Comparison of the Accu-Chek Aviva point-of-care glucometer with blood gas and laboratory methods of analysis of glucose measurement in equine emergency patients.

The research article compares the accuracy of glucose measurements in critically ill horses using various methods, including point-of-care glucometry, blood gas analysis, and standard laboratory techniques. It finds that glucometry with plasma shows excellent agreement with laboratory standards, as does blood gas analysis, but glucometry with whole blood shows poor correlation with these standards.

Research Objective

• The research aimed to evaluate the accuracy of common glucose measurement methods in critically ill horses, with the presumption of good agreement with laboratory standards. The researchers hypothesized that glucometry using plasma would provide a more accurate reading than glucometry with whole blood.

Research Methods

• Fifty equine emergency patients over one year of age were sequentially admitted for the study. At admission, venous blood samples were collected and immediately tested using different methods—point-of-care glucometry on both whole blood and plasma, multielectrode blood gas analyzer with whole blood, and standard laboratory analysis with plasma.
• To compare and evaluate the results, the researchers utilized Lin’s concordance correlation and Pearson’s correlation, as well as robust regression. The Bland-Altman technique tested bias and limits of agreement. Bivariate regression analysis was deployed to explore potential confounding factors.

Research Results

• The results exhibited significant concordance in all comparisons, with the highest agreement coming from standard laboratory techniques (CHEM) and point-of-care glucometry plasma (POC/PL). The weakest agreement was between measurements from whole blood and plasma conducted with point-of-care glucometry.
• It was found that the Pearson’s correlation was excellent for all comparisons except those with point-of-care glucometry whole blood (POC/WB). Likewise, robust regression coefficients were excellent for every comparison except those with POC/WB.

Research Conclusions

• Point-of-care glucometry with plasma and blood gas analysis demonstrated excellent agreement with the laboratory standard. However, point-of-care glucometry with whole blood correlated poorly with the laboratory standard.
• The differences observed could be clinically important as they might impact medical decisions based on glucose concentrations in critically ill horses. Hence, the type of blood sample (plasma or whole blood) and the method of glucose measurement can significantly influence the accuracy of results.