The Effect of Recurrent Practice at Home on the Acceptability of Capillary Blood Glucose Readings: Accuracy of self blood glucose testing

Kabadi, Udaya M.; O’Connell, Kathleen; Johnson, Jennal; Kabadi, Mary U.

doi:10.2337/diacare.17.10.1110

Cited by 39 publications

(21 citation statements)

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“…Only 45% of the patients' measurements were within 10% of the hexokinase value, and only 63% were within 15%; these figures fall far short of the ADA benchmarks. In addition, these results are in accord with numerous studies that report the failure of patients to achieve the ADA goal for SMBG accuracy (14)(15)(16)(17) The new EG was created to reflect the opinion of a large number of clinical diabetes experts. The consensus EG lacks the discontinuities of Clarke et al' s EG but, otherwise, it gives similar results.…”

Section: Figure 1-egs For Type 1 Diabetes (A) and Type 2 Diabetes (B)supporting

confidence: 66%

A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.

et al. 2000

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OBJECTIVE -The objectives of this study were 1) to construct new error grids (EGs) for blood glucose (BG) self-monitoring by using the expertise of a large panel of clinicians and 2) to use the new EGs to evaluate the accuracy of BG measurements made by patients. RESEARCH DESIGN AND METHODS -To construct newEGs for type 1 and type 2 diabetic patients, a total of 100 experts of diabetes were asked to assign any error in BG measurement to 1 of 5 risk categories. We used these EGs to evaluate the accuracy of self-monitoring of blood glucose (SMBG) levels in 152 diabetic patients. The SMBG data were used to compare the new type 1 diabetes EG with a traditional EG.RESULTS -Both the type 1 and type 2 diabetes EGs divide the risk plane into 8 concentric zones with no discontinuities. The new EGs are similar to each other, but they differ from the traditional EG in several significant ways. When used to evaluate a data set of measurements made by a sample of patients experienced in SMBG, the new type 1 diabetes EG rated 98.6% of their measurements as clinically acceptable, compared with 95% for the traditional EG. CONCLUSIONS -The consensus EGs furnish a new tool for evaluating errors in the mea E m e r g i n g T r e a t m e n t s a n d T e c h n o l o g i e s 1144DIABETES CARE, VOLUME 23, NUMBER 8, AUGUST 2000 New error grid for blood glucose 152 patients who routinely monitor their own BG. The study was performed in a diabetes clinic with patients using their own meters. The distribution of errors in our sample is considered in light of both EGs and the latest recommendations of the American Diabetes Association (ADA). RESEARCH DESIGN AND METHODS Consensus EGWe surveyed 100 physicians at the 1994 ADA Annual Meeting to construct an unbiased tool to analyze the clinical significance of SMBG measurement errors. All of the respondents were clinicians who treated diabetic patients. Pursuant to constructing an EG in the fashion of Clarke et al. (6), each doctor was asked to assign any plausible error in BG measurement to 1 of 5 risk categories. The risk categories, in order of increasing severity, were defined as follows: A: no effect on clinical action; B: altered clinical action or little or no effect on clinical outcome; C: altered clinical action-likely to effect clinical outcome; D: altered clinical action-could have significant medical risk; and E: altered clinical action-could have dangerous consequences.The above definitions were intended to correspond to the definitions of the risk zones in the Clarke EG while allowing the respondents maximal freedom to set their own boundaries. For example, zone A of the Clarke EG is defined as Ͻ20% deviation or having both reference and measured BGs Ͻ70 mg/dl. In addition, the UVA authors (6) stated that "values falling within this range are clinically accurate in that they would lead to clinically correct treatment decisions." Our definition of zone A asks each respondent to define his or her own range of "clinically accurate measurements," which is clarified as having "no effe...

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Section: Figure 1-egs For Type 1 Diabetes (A) and Type 2 Diabetes (B)supporting

confidence: 66%

A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.

et al. 2000

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“…Patient factors are also important, particularly adequate training. Recurrent education at clinic visits and comparison of SMBG with concurrent laboratory glucose analysis improved the accuracy of patients' blood glucose readings (118 ). Thus, it is important to evaluate the patient's technique at regular intervals (21 ).…”

Section: Rationalementioning

confidence: 99%

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

et al. 2011

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BACKGROUND Multiple laboratory tests are used to diagnose and manage patients with diabetes mellitus. The quality of the scientific evidence supporting the use of these tests varies substantially. APPROACH An expert committee compiled evidence-based recommendations for the use of laboratory testing for patients with diabetes. A new system was developed to grade the overall quality of the evidence and the strength of the recommendations. Draft guidelines were posted on the Internet and presented at the 2007 Arnold O. Beckman Conference. The document was modified in response to oral and written comments, and a revised draft was posted in 2010 and again modified in response to written comments. The National Academy of Clinical Biochemistry and the Evidence Based Laboratory Medicine Committee of the AACC jointly reviewed the guidelines, which were accepted after revisions by the Professional Practice Committee and subsequently approved by the Executive Committee of the American Diabetes Association. CONTENT In addition to long-standing criteria based on measurement of plasma glucose, diabetes can be diagnosed by demonstrating increased blood hemoglobin A1c (Hb A1c) concentrations. Monitoring of glycemic control is performed by self-monitoring of plasma or blood glucose with meters and by laboratory analysis of Hb A1c. The potential roles of noninvasive glucose monitoring, genetic testing, and measurement of autoantibodies, urine albumin, insulin, proinsulin, C-peptide, and other analytes are addressed. SUMMARY The guidelines provide specific recommendations that are based on published data or derived from expert consensus. Several analytes have minimal clinical value at present, and their measurement is not recommended.

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“…However, this list (5,7-11) is incomplete, with there being many additional studies incorporating EGA (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30)(31). What is important to point out is that in all of these published studies the authors reported both EGA results and standard statistical results.…”

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confidence: 99%

Understanding Error Grid Analysis

et al. 1997

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The Effect of Recurrent Practice at Home on the Acceptability of Capillary Blood Glucose Readings: Accuracy of self blood glucose testing

Cited by 39 publications

References 0 publications

A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.

A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.

Guidelines and Recommendations for Laboratory Analysis in the Diagnosis and Management of Diabetes Mellitus

Understanding Error Grid Analysis

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