Sanchez-Carrillo C I, Ramirez-Sanchez T J, Zambrana-Castañeda M, Selwyn B J
Int J Technol Assess Health Care. 1989;5(4):659-67. doi: 10.1017/s0266462300008527.
A colorimetric instrument for the noninvasive quantification of hemoglobin, designed using color shades resembling those observed in the conjunctiva, was tested. The instrument's colors are contrasted against the color of the conjunctiva to measure hemoglobin content. Sensitivity, specificity, negative predictive value, and false-negative value were estimated to test the instrument's accuracy; kappa coefficients were used to estimate inter- and intraobserver variability. Physician field evaluations of conjunctiva color for the screening of anemia, reported in the literature, have had sensitivities and specificities as high as 70%. Readings with the instrument demonstrated a 63% sensitivity, 72% specificity, and 38% false negatives for screening hemoglobin values of less than or equal to 13 g/dl. The interobserver kappa coefficients for three pairs of readers were good to excellent for the same hemoglobin screening value. Statistically significant differences were noted, however, between observers during the reliability test. The instrument can be used by unskilled personnel to improve their decision-making about whom to send for further care or for supplementation with iron.
测试了一种用于无创定量血红蛋白的比色仪器，其设计所采用的颜色深浅类似于在结膜中观察到的颜色。该仪器的颜色与结膜颜色形成对比以测量血红蛋白含量。估计了灵敏度、特异性、阴性预测值和假阴性值以测试该仪器的准确性；使用kappa系数来估计观察者间和观察者内的变异性。文献报道的医生对结膜颜色进行贫血筛查的现场评估，其灵敏度和特异性高达70%。使用该仪器进行读数时，对于筛查血红蛋白值小于或等于13 g/dl的情况，显示出63%的灵敏度、72%的特异性和38%的假阴性。对于相同的血红蛋白筛查值，三对读者之间的观察者间kappa系数良好至优秀。然而，在可靠性测试期间，观察者之间存在统计学上的显著差异。非专业人员可以使用该仪器来改进他们关于将谁送去进一步治疗或补充铁剂的决策。
