Jain Anjly, Rao Nandini, Sharifi Mahtab, Bhatt Nirav, Patel Payal, Nirmal Divyabala, Persaud Jham Want, Nair Devaki R
1 Department of Clinical Biochemistry, Royal Free London NHS Foundation Trust, London, UK.
2 B.A.P.S. Healthcare, Swaminarayan Mandir, Neasden, London, UK.
Ann Clin Biochem. 2017 May;54(3):331-341. doi: 10.1177/0004563216661737. Epub 2016 Jul 15.
Background A 'one stop shop' model for multifactorial risk factor management in a culturally sensitive environment may improve cardiovascular disease and diabetes prevention. A full biochemical profile for cardiovascular disease risk assessment includes a lipid profile, glucose, glycated haemoglobin and urine albumin creatinine ratio measurements. This may require the use of more than one point of care testing instrument. Methods Individuals who attended a community cardiovascular disease risk screening or an audit programme of the diabetic care pathway in the community were sampled. Bland-Altman and Deming regression plots were used to assess agreement between methods for total cholesterol, high-density lipoprotein cholesterol, triglycerides, glycated haemoglobin and urine albumin creatinine ratio. Results There was good agreement between the Afinion AS100 analyser, Cholestech LDX and the laboratory methods for total cholesterol, high-density lipoprotein cholesterol and triglycerides ( n = 232). The Afinion AS100 agreed well with the laboratory method for glycated haemoglobin ( n = 255) and urine albumin creatinine ratio ( n = 176). There was statistically significant bias ( p = 0.03 to <0.0001) for several measurements. However, these were judged not to be clinically relevant. Specifically for the total cholesterol and high-density lipoprotein cholesterol values, we obtained good agreement (weighted kappa: 0.91 and 0.94 for the Afinion AS100 vs. Cholestech LDX and Afinion AS100 vs. laboratory method, respectively) for cardiovascular disease risk calculation using QRISK2. Conclusions Point of care testing can support a 'one stop shop' approach by providing rapid, reliable results. The Afinion AS100 analyser provides a multi-analyte platform and compares well with laboratory-based methods and another well-established point of care testing analyser.
背景 在具有文化敏感性的环境中采用“一站式服务”模式进行多因素风险因素管理，可能会改善心血管疾病和糖尿病的预防。用于心血管疾病风险评估的完整生化指标包括血脂谱、血糖、糖化血红蛋白和尿白蛋白肌酐比值测量。这可能需要使用不止一种即时检验仪器。方法 对参加社区心血管疾病风险筛查或社区糖尿病护理路径审核项目的个体进行抽样。采用Bland-Altman图和Deming回归图评估总胆固醇、高密度脂蛋白胆固醇、甘油三酯、糖化血红蛋白和尿白蛋白肌酐比值的方法之间的一致性。结果 在总胆固醇、高密度脂蛋白胆固醇和甘油三酯方面，Afinion AS100分析仪、Cholestech LDX与实验室方法之间具有良好的一致性（n = 232）。Afinion AS100与实验室方法在糖化血红蛋白（n = 255）和尿白蛋白肌酐比值（n = 176）方面一致性良好。几项测量存在统计学显著偏差（p = 0.03至<0.0001）。然而，这些偏差被判定为与临床无关。具体而言，对于总胆固醇和高密度脂蛋白胆固醇值，使用QRISK2进行心血管疾病风险计算时，我们获得了良好的一致性（Afinion AS100与Cholestech LDX以及Afinion AS100与实验室方法的加权kappa分别为0.91和0.94）。结论 即时检验通过提供快速、可靠的结果，可支持“一站式服务”模式。Afinion AS100分析仪提供了一个多分析物平台，与基于实验室的方法以及另一种成熟的即时检验分析仪相比表现良好。
