Comparison of noninvasive and invasive point‐of‐care testing methods with reference method for hemoglobin measurement

Avcıoğlu, Gamze; Nural, Cemil; Yılmaz, Fatma Meriç; Baran, Pervin; Erel, Özcan; Yılmaz, Gülsen

doi:10.1002/jcla.22309

Cited by 12 publications

(11 citation statements)

References 10 publications

(16 reference statements)

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“…One approach, as used in this study, involved drawing venous blood and laboratory measurement of full blood parameters. However, smaller devices that provide point-of-care metrics of haemoglobin and haematocrit are now available ( Nkrumah et al, 2011 ; Avcioglu et al, 2018 ; Singh et al, 2015 ). These devices require finger-prick samples of capillary blood, are quick, easy to obtain, and relatively non-invasive.…”

Section: Discussionmentioning

confidence: 99%

Individual differences in haemoglobin concentration influence bold fMRI functional connectivity and its correlation with cognition

et al. 2020

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Resting-state connectivity measures the temporal coherence of the spontaneous neural activity of spatially distinct regions, and is commonly measured using BOLD-fMRI. The BOLD response follows neuronal activity, when changes in the relative concentration of oxygenated and deoxygenated haemoglobin cause fluctuations in the MRI T2* signal. Since the BOLD signal detects changes in relative concentrations of oxy/deoxy-haemoglobin, individual differences in haemoglobin levels may influence the BOLD signal-to-noise ratio in a manner independent of the degree of neural activity. In this study, we examined whether group differences in haemoglobin may confound measures of functional connectivity. We investigated whether relationships between measures of functional connectivity and cognitive performance could be influenced by individual variability in haemoglobin. Finally, we mapped the neuroanatomical distribution of the influence of haemoglobin on functional connectivity to determine where group differences in functional connectivity are manifest. In a cohort of 518 healthy elderly subjects (259 men), each sex group was median-split into two groups with high and low haemoglobin concentration. Significant differences were obtained in functional connectivity between the high and low haemoglobin groups for both men and women (Cohen’s d 0.17 and 0.03 for men and women respectively). The haemoglobin connectome in males showed a widespread systematic increase in functional connectivity correlation values, whilst the female connectome showed predominantly parietal and subcortical increases and temporo-parietal decreases. Despite the haemoglobin groups having no differences in cognitive measures, significant differences in the linear relationships between cognitive performance and functional connectivity were obtained for all 5 cognitive tests in males, and 4 out of 5 tests in females. Our findings confirm that individual variability in haemoglobin levels that give rise to group differences are an important confounding variable in BOLD-fMRI-based studies of functional connectivity. Controlling for haemoglobin variability as a potentially confounding variable is crucial to ensure the reproducibility of human brain connectome studies, especially in studies that compare groups of individuals, compare sexes, or examine connectivity-cognition relationships.

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Section: Discussionmentioning

confidence: 99%

Individual differences in haemoglobin concentration influence bold fMRI functional connectivity and its correlation with cognition

et al. 2020

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“…The study design was a within‐person comparison, enhancing validity by providing head‐to‐head comparisons of different methods to measure haemoglobin concentrations. It involved evaluation of four methods, making it wider in scope than previous efforts focusing on fewer methods 7,9,32‐34 . It used a state‐of‐the‐art haematology analyser in an accredited central laboratory as the reference standard.…”

Section: Discussionmentioning

confidence: 99%

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

Bell

Sweeting

Ramond

et al. 2020

Transfusion Medicine

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Objective To compare four haemoglobin measurement methods in whole blood donors. Background To safeguard donors, blood services measure haemoglobin concentration in advance of each donation. NHS Blood and Transplant's (NHSBT) customary method have been capillary gravimetry (copper sulphate), followed by venous spectrophotometry (HemoCue) for donors failing gravimetry. However, NHSBT's customary method results in 10% of donors being inappropriately bled (ie, with haemoglobin values below the regulatory threshold). Methods We compared the following four methods in 21 840 blood donors (aged ≥18 years) recruited from 10 NHSBT centres in England, with the Sysmex XN‐2000 haematology analyser, the reference standard: (1) NHSBT's customary method; (2) “post donation” approach, that is, estimating current haemoglobin concentration from that measured by a haematology analyser at a donor's most recent prior donation; (3) “portable haemoglobinometry” (using capillary HemoCue); (4) non‐invasive spectrometry (using MBR Haemospect or Orsense NMB200). We assessed sensitivity; specificity; proportion who would have been inappropriately bled, or rejected from donation (“deferred”) incorrectly; and test preference. Results Compared with the reference standard, the methods ranged in test sensitivity from 17.0% (MBR Haemospect) to 79.0% (portable haemoglobinometry) in men, and from 19.0% (MBR Haemospect) to 82.8% (portable haemoglobinometry) in women. For specificity, the methods ranged from 87.2% (MBR Haemospect) to 99.9% (NHSBT's customary method) in men, and from 74.1% (Orsense NMB200) to 99.8% (NHSBT's customary method) in women. The proportion of donors who would have been inappropriately bled ranged from 2.2% in men for portable haemoglobinometry to 18.9% in women for MBR Haemospect. The proportion of donors who would have been deferred incorrectly with haemoglobin concentration above the minimum threshold ranged from 0.1% in men for NHSBT's customary method to 20.3% in women for OrSense. Most donors preferred non‐invasive spectrometry. Conclusion In the largest study reporting head‐to‐head comparisons of four methods to measure haemoglobin prior to blood donation, our results support replacement of NHSBT's customary method with portable haemoglobinometry.

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“…One approach, as used in this study, involved drawing venous blood and laboratory measurement of full blood parameters. However, smaller devices that provide point-of-care metrics of haemoglobin and haematocrit are now available (Nkrumah et al, 2011;(Avcioglu et al, 2018;Singh et al, 2015). These devices require finger-prick samples of capillary blood, are quick, easy to obtain, and relatively non-invasive.…”

Section: Discussionmentioning

confidence: 99%

“…These devices require finger-prick samples of capillary blood, are quick, easy to obtain, and relatively non-invasive. Comparisons of point-of-care devices for measuring haemoglobin have been performed (Avcioglu et al, 2018;Singh et al, 2015). Avcioglu et al showed that the point-of-care measurement of haemoglobin was correlated with venous haemoglobin measures analysed with gold-standard cell analysers, with R 2 =0.825.…”

Section: Discussionmentioning

confidence: 99%

Individual differences in haemoglobin concentration influence BOLD fMRI functional connectivity and its correlation with cognition

Ward

Orchard

Oldham

et al. 2019

Preprint

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Highlights:• Individual differences in haemoglobin significantly impact measures of functional connectivity in the elderly.• Significant differences in connectivity-cognition relationships are shown between groups separated by haemoglobin values without accompanying cognitive differences.• The influence of haemoglobin on functional connectivity differs between men and women. Abstract:Resting-state connectivity measures the temporal coherence of the spontaneous neural activity of spatially distinct regions, and is commonly measured using BOLD-fMRI. The BOLD response follows neuronal activity, when changes in the relative concentration of oxygenated and deoxygenated haemoglobin cause fluctuations in the MRI T2* signal. Since the BOLD signal detects changes in relative concentrations of oxy/deoxy-haemoglobin, individual differences in haemoglobin levels may influence the BOLD signal-to-noise ratio in a manner independent of the degree of neural activity. In this study, we examined whether group differences in haemoglobin may confound measures of functional connectivity. We investigated whether relationships between measures of functional connectivity and cognitive performance could be influenced by individual variability in haemoglobin. Finally, we mapped the neuroanatomical distribution of the influence of haemoglobin on functional connectivity to determine where group differences in functional connectivity are manifest.In a cohort of 518 healthy elderly subjects (259 men) each sex group was median split into two groups with high and low haemoglobin concentration. Significant differences were obtained in functional connectivity between the high and low haemoglobin groups for both men and women (Cohen's d 0.17 and 0.03 for men and women respectively). The haemoglobin connectome in males showed a widespread systematic increase in functional connectivity correlational scores, whilst the female connectome showed predominantly parietal and subcortical increases and temporo-parietal decreases. Despite the haemoglobin groups having no differences in cognitive measures, significant differences in the linear relationships between cognitive performance and functional connectivity were obtained for all 5 cognitive tests in males, and 4 out of 5 tests in females.Our findings confirm that individual variability in haemoglobin levels that give rise to group differences are an important confounding variable in BOLD-fMRI-based studies of functional connectivity. Controlling for haemoglobin variability as a potentially confounding variable is crucial to ensure the reproducibility of human brain connectome studies, especially in studies that compare groups of individuals, compare sexes, or examine connectivity-cognition relationships.

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Comparison of noninvasive and invasive point‐of‐care testing methods with reference method for hemoglobin measurement

Cited by 12 publications

References 10 publications

Individual differences in haemoglobin concentration influence bold fMRI functional connectivity and its correlation with cognition

Individual differences in haemoglobin concentration influence bold fMRI functional connectivity and its correlation with cognition

Comparison of four methods to measure haemoglobin concentrations in whole blood donors (COMPARE): A diagnostic accuracy study

Individual differences in haemoglobin concentration influence BOLD fMRI functional connectivity and its correlation with cognition

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