Clarke Error Grid Analysis for Performance Evaluation of Glucometers in a Tertiary Care Referral Hospital

Sengupta, Sohini; Handoo, Anil; Haq, Inaamul; Dahiya, Karamvir; Mehta, Sanjay; Kaushik, Mradul

doi:10.1007/s12291-021-00971-4

Cited by 10 publications

(4 citation statements)

References 15 publications

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“…The potential of the proposed method for continuous BGL monitoring is evidenced by 100% of the estimated BGL values falling within the clinically acceptable regions A and B of the CEG plots for all four subjects, as shown in Figure 10 . The estimated CEG values in Region A fall within 20% of the reference (correct) BGL value, which has no negative effect on the clinical decisions, while the values in Region B of CEG are more than 20% apart from the reference BGL value, but this has low to no impact on clinical outcome [ 33 ] and does not lead to inappropriate treatment. This level of accuracy is particularly important for diagnosing hypoglycemia and hyperglycemia, where immediate intervention is required, as clinically wrong diagnosis may lead to the potentially fatal decision to inject insulin in patients with extremely low blood glucose levels.…”

Section: Discussionmentioning

confidence: 99%

“…The ensemble regression trees model resulted in the lowest root mean squared error (RMSE) value and was chosen for the analysis of the unseen data. To test the clinical significance of the test data, the Clarke error grid (CEG) was used [ 33 ], along with the mean absolute relative difference (MARD), the correlation coefficient r, and the RMSE.…”

Section: Signal Processing/methodsmentioning

confidence: 99%

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An In-Ear PPG-Based Blood Glucose Monitor: A Proof-of-Concept Study

Hammour

Mandic

2023

Sensors

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Monitoring diabetes saves lives. To this end, we introduce a novel, unobtrusive, and readily deployable in-ear device for the continuous and non-invasive measurement of blood glucose levels (BGLs). The device is equipped with a low-cost commercially available pulse oximeter whose infrared wavelength (880 nm) is used for the acquisition of photoplethysmography (PPG). For rigor, we considered a full range of diabetic conditions (non-diabetic, pre-diabetic, type I diabetic, and type II diabetic). Recordings spanned nine different days, starting in the morning while fasting, up to a minimum of a two-hour period after eating a carbohydrate-rich breakfast. The BGLs from PPG were estimated using a suite of regression-based machine learning models, which were trained on characteristic features of PPG cycles pertaining to high and low BGLs. The analysis shows that, as desired, an average of 82% of the BGLs estimated from PPG lie in region A of the Clarke error grid (CEG) plot, with 100% of the estimated BGLs in the clinically acceptable CEG regions A and B. These results demonstrate the potential of the ear canal as a site for non-invasive blood glucose monitoring.

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Section: Discussionmentioning

confidence: 99%

Section: Signal Processing/methodsmentioning

confidence: 99%

An In-Ear PPG-Based Blood Glucose Monitor: A Proof-of-Concept Study

Hammour

Mandic

2023

Sensors

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“…It is, therefore, imperative to monitor blood glucose level of severely malnourished child at a regular interval. Glucometer is a widely used point-of-care-testing device for bedside monitoring of blood glucose levels (47) . However, we found that two of the hospitals did not have a glucometer in the paediatric ward.…”

Section: Discussionmentioning

confidence: 99%

A qualitative assessment of facility readiness and barriers to the facility-based management of childhood severe acute malnutrition in the public healthcare settings in Bangladesh

Fahim

Islam

Rasul

et al. 2022

Public Health Nutr.

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Objective: To assess facility readiness and identify barriers to the facility-based management of childhood severe acute malnutrition (SAM) in public healthcare settings. Design: Qualitative methods were applied to assess readiness and identify different perspectives on barriers to the facility-based management of children with SAM. Data collection was done using in-depth interviews, key informant interviews, exit interviews, and pre-tested observation tools. Settings: Two tertiary care and four district hospitals in Rangpur and Sylhet Divisions of Bangladesh. Participants: Healthcare professionals and caregivers of children with SAM. Results: Anthropometric tools, glucometer, medicines, F-75, F-100, and national guidelines for facility-based management of childhood SAM were found unavailable in some of the hospitals. Sitting and sleeping arrangements for the caregivers were absent in all of the chosen facilities. We identified a combination of health system and contextual barriers that inhibited the facility-based management of SAM. The health system barriers include inadequate manpower, rapid turnover of staff, increased workload, lack of training, and lack of adherence to management protocol. The major facility barriers were insufficient space and unavailability of required equipment, medicines, and foods for hospitalized children with SAM. The reluctance of caregivers to complete the treatment regimen, their insufficient knowledge regarding proper feeding, increased number of attendants, and poverty of parents were the principal contextual barriers. Conclusions: The study findings provide insights on barriers that are curbing the facility-based management of SAM and emphasize policy efforts to develop feasible interventions to reduce the barriers and ensure the preparedness of the facilities for effective service delivery.

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“…The primary goal of glucose sensors used in diabetes care is to detect hyperglycemia, i.e., glycemia above 120 -150 mg/dL or 7 -9 mM depending on the type of diabetes. The demand for accurate glucose measurements in order to manage diabetes has been summarized in the Clark Error Grid that is an essential tool for checking the clinical accuracy of self-monitoring of blood glucose monitors [116,117]. Biosensor accuracy in the 3 -10 mM is therefore the primary need.…”

Section: Electrochemical Enzymatic Glucose Sensormentioning

confidence: 99%

Insight into continuous glucose monitoring: from medical basics to commercialized devices

et al. 2023

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According to the latest statistics, more than 537 million people around the world struggle with diabetes and its adverse consequences. As well as acute risks of hypo-or hyper-glycemia, long-term vascular complications may occur, including coronary heart disease or stroke, as well as diabetic nephropathy leading to end-stage disease, neuropathy or retinopathy. Therefore, there is an urgent need to improve diabetes management to reduce the risk of complications but also to improve patient's quality life. The impact of continuous glucose monitoring (CGM) is well recognized, in this regard. The current review aims at introducing the basic principles of glucose sensing, including electrochemical and optical detection, summarizing CGM technology, its requirements, advantages and disadvantages. The role of CGM systems in the clinical diagnostics/personal testing, difficulties in their utilization and recommendations are also discussed. In the end, challenges and prospects in future CGM systems are discussed and non-invasive, wearable glucose biosensors are introduced. Though the scope of this review is CGMs and provides information about medical issues and analytical principles, consideration of broader use will be critical in future if the right systems are to be selected for effective diabetes management.

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Clarke Error Grid Analysis for Performance Evaluation of Glucometers in a Tertiary Care Referral Hospital

Cited by 10 publications

References 15 publications

An In-Ear PPG-Based Blood Glucose Monitor: A Proof-of-Concept Study

An In-Ear PPG-Based Blood Glucose Monitor: A Proof-of-Concept Study

A qualitative assessment of facility readiness and barriers to the facility-based management of childhood severe acute malnutrition in the public healthcare settings in Bangladesh

Insight into continuous glucose monitoring: from medical basics to commercialized devices

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