Clinical reliability of point-of-care tests to support community based acute ambulatory care

Journal article

Objective: To ensure clinicians can rely on point-of-care testing results, we assessed agreement between point-of-care tests for creatinine, urea, sodium, potassium, calcium, Hb, INR, CRP and subsequent corresponding laboratory tests.

Participants: Community-dwelling adults referred to a community-based acute ambulatory care unit.

Interventions: The Abbott i-STATTM (Hb, clinical chemistry, INR) and the AfinionTM Analyser (CRP) and corresponding laboratory analyses.

Outcomes: Agreement (Bland-Altman) and bias (Passing-Bablok regression).

Results: Among 462 adults we found an absolute mean difference between point-of-care and central laboratory analyses of 6.4g/L (95%LOA -7.9 to +20.6) for haemoglobin, -0.5mmol/L (95%LOA -4.5 to +3.5) for sodium, 0.2mmol/L (95%LOA -0.6 to +0.9) for potassium, 0.0mmol/L (95%LOA -0.3 to +0.3) for calcium, 9.0 μmol/L (95%LOA -18.5 to +36.4) for creatinine, 0.0mmol/L (95%LOA -2.7 to +2.6) for urea, -0.2 (95%LOA -2.4 to +2.0) for INR, -5.0 mg/L (95%LOA -24.4 to +14.4) for CRP.

Conclusions: There was acceptable agreement and bias for these analytes, except for haemoglobin and creatinine.

Authors: Verbakel, JY; Richardson, C; Elias, T; Bowen, J; Hassanzadeh, R

• Publication status: Published
• Peer review status: Peer reviewed
• Publisher: Rila Publications Ltd
• Journal: Acute Medicine
• Volume: 19
• Issue: 1
• Pages: 4-14
• Publication date: 2020-03-28
• Acceptance date: 2019-12-31
• EISSN: 1747-4892
• ISSN: 1747-4884
• Language: English
• Keywords: clinical accuracy; FFR; acute care; ambulatory care; point-of-care testing; service evaluation