 365, Issues 1-2, March 2006, Pages 257-263
 
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doi:10.1016/j.cca.2005.09.003    How to Cite or Link Using DOI (Opens New Window)
Copyright © 2005 Elsevier B.V. All rights reserved.

Nurse-based evaluation of point-of-care assays for glycated haemoglobin

Andrew St Johna, Corresponding Author Contact Information, E-mail The Corresponding Author, Timothy M.E. Davisb, Ian Goodallc, Mary Anne Townsendd and Christopher P. Pricee

aARC Consulting, Perth, W Australia 6050, Australia

bUniversity of Western Australia, School of Medicine and Pharmacology, Fremantle Hospital, Fremantle, WA 6160, Australia

cDivision of Laboratory Medicine, Austin Health, Heidelberg, Victoria 3084, Australia

dDepartment of Biochemistry, Fremantle Hospital, Fremantle W Australia 6150, Australia

eDiagnostics Division, Bayer HealthCare, Strawberry Hill, Newbury, Berks, UK


Received 20 July 2005; 
revised 2 September 2005; 
accepted 2 September 2005. 
Available online 3 October 2005.

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Abstract

Background

Various devices are now available to measure glycated haemoglobin (HbA1c) outside of the laboratory. The aim of this study was to assess the performance of these point-of-care instruments in the hands of non-laboratory trained personnel.

Methods

Two nursing staff tested samples from patients attending a diabetes research clinic using the following point-of-care devices for HbA1c-Metrica A1C Now, Bayer DCA 2000, Cholestech GDX and Axis-Shield Nycocard HbA1c. In addition they performed regular analysis of quality control samples. The effects on analytical performance of multiple operators as well as laboratory-trained staff, were also assessed. All measurements were compared to a boronate-affinity HPLC method in the central laboratory.

Results

The mean HbA1c difference of the point-of-care devices compared to the laboratory reference method ranged from − 0.31% to + 0.39%. Only the DCA device had a between batch imprecision of less than 5%. The analytical performance obtained by laboratory staff was similar to nursing staff for 3 devices and better for the Nycocard device.

Conclusions

On the basis of the results obtained by nursing staff, only the DCA of the devices tested, can be recommended for measurement of HbA1c outside of the laboratory.

Keywords: Glycated haemoglobin; HbA1c; Point of care testing; Analytical evaluation

Article Outline

1. Introduction
2. Materials and methods
2.1. Subjects and sample collection
2.2. HbA1c methods
2.3. Study design
2.4. Data analysis
3. Results
3.1. General performance
3.1.1. A1C now
3.1.2. DCA
3.1.3. GDX
3.1.4. NycoCard
3.2. Assessment of accuracy and patient comparisons
3.3. Imprecision studies
3.4. Method manipulation studies
4. Discussion
Acknowledgements
References



Clinica Chimica Acta
Volume 365, Issues 1-2, March 2006, Pages 257-263
 
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