Inter‐ and intra‐operator variability in the analysis of packed cell volume

Breheny, Craig; Brown, Andrew; Handel, Ian; Gow, Adam

doi:10.1111/jsap.12603

Cited by 9 publications

(12 citation statements)

References 10 publications

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“…It is of note that despite alteration in teaching of PCV measurement and a new cohort of students, there was no change in the range within which 95 per cent of the no SOP results fell (0.09 l/l), in comparison with the initial paper 2 . This confirms the finding of the initial paper that there is variation in PCV measurement and also the magnitude of this variation.…”

Section: Discussionsupporting

confidence: 71%

“…PCV measurement has previously been described as a ‘waived test’, defined as a test carrying a low risk for incorrect results, and as such can be performed by nurses and medical students 1 . A previous study demonstrated that this was not the case in a veterinary teaching hospital, and clinically significant variation did exist for PCV measurement 2 …”

Section: Introductionmentioning

confidence: 93%

“…For the study subjects, the absolute reading (in l/l) was plotted divided as to whether an SOP was given or not. A tolerance of 0.02 l/l was deemed acceptable for clinical decision making as per Breheny et al 2 The percentage of results which were within 0.02 l/l of the reference value was plotted, grouped by SOP and no SOP. Binary logistic regression was used to estimate the probability that each group would read a PCV within the 0.02 l/l tolerance.…”

Section: Statisticsmentioning

confidence: 99%

“…Prior study demonstrated that in the analytical stage, errors were common in preparation of the capillaries: mainly inadequate mixing of the samples, as well as underilling or overilling the capillaries. 2 Inappropriate use of the reader was a further important source of analytical error. This resulted from incorrect placement of the capillary within the reader, and failure to move the top of the plasma to the appropriate line or to move the reading line to the top of the red cell column.…”

Section: Introductionmentioning

confidence: 99%

“…1 A previous study demonstrated that this was not the case in a veterinary teaching hospital, and clinically significant variation did exist for PCV measurement. 2 A major factor in the accuracy and reliability of this diagnostic test is operator-dependent variation and experience. 2 Incorrect results can result in erroneous conclusions, potentially leading either to interventions which could be unnecessary or result in a delay to act, which may be detrimental to the patient.…”

Section: Introductionmentioning

confidence: 99%

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Standard operating procedure reduces interoperator variation and improves accuracy when measuring packed cell volume

et al. 2019

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ObjectiveTo evaluate whether a standard operating procedure (SOP) for canine packed cell volume (PCV) measurement reduces operator-dependent variation and improves accuracy within a veterinary teaching hospital environment.Materials and methodsClinical staff and final-year undergraduate veterinary students were recruited to perform PCV measurements in blinded duplicate samples. Participants were randomly allocated to perform this with or without an SOP. Participants’ results were compared against a reference, generated by the authors following the World Health Organization guidelines.ResultsThe study population comprised 18 clinical staff and 39 students. Three clinical staff and seven students displayed errors consistent with inaccurate reading, only one of whom had access to the SOP. Five students and two clinical staff had errors attributable to incorrect preparation, with only one having access to the SOP. Interoperator variation was significantly less using the SOP. Using the SOP, 95 per cent of the results were within 0.0125 l/l of the reference value, in comparison with within 0.09 l/l without SOP. Interoperator variation was significantly less in the SOP group (P=0.0025).Clinical significanceUsing the SOP resulted in less variation and more accurate results. This confirms that PCV measurement with an SOP can truly be a ‘waived’ test.

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Section: Discussionsupporting

confidence: 71%

Section: Introductionmentioning

confidence: 93%

Section: Statisticsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Standard operating procedure reduces interoperator variation and improves accuracy when measuring packed cell volume

et al. 2019

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Quality Management of Hematology Techniques

Stirn¹,

Freeman²

2022

Schalm's Veterinary Hematology

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The effect of myxomatous mitral valve disease severity on packed cell volume in dogs

Wilshaw

Stein

Lotter

et al. 2021

J of Small Animal Practice

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Objectives The aim of this study was to examine whether associations between disease severity and packed cell volume exist in dogs with myxomatous mitral valve disease. Materials and Methods Data were selected from 289 dogs that had been examined at a research clinic (2004–2017) on multiple occasions (n=1465). American College of Veterinary Internal Medicine stage and echocardiographic measurements were entered in separate multivariable linear mixed effects models with packed cell volume as the dependent variable. Age, breed, sex, weight and blood urea nitrogen concentrations were additionally tested in these analyses to control for patient characteristics. Results Packed cell volume (% whole blood) in stages B1 and B2 (B1: 42.62 ±0.27, P=0.001; B2: 41.77± 0.42, P < 0.001) was lower than stage A (44.57 ±0.53). In stage C, packed cell volume was greater than both preclinical stages (C: 43.84 ±0.46). When the administration of loop diuretics was included in statistical models, packed cell volume was inversely related to normalised left ventricular internal diameters (β: −2.37; 95% confidence intervals: −3.49, −1.25; P < 0.001). Clinical Significance Dogs with myxomatous mitral valve disease may develop reductions in packed cell volume as their disease progresses. Although this finding was statistically significant at a population level, it should be noted that the differences described are relatively small. This, along with other causes of variation in packed cell volume, means that changes would be challenging to appreciate within individual patients. Plasma volume depletion following diuretic administration may explain why findings differed in stage C.

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Inter‐ and intra‐operator variability in the analysis of packed cell volume

Cited by 9 publications

References 10 publications

Standard operating procedure reduces interoperator variation and improves accuracy when measuring packed cell volume

Standard operating procedure reduces interoperator variation and improves accuracy when measuring packed cell volume

Quality Management of Hematology Techniques

The effect of myxomatous mitral valve disease severity on packed cell volume in dogs

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