Interpretation of Point-Of-Care Test Results

Variations were found in the values of hemoglobin when measured by a hematology lab analyzer and a point-of-care hemoglobinometer.

HealthDay News –  There are drop-to-drop variations in measures of blood components from fingerprick blood, measured by point-of-care testing units, that is greater than variation in drops of venous blood, according to a recently published study n the American Journal of Clinical Pathology.

Meaghan M. Bond and Rebecca R. Richards-Kortum, PhD, both from Rice University in Houston, used a hematology analyzer to analyze the hemoglobin concentration, total white blood cell (WBC) count, three-part WBC differential, and platelet count in six successive drops of blood collected from one fingerprick from each of 11 donors. Additionally, a hemoglobinometer was used to measure the hemoglobin concentration of 10 drops of fingerprick blood from each of seven donors.

The researchers found that the average percent coefficient of variation (CV) for successive drops of fingerprick blood ranged from three times higher (for lymphocyte count) to more than seven times higher (for granulocyte count), compared to venous controls measured using a hematology analyzer. For hemoglobin, the average percent CV for fingerprick blood was up to five times higher, compared to venous blood measured using a point-of-care hemoglobinometer.


Summary and Clinical Applicability

Variations in laboratory tests values, as represented by the average percent coefficient of variation, were significantly higher for WBC, granulocyte, platelet, and hemoglobin counts when measured by a point-of-care device as compared to standard hematology lab blood analyzer.

The authors write, “for clinical decision making, we recommend using fingerprick blood to assess hemoglobin or WBC concentration only when the degree of variability is acceptable; the degree of acceptable variability will depend on the clinical condition being assessed”.

Reference

Bond MM, Richards-kortum RR. Drop-to-drop variation in the cellular components of fingerprick blood: implications for point-of-care diagnostic development. Am J Clin Pathol. 2015;144(6):885-94.