Effects of preanalytical factors on hemoglobin measurement: A comparison of two HemoCue® point-of-care analyzers

Whitehead, Ralph D.; Zhang, Ming; Sternberg, Maya; Schleicher, Rosemary L.; Drammeh, Bakary; Mapango, Carine; Pfeiffer, Christine M.

doi:10.1016/j.clinbiochem.2017.04.006

Cited by 40 publications

(76 citation statements)

References 13 publications

(20 reference statements)

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“…10,11,53–55 For both sources, blood collection may be more challenging among younger children compared with older children and adults because their fingers and veins are smaller. 1 …”

Section: Resultsmentioning

confidence: 99%

“…62 When applying the mean difference threshold of ±7% for the comparison of sources of blood collection (venous or cord blood as the reference), all studies were within the ±7% variation threshold . 11,19,51,52,54,56–65,76,87,140 …”

Section: Resultsmentioning

confidence: 99%

“…8–11 Clinical laboratories are controlled environments. Field settings include areas in the natural environment outside of a controlled environment.…”

Section: Introductionmentioning

confidence: 99%

“…These are reported as Supplementary Text S3 (online only) and Figure S2A and S2B (online only) and not the main body of the paper, because although they may be models currently used in clinical settings or the field by population-based surveys to assess anemia, they were compared with other methods and analyzers other than the AHA or they are models no longer supported by the manufacturer (e.g., HemoCue ® B-Hb). 11 …”

Section: Introductionmentioning

confidence: 99%

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Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings

Whitehead

Mei

Mapango

et al. 2019

Annals of the New York Academy of Sciences

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118

100

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This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. We conducted a literature review for methods used to measure Hb in clinical laboratories and field settings. We described methods to measure Hb and factors influencing results. Automated hematology analyzer (AHA) was reference for all Hb comparisons using evaluation criteria of ±7% set by College of American Pathologists (CAP) and Clinical Laboratory Improvement Amendments (CLIA). Capillary fingerprick blood usually produces higher Hb concentrations compared with venous blood. Individual drops produced lower concentrations than pooled capillary blood. Compared with the AHA: (1) overall cyanmethemoglobin (1.0–8.0 g/L), WHO Colour Scale (0.5–10.0 g/L), paper-based devices (5.0–7.0 g/L), HemoCue® Hb-201 (1.0–16.0 g/L) and Hb-301 (0.5–6.0 g/L), and Masimo Pronto® (0.3–14.0 g/L) overestimated concentrations; (2) Masimo Radical® −7 both under- and overestimated concentrations (0.3–104.0 g/L); and (3) other methods underestimated concentrations (2.0–16.0 g/L). Most mean concentration comparisons varied less than ±7% of the reference. Hb measurements are influenced by several analytical factors. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.This paper describes and compares methods and analyzers used to measure hemoglobin (Hb) in clinical laboratories and field settings. With few exceptions, mean concentration bias was within ±7%, suggesting acceptable performance. Appropriate, high-quality methods in all settings are necessary to ensure the accuracy of Hb measurements.

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“…10,11,53–55 For both sources, blood collection may be more challenging among younger children compared with older children and adults because their fingers and veins are smaller. 1 …”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

“…8–11 Clinical laboratories are controlled environments. Field settings include areas in the natural environment outside of a controlled environment.…”

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 2 more Smart Citations

Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings

Whitehead

Mei

Mapango

et al. 2019

Annals of the New York Academy of Sciences

Self Cite

118

100

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show abstract

“…While the preference for a particular anticoagulant in plasma and the influence of hemolysis and other preanalytical factors (e.g., bilirubin, lipemia) on the test result may be test specific, serum is usually the preferred matrix over plasma and iron measurement is generally more affected by hemolysis than SF and sTfR. For whole blood-based iron status indicators, fresh whole blood needs to be analyzed directly for Hb or refrigerated for 1–2 d prior to analysis (23) and refrigerated whole blood is stable for a week if protected from UV light for analysis of EP (4). …”

Section: Commonly Used Iron Status Indicators and Their Analysismentioning

confidence: 99%

Laboratory methodologies for indicators of iron status: strengths, limitations, and analytical challenges

Pfeiffer

Looker

2017

The American Journal of Clinical Nutrition

162

167

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Biochemical assessment of iron status relies on serum-based indicators, such as serum ferritin (SF), transferrin saturation, and soluble transferrin receptor (sTfR), as well as erythrocyte protoporphyrin (EP). These indicators present challenges for clinical practice and national nutrition surveys, and often iron status interpretation is based on the combination of several indicators. The diagnosis of iron deficiency (ID) through SF concentration, the most commonly used indicator, is complicated by concomitant inflammation. sTfR concentration is an indicator of functional ID that is not an acute-phase reactant, but challenges in its interpretation arise due to the lack of assay standardization, common reference ranges, and common cutpoints. It is unclear which indicators are best suited to assess excess iron status. The value of hepcidin, non-transferrin bound iron, and reticulocyte indices is being explored in research settings. Serum-based indicators are generally measured on fully-automated clinical analyzers available in most hospitals. Although international reference materials have been available for years, the standardization of immunoassays is complicated by the heterogeneity of antibodies used and the absence of physico-chemical reference methods to establish “true” concentrations. From 1988 to 2006, the assessment of iron status in the National Health and Nutrition Examination Survey (NHANES) was based on the multi-indicator ferritin model. However, the model did not indicate the severity of ID and produced categorical estimates. More recently, iron status assessment in NHANES has used the total body iron stores (TBI) model, in which the log ratio of sTfR to SF is assessed. Together, sTfR and SF concentrations cover the full range of iron status. The TBI model better predicts the absence of bone marrow iron than SF concentratio alone and TBI can be analyzed as a continuous variable. Additional consideration of methodologies, interpretation of indicators, and analytical standardization is important for further improvements in iron status assessment.

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Measurement Methods for Anemia and Iron Status Surveillance

Namasté

Brindle

Garrett

2022

Nutrition and Health

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Effects of preanalytical factors on hemoglobin measurement: A comparison of two HemoCue® point-of-care analyzers

Cited by 40 publications

References 13 publications

Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings

Methods and analyzers for hemoglobin measurement in clinical laboratories and field settings

Laboratory methodologies for indicators of iron status: strengths, limitations, and analytical challenges

Measurement Methods for Anemia and Iron Status Surveillance

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