Comparison of the StaRRsed Interliner device with Westergren method in erythrocyte sedimentation rate measurement

Abstract

Introduction With recent advances in technology, many manual tests are being replaced by automated devices due to a wide range of advantages. One of these tests is the erythrocyte sedimentation rate (ESR) test that is used to determine inflammatory activity. This study aimed to evaluate the agreement between the Starrsed Interliner sedimentation device and the gold standard method, that is the Westergren method, used in ESR measurement. Methods One hundred fifty‐one patients who presented to Gaziantep University Faculty of Medicine, Şahinbey Training and Research Hospital were included in this study. ESR values were measured simultaneously within 2 hours using the ESR analyzer Starrsed Interliner device and the gold standard method of measuring ESR, that is the Westergren method, from blood samples collected from the same patients in EDTA and citrate tubes. Results Agreement between the results from the Starrsed Interliner device and the Westergren method was evaluated using the Intraclass Correlation method. Consequently, a poor correlation was observed at values <20 mm/h, a moderate correlation was observed at values 20 to 80 mm/h and >80 mm/h, and an excellent correlation was observed when all results were considered. Method comparison was conducted according to the Passing‐Bablok regression analysis (y = −1.50 + 0.75x) (P < .0001). The mean difference between the two methods was 10.1 according to the Bland‐Altman analysis. Conclusions Despite the advantages of the Starrsed Interliner device, such as lower laboratory workloads, lower costs and turnaround time, the difference between the two methods, as found in this study, may lead to different clinical interpretations for results in some patient.

Performance comparison of Westergren modified SRS 100/II and alternate iSED® method for erythrocyte sedimentation rate

“…The erythrocyte sedimentation rate (ESR) is a widely used, non‐specific screening laboratory test used for inflammation assessment and it was introduced in the early 1900s 1,2 . It is elevated in different pathological conditions such as infections, neoplasms, autoimmune diseases or chronic inflammation 3 . The process of erythrocyte sedimentation includes the rate at which erythrocytes settle from the plasma in three phases 4 .…”

“…Erythrocyte aggregation is recognized as the most critical phase of erythrocyte sedimentation because it has the greatest impact on the overall sedimentation process 5 . Moreover, this phase is enhanced by negatively charged plasma proteins mainly positive reactants of the acute phase such as C‐reactive protein, fibrinogen, alpha or gamma globulins which decrease the normal distance between erythrocytes 1,3,4 . This explains the use of ESR in the diagnosis of inflammatory diseases 1,3,4 .…”

“…Moreover, this phase is enhanced by negatively charged plasma proteins mainly positive reactants of the acute phase such as C‐reactive protein, fibrinogen, alpha or gamma globulins which decrease the normal distance between erythrocytes 1,3,4 . This explains the use of ESR in the diagnosis of inflammatory diseases 1,3,4 . Additionally, ESR depends on the size, shape, and concentration of erythrocytes, namely macrocytes settle faster than normal erythrocytes while microcytes and poikilocytes settle slower 1 .…”

“…Namely, these modified versions of the Westergren method and alternate methods are based on different methodologies (photometric rheology, centrifugation, capillary photometric‐kinetic technology, etc.) and are able to rapidly provide results 3,11 . Advantages of these systems include the use of ethylenediaminetetraacetic acid (EDTA) as an anticoagulant for the majority of methods 3,11 .…”

“…and are able to rapidly provide results 3,11 . Advantages of these systems include the use of ethylenediaminetetraacetic acid (EDTA) as an anticoagulant for the majority of methods 3,11 . In this way, ESR analysis can be performed from the same sample used for routine haematology testing, thus sparing the patient from excessive blood draw and reducing costs and biological waste 3,11 .…”