Johnson Beth M, Fry Michael M, Flatland Bente, Kirk Claudia A
Department of Small Animal Clinical Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN 37996, USA.
J Am Vet Med Assoc. 2009 Dec 1;235(11):1309-13. doi: 10.2460/javma.235.11.1309.
To compare blood glucose concentrations measured with 2 portable blood glucose meters (PBGMs) validated for use in dogs (PBGM-D) and humans (PBGM-H) and an automated chemistry analyzer.
Validation study.
92 samples of fresh whole blood and plasma from 83 dogs with various diseases.
Each PBGM was used to measure whole blood glucose concentration, and the automated analyzer was used to measure plasma glucose concentration. Passing-Bablok linear regression and Bland-Altman plots were used to determine correlations and bias between the PBGMs and the automated analyzer. Calculated acceptability limits based on combined inherent instrument imprecision were used with Bland-Altman plots to determine agreement. Clinical relevance was assessed via error grid analysis.
Although correlation between results of both PBGMs and the standard analyzer was > 0.90, disagreement was greater than could be explained by instrument imprecision alone. Mean difference between PBGM-H and chemistry-analyzer values was -15.8 mg/dL. Mean difference between PBGM-D and chemistry-analyzer values was 2.4 mg/dL. Linear regression analysis revealed proportional bias of PBGM-H (greater disagreement at higher glucose concentrations); no proportional bias was detected for PBGM-D. No constant bias was detected for either PBGM. Error grid analysis revealed all measurements from both PBGMs were within zones without an anticipated effect on clinical outcome.
Neither PBGM had exact agreement with the automated analyzer; however, the disagreement detected did not have serious clinical consequences. Our findings stressed the importance of using the same device for monitoring trends in dogs and using instrument-specific reference ranges.
比较两种经验证可用于犬类（PBGM-D）和人类（PBGM-H）的便携式血糖仪以及一台自动化学分析仪所测得的血糖浓度。
验证研究。
来自83只患有各种疾病的犬的92份新鲜全血和血浆样本。
使用每种便携式血糖仪测量全血葡萄糖浓度，使用自动分析仪测量血浆葡萄糖浓度。采用Passing-Bablok线性回归和Bland-Altman图来确定便携式血糖仪与自动分析仪之间的相关性和偏差。将基于仪器固有不精密度合并计算得出的可接受限度用于Bland-Altman图以确定一致性。通过误差网格分析评估临床相关性。
尽管两种便携式血糖仪与标准分析仪的结果之间的相关性均>0.90，但差异大于仅由仪器不精密度所能解释的范围。PBGM-H与化学分析仪值之间的平均差异为-15.8mg/dL。PBGM-D与化学分析仪值之间的平均差异为2.4mg/dL。线性回归分析显示PBGM-H存在比例偏差（在较高葡萄糖浓度下差异更大）；未检测到PBGM-D存在比例偏差。两种便携式血糖仪均未检测到恒定偏差。误差网格分析显示，两种便携式血糖仪的所有测量值均在对临床结果无预期影响的区域内。
两种便携式血糖仪与自动分析仪均未完全一致；然而，所检测到的差异并无严重临床后果。我们的研究结果强调了在监测犬类血糖变化趋势时使用同一设备以及使用特定仪器参考范围的重要性。
