Krisher Lyndsay, Jaramillo Diana, Dye-Robinson Amy, Dally Miranda, Butler-Dawson Jaime, Brindley Stephen, Pilloni Daniel, Cruz Alex, Villarreal Hernandez Karely, Schaeffer Joshua, Adgate John L, Newman Lee S
Center for Health, Work & Environment, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.
Department of Environmental & Occupational Health, Colorado School of Public Health, University of Colorado Anschutz Medical Campus, Aurora, Colorado, United States of America.
PLOS Glob Public Health. 2024 Jul 23;4(7):e0003380. doi: 10.1371/journal.pgph.0003380. eCollection 2024.
With chronic disease prevalence on the rise globally, surveillance and monitoring are critical to improving health outcomes. Point-of-care (POC) testing can facilitate epidemiological research and enhance surveillance systems in limited resource settings, but previous research has identified bias between POC devices and laboratory testing. We compared the performance of two POC blood analyzers, the iSTAT handheld (Abbott, Princeton, NJ, USA) and the StatSensor Creatinine (Nova Biomedical, Waltham, MA, USA) to concurrent blood samples analyzed at a local laboratory that were collected from 89 agricultural workers in Guatemala. We measured creatinine and other measures of underlying health status with the POC and the lab blood samples. Pearson correlation coefficients, Bland-Altman plots, no intercept linear regression models and two-sample t-tests were used to evaluate the agreement between the POC and lab values collected across three study days and to assess differences by study day in a field setting. On average there was no observed difference between the iSTAT and lab creatinine measurements (p = 0.91), regardless of study day. Using lab creatinine as the gold standard, iSTAT creatinine results were more accurate compared to the Statsensor, which showed some bias, especially at higher values. The iSTAT had good agreement with the lab for sodium and blood urea nitrogen (BUN), but showed differences for potassium, anion gap, bicarbonate (TCO2), glucose, and hematocrit. In this tropical field setting, the research team devised a protocol to prevent the devices from overheating. In limited resource settings, POC devices carry advantages compared to traditional lab analyses, providing timely results to patients, researchers, and healthcare systems to better evaluate chronic health conditions. Technical challenges due to use of POC devices in high heat and humidity environments can be addressed using a standard protocol for transporting and operating the devices.
随着全球慢性病患病率的上升，监测对于改善健康状况至关重要。即时检验（POC）可促进流行病学研究，并加强资源有限环境中的监测系统，但先前的研究已发现POC设备与实验室检测之间存在偏差。我们比较了两款POC血液分析仪，即iSTAT手持式分析仪（美国新泽西州普林斯顿的雅培公司）和StatSensor肌酐分析仪（美国马萨诸塞州沃尔瑟姆的诺瓦生物医学公司）与当地实验室对危地马拉89名农业工人采集的同期血样的检测性能。我们使用POC和实验室血样测量了肌酐及其他潜在健康状况指标。使用Pearson相关系数、Bland-Altman图、无截距线性回归模型和双样本t检验来评估在三个研究日采集的POC与实验室值之间的一致性，并在现场环境中按研究日评估差异。平均而言，无论研究日如何，iSTAT与实验室肌酐测量值之间均未观察到差异（p = 0.91）。以实验室肌酐作为金标准，与显示出一些偏差（尤其是在较高值时）的StatSensor相比，iSTAT肌酐结果更准确。iSTAT与实验室在钠和血尿素氮（BUN）方面一致性良好，但在钾、阴离子间隙、碳酸氢盐（TCO2）、葡萄糖和血细胞比容方面存在差异。在这个热带现场环境中，研究团队制定了一项方案以防止设备过热。在资源有限的环境中，与传统实验室分析相比，POC设备具有优势，可为患者、研究人员和医疗系统提供及时结果，以更好地评估慢性健康状况。在高温高湿环境中使用POC设备所带来的技术挑战可通过运输和操作设备的标准方案来解决。
