Setford Steven, Grady Mike, Phillips Stuart, Miller Lesley, Mackintosh Stephen, Cameron Hilary, Corrigall Krisna
1 LifeScan Scotland Ltd, Inverness, UK.
2 LifeScan Inc, Wayne, PA, USA.
J Diabetes Sci Technol. 2017 Nov;11(6):1155-1162. doi: 10.1177/1932296817703133. Epub 2017 Apr 13.
A key approach in enabling people with diabetes to better manage their condition is through self-monitoring of blood glucose (SMBG). Any functional SMBG system should demonstrate clinical accuracy across a broad glucose range and be insensitive to hematocrit. Furthermore, it should be incumbent on the manufacturer to demonstrate that their product continues to meet clinical accuracy claims during product lifetime.
Test strips from a globally distributed SMBG product were sampled from randomly selected production batches as part of the manufacturer's routine product evaluation process. Clinical accuracy was assessed within diabetes patients at 3 clinic sites against a standard reference method and evaluated against system accuracy in accordance with the ISO 15197:2015 standard (unchanged from ISO 15197:2013 in terms of performance specifications). Data were collected over 7 years (2010-2016) and comprised 73,600 individual glucose results. Overall clinic performance was assessed, as was accuracy at low and high glucose levels and extremes of hematocrit.
Across the 7-year surveillance period, overall test strip clinical accuracy was 97.8% versus the 95% ISO-defined minimum criterion with by-year values of 97.0-98.6%. Accuracy at the lowest (≤50 mg/dL) and highest (>400 mg/dL) ranges of glucose was 97.0% and 98.3% respectively. Within these low/high blood glucose subpopulations, accuracy at the lower and upper first percentile hematocrit ranges, was 98.9%, and 97.1% respectively.
This 7-year surveillance program showed the test strips to have excellent clinical accuracy at the outer ranges of subject blood glucose and hematocrit, based on assessment against the ISO 15197:2015 clinical accuracy criterion.
使糖尿病患者更好地管理自身病情的一个关键方法是通过自我血糖监测(SMBG)。任何有效的SMBG系统都应在较宽的血糖范围内具备临床准确性,且对血细胞比容不敏感。此外,制造商有责任证明其产品在产品生命周期内持续满足临床准确性要求。
作为制造商常规产品评估流程的一部分,从全球销售的一种SMBG产品的测试条中随机抽取生产批次进行采样。在3个临床地点,针对糖尿病患者,采用标准参考方法评估临床准确性,并根据ISO 15197:2015标准(在性能规格方面与ISO 15197:2013相同)评估系统准确性。数据收集历时7年(2010 - 2016年),包含73,600个个体血糖检测结果。评估了整体临床性能,以及低、高血糖水平和血细胞比容极值时的准确性。
在7年的监测期内,测试条的整体临床准确性为97.8%,高于ISO定义的95%最低标准,逐年值为97.0 - 98.6%。血糖最低范围(≤50 mg/dL)和最高范围(>400 mg/dL)时的准确性分别为97.0%和98.3%。在这些低/高血糖亚组中,血细胞比容处于第一百分位数下限和上限范围时的准确性分别为98.9%和97.1%。
基于根据ISO 15197:2015临床准确性标准进行的评估,这个为期7年的监测项目表明,测试条在受试者血糖和血细胞比容的极端范围内具有出色的临床准确性。