![]() ![]() ![]() The suitability of many of these devices for the accurate measurement of HbA 1c has been questioned, with some POC HbA 1c test devices reported not to meet accepted accuracy and precision criteria. They provide a test result within a few minutes allowing clinical decisions and medication changes to take place immediately. Point-of-care (POC) analysers are bench-top instruments that use a finger-prick blood sample and are designed for use in a treatment room or at the bed-side. HbA 1c monitoring often requires the patient to attend the health center twice: once to have blood taken and then returning to get test results and receive adjustments to medication. In 2011, a World Health Organization consultation concluded that HbA 1cat a threshold of 6.5% (48 mmol/mol) can be used as a diagnostic test for diabetes. Regular monitoring of glycated hemoglobin subfraction A 1c (HbA 1c) in people with diabetes and treatment with glucose-lowering medications to improve glycaemic control can reduce the risk of developing complications. The implications of this on clinical decision-making and patient outcomes now need to be tested in a randomized trial. Use of a device with a mean negative bias compared to a laboratory method may lead to higher levels of glycemia and a lower risk of hypoglycaemia. ![]() This is the first meta-analysis to directly compare performance of POC HbA 1c devices. There was no difference in bias between clinical or laboratory operators in two devices. There was substantial variability in bias within devices. Nine devices had a negative mean bias which was significant for three devices. Devices evaluated were A1cgear, A1cNow, Afinion, B-analyst, Clover, Cobas b101, DCA 2000/Vantage, HemoCue, Innovastar, Nycocard, Quo-Lab, Quo-Test and SDA1cCare. Sixty-one studies were included in the meta-analysis of mean bias. Two researchers independently reviewed 1739 records for eligibility. Study quality was assessed using the QUADAS2 tool. Mean bias and variability between the POC and laboratory test were combined in a meta-analysis. Two reviewers screened articles and extracted data on bias, precision and diagnostic accuracy. Medline, Embase and Web of Science databases were searched in June 2015 for published reports comparing POC HbA 1c devices with laboratory methods. We carried out a systematic review and meta-analysis using a novel approach to compare the accuracy and precision of POC HbA 1c devices. Reports have raised concerns about the analytical performance of some of these devices. Point-of-care (POC) devices could be used to measure hemoglobin A 1c (HbA 1c) in the doctors’ office, allowing immediate feedback of results to patients. ![]()
0 Comments
Leave a Reply. |
AuthorWrite something about yourself. No need to be fancy, just an overview. ArchivesCategories |