Level of agreement of point-of-care and laboratory HbA1c measurements in the preoperative outpatient clinic in non-diabetic patients who are overweight or obese

Abstract

Implementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate the early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist. We determined the level of agreement between a point-of-care and laboratory HbA1c test in non-diabetic patients visiting the outpatient clinic for preoperative risk profiling. Point-of-care HbA1c levels were measured in whole blood obtained by a finger prick (Siemens DCA Vantage HbA1c analyzer) and in hemolysed EDTA blood in the central laboratory (LAB). Bland Altman and Clarke’s error grid analysis were used to analyze the agreement between the point-of-care and laboratory measurements. Patients (n = 49) were 55 ± 11 years old, 47% were male with a body mass index (BMI) of 30.6 ± 3.4 kg/m2. The mean HbA1c was 38.1 ± 3.7 mmol/mol or 5.6 ± 0.3%. One patient was diagnosed with a HbA1c indicative for diabetes mellitus (6.7%). Bland Altman analysis revealed a bias of − 0.53 ± 1.81 mmol/mol with limits of agreement of − 4.09 to 3.03 mmol/mol and a bias of − 0.05 ± 0.17% with limits of agreement − 0.39 to 0.28%. The percentage error was 9.2% and 5.9% for HbA1c expressed in mmol/mol and %, respectively. Clarke’s error grid analysis showed that 48 out of 49 measurements were located in area A (98%). Point-of-care HbA1c measurements showed a high level of agreement with the laboratory test in the outpatient setting, and may be used for preoperative risk profiling in patients prone to cardiometabolic complications.Trial registration: Netherlands Trial Register NTR3057.

Derivation and validation of gray-box models to estimate noninvasive in-vivo percentage glycated hemoglobin using digital volume pulse waveform

“…The following results were obtained with the two models after %HbA1c value calibration: the plot of Clarke’s error grid analysis (EGA) 29 , 30 is given with the Bland–Altman analysis in Fig. 10 for the blood-vessel model and Fig.…”

Level of Agreement and Correlation Between the Estimated Hemoglobin A1c Results Derived by Continuous or Conventional Glucose Monitoring Systems Compared with the Point-of-Care or Laboratory-Based Measurements: An Observational Study

“…They concluded that POCT-HbA1c is a potential method for diabetes screening and monitoring, especially when a rapid result is needed [ 36 ]. Moreover, the study by Raalten et al demonstrated high limits of agreement between the POCT HbA1c and the central laboratory HbA1c tests in non-diabetic, obese patients in the preoperative outpatient setting [ 37 ]. On the other hand, the recently published local experience of PSMMC hospital showed that POCT for HbA1c improved the patient’s adherence to the physician’s recommendations for HbA1c testing and higher patient satisfaction [ 26 ].…”

Latent tuberculosis infection among patients with and without type-2 diabetes mellitus: results from a hospital case-control study in Atlanta

“…Among cases, HbA1c (%) was obtained from the electronic medical chart by abstracting the plasma HbA1c value closest to the date of study enrollment. Eligible controls included adult family members/friends of cases with HbA1c < 5.7% (measured at the time of screening by a point-of-care HbA1c [ 11 ], Siemens DCA Vantage Analyzer) and no self-reported prior diagnosis of pre-diabetes, T2DM, HIV, or TB disease. HbA1c values were categorized according to the American Diabetes Association classification with HbA1c < 5.7% considered as “normoglycemic”, HbA1c 5.7–6.4% as “pre-diabetes” and, HbA1c ≥ 6.5% as “diabetes” [ 12 ].…”