Noninvasive Assessment of Excessive Erythrocytosis as a Screening Method for Chronic Mountain Sickness at High Altitude

Vyas, Kaetan J.; Danz, David; Gilman, Robert H.; Wise, Robert A.; León‐Velarde, Fabiola; Miranda, J. Jaime

doi:10.1089/ham.2015.0026

Cited by 7 publications

(7 citation statements)

References 27 publications

(28 reference statements)

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“…TrueHb has been evaluated in adult population in India in a single study with encouraging results [4]. Massimo have poor accuracy in most of the studies, although the precision was greater at higher levels of Hb, similar to our study [6,13,[15][16][17]22].…”

Section: Discussionsupporting

confidence: 80%

Diagnostic accuracy of point-of-care devices for detection of anemia in community settings in India

Neogi

Sharma

Pandey

et al. 2020

BMC Health Serv Res

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Background: Accurate diagnosis of anemia by community workers using a point-of-care device is a challenge. The objective of the study was to establish the diagnostic accuracy of point-of-care devices for detecting anemia in community settings. Methods: It was diagnostic accuracy study with cross-sectional design on adult patients attending the outpatient department of rural/ urban health centres of Medical colleges from India. The index tests were HemoCue, TrueHb, Massimo's device and spectroscopic device, compared against autoanalyzer (gold standard). Accuracy was expressed by sensitivity, specificity, likelihood ratios, predictive values, area under the curve (AUC) and levels of agreement. For the diagnostic accuracy component, 1407 participants were recruited with a minimum of 600 for each device. An additional 200 participants were considered to elucidate the performance of devices in different weather conditions. Results: HemoCue and TrueHb performed better than Massimo and spectroscopic devices. Detection of anemia by technicians was similar between TrueHb and HemoCue (AUC 0.92 v/s 0.90, p > 0.05). Community workers performed better with Hemocue for detecting anemia compared to TrueHb (AUC 0.92 v/s 0.90, p < 0.05). For detection of severe anemia, accuracy of TrueHb was significantly better with technicians (AUC 0.91 v/s 0.70; p < 0.05) and community workers (AUC 0.91 v/s 0.73; p < 0.05). HemoCue showed a bias or mean difference (95%CI) of 0.47 g/dl (0.42, 0.52) for all values, and 0.92 g/dl (0.82, 1.03) for severe anemia. For TrueHb, it was − 0.28 g/dl (− 0.37, − 0.20) for all readings, and 0.06 g/dl (− 0.52, 0.63) for severe anemia. TrueHb appeared to be more consistent across different weather conditions, although it overestimated Hb in extreme cold weather conditions. Conclusion: For detection of anemia, True Hb and HemoCue were comparable. For severe anemia, True Hb seemed to be a better and feasible point-of-care device for detecting anemia in the community settings.

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Section: Discussionsupporting

confidence: 80%

Diagnostic accuracy of point-of-care devices for detection of anemia in community settings in India

Neogi

Sharma

Pandey

et al. 2020

BMC Health Serv Res

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“…5B). Eight studies 40,42,112,117,[129][130][131]133 found higher mean Hb concentrations (0.3-14.0 g/L) and two 132,139 found lower mean concentrations (9.2−11.0 g/L) by the Pronto-7 compared with the reference. Eight studies 40,42,112,117,[129][130][131][132] were within the ±7% threshold for mean concentration variation for comparisons of the Masimo Pronto-7 with the reference, while two studies exceeded the ±7% bias 133,139 ( Fig.…”

Section: Figure 4 Differences In Mean Hb Of the Other Invasive Pointmentioning

confidence: 94%

“…Ten studies analyzed venous blood by the Masimo Pronto-7 compared with the reference among children aged 6 months to 17 years and adult males and females aged 18 years and older 40,42,112,117,[129][130][131][132][133]139 (Fig. 5B).…”

Section: Figure 4 Differences In Mean Hb Of the Other Invasive Pointmentioning

confidence: 99%

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

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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“…However, comparison of earlier results to current POC device performance is limited given ongoing software and hardware revisions [ 30 ]. More recent generations of POC devices (including the device used in this study), have been evaluated in subjects in a variety of clinical settings [ 9 , 31 , 32 ] and in healthy volunteers [ 33 , 34 ], with good correlation between POC hemoglobin and laboratory reference measures. A recent large meta-analysis evaluating the accuracy and precision of current POC devices against central laboratory hemoglobin measurements reported a pooled random-effects mean difference of POC minus central laboratory hemoglobin values of 0.10 ± 1.37 g/dL (limits of agreement − 2.59 to 2.80 g/dL) [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Noninvasive hematocrit assessment for cardiovascular magnetic resonance extracellular volume quantification using a point-of-care device and synthetic derivation

Robison

Karur

Wald

et al. 2018

Journal of Cardiovascular Magnetic Resonance

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BackgroundCalculation of cardiovascular magnetic resonance (CMR) extracellular volume (ECV) requires input of hematocrit, which may not be readily available. The purpose of this study was to evaluate the diagnostic accuracy of ECV calculated using various noninvasive measures of hematocrit compared to ECV calculated with input of laboratory hematocrit as the reference standard.MethodsOne hundred twenty three subjects (47.7 ± 14.1 years; 42% male) were prospectively recruited for CMR T1 mapping between August 2016 and April 2017. Laboratory hematocrit was assessed by venipuncture. Noninvasive hematocrit was assessed with a point-of-care (POC) device (Pronto-7® Pulse CO-Oximeter®, Masimo Personal Health, Irvine, California, USA) and by synthetic derivation based on the relationship with blood pool T1 values. Left ventricular ECV was calculated with input of laboratory hematocrit (Lab-ECV), POC hematocrit (POC-ECV), and synthetic hematocrit (synthetic-ECV), respectively. Statistical analysis included Wilcoxon signed-rank test, Bland-Altman analysis, receiver-operating curve analysis and intra-class correlation (ICC).ResultsThere was no significant difference between Lab-ECV and POC-ECV (27.1 ± 4.7% vs. 27.3 ± 4.8%, p = 0.106), with minimal bias and modest precision (bias − 0.18%, 95%CI [− 2.85, 2.49]). There was no significant difference between Lab-ECV and synthetic-ECV (26.7 ± 4.4% vs. 26.5 ± 4.3%, p = 0.084) in subjects imaged at 1.5 T, although bias was slightly higher and limits of agreement were wider (bias 0.23%, 95%CI [− 2.82, 3.27]). For discrimination of abnormal Lab-ECV ≥30%, POC-ECV had good diagnostic performance (sensitivity 85%, specificity 96%, accuracy 94%, and AUC 0.902) and synthetic-ECV had moderate diagnostic performance (sensitivity 71%, specificity 98%, accuracy 93%, and AUC 0.849). POC-ECV had excellent test-retest (ICC 0.994, 95%CI[0.987, 0.997]) and inter-observer agreement (ICC 0.974, 95%CI[0.929, 0.991]).ConclusionsMyocardial ECV can be accurately and reproducibly calculated with input of hematocrit measured using a noninvasive POC device, potentially overcoming an important barrier to implementation of ECV. Further evaluation of synthetic ECV is required prior to clinical implementation.

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Noninvasive Assessment of Excessive Erythrocytosis as a Screening Method for Chronic Mountain Sickness at High Altitude

Cited by 7 publications

References 27 publications

Diagnostic accuracy of point-of-care devices for detection of anemia in community settings in India

Diagnostic accuracy of point-of-care devices for detection of anemia in community settings in India

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

Noninvasive hematocrit assessment for cardiovascular magnetic resonance extracellular volume quantification using a point-of-care device and synthetic derivation

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