Validity of non-invasive point-of-care hemoglobin estimation in healthy and sick children—a method comparison study

Bhat, A.; Upadhyay, Amit; Jaiswal, Vijay; Chawla, Deepak; Singh, Dharamveer; Kumar, Mithilesh; Yadav, Chander Prakash

doi:10.1007/s00431-015-2602-9

Cited by 17 publications

(13 citation statements)

References 28 publications

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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: 82%

“…Some devices that have the potential for use in field settings in India include invasive devices (require finger pricking for taking blood -HemoCue, TrueHb) and non-invasive devices (do not require pricking -Massimo's device and AJO spectroscopic device). HemoCue and Massimo's device have been validated and extensively evaluated in field settings [6,[10][11][12][13][14][15][16]. The findings are however not very consistent [12,[15][16][17].…”

Section: Introductionmentioning

confidence: 95%

“…Appropriate treatment relies on accurate diagnosis at the point of care. Different devices for detection of anemia have been evaluated in the country [4,[6][7][8][9]. A device for use in communities or primary healthcare facilities in resource-poor settings should be inexpensive, rapid, and easy to perform with reasonable accuracy.…”

Section: Introductionmentioning

confidence: 99%

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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: 82%

Section: Introductionmentioning

confidence: 95%

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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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“…The Pronto® device with DCI-mini™ sensors (Masimo Corporation, Irvine, CA) is designed for use with infants and children weighing 3 to 30 kg. The device has already been assessed in high-resource settings, primarily for continuous monitoring of pediatric patients in critical care settings [ 9 , 10 ], but evidence to support its use in Africa and for community-based screening is not yet available.…”

Section: Introductionmentioning

confidence: 99%

An evaluation of hemoglobin measurement tools and their accuracy and reliability when screening for child anemia in Rwanda: A randomized study

et al. 2018

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Blood hemoglobin (Hb) is a common indicator for diagnosing anemia and is often determined through laboratory analysis of venous samples. One alternative to laboratory-based methods is the handheld HemoCue® Hb 201+ device, which requires a finger prick and wicking of blood into a pretreated cuvette for analysis. An alternative HemoCue® gravity method is being investigated for improved accuracy. Further, recent developments in noninvasive technologies could provide an accurate, rapid, safe, point-of-care option for hemoglobin estimation while addressing some limitations of current tools, but device performance must be assessed in low-resource settings. This study evaluated the performance of two HemoCue® Hb 201+ blood sampling methods and a noninvasive device (Pronto® with DCI-mini™ sensors) in a Rwandan pediatric clinic. Reference hemoglobin values were determined in 132 children 6 to 59 months of age by using a standard hematology analyzer (Sysmex KN21TM). Half were tested using the HemoCue® wicking method; half were tested using the HemoCue® gravity method; and 112 had successful hemoglobin readings with Pronto® DCI-mini™. Statistical analysis was used to assess the level of bias generated by each method and the key drivers of bias. The HemoCue® gravity method was the least biased. The HemoCue® wicking and Pronto® methods biases were inversely related to the Sysmex KN21TM results. Both HemoCue® sampling methods correctly classified patients’ anemic status in 80% or more of instances, whereas the Pronto® device had a correct classification rate of only 69%. The HemoCue® gravity method was more accurate than the traditional HemoCue® wicking method in this study, but its accuracy and operational feasibility should be confirmed by future studies. The Pronto® DCI-mini™ devices showed considerable promise but require further improvements in sensitivity and specificity before wider adoption.

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“…Since its introduction on the market more than half a decade ago, non-invasive SpHb has been the focus of numerous studies in pediatric, 11–15 spine, 16–18 trauma, 19, 20 obstetric, 21–23 urological, 24 abdominal surgery, 25, 26 emergency, 27–29 critically ill 30–32 and other patient groups 33–40 as well as a few review articles. 1–3 …”

Section: Discussionmentioning

confidence: 99%

Noninvasively Measured Hemoglobin Concentration Reflects Arterial Hemoglobin Concentration Before but Not After Cardiopulmonary Bypass in Patients Undergoing Coronary Artery or Valve Surgery

Riess

Pagel

2016

Journal of Cardiothoracic and Vascular Anesthesia

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Objective This study compared non-invasively measured hemoglobin and arterial hemoglobin before and after cardiopulmonary bypass in patients undergoing coronary artery or valve surgery. Design Observational study with retrospective data analysis. Setting Veterans Affairs hospital. Participants Thirty-five men. Interventions None. Measurements and Main Results We compared hemoglobin values measured non-invasively by co-oximetry (Radical-7 Pulse CO-Oximeter; Masimo, Irvine, CA) to corresponding arterial hemoglobin concentrations taken at clinically relevant time points chosen at the discretion of the cardiac anesthesiologist. Thirty-five and 27 pooled pairs of data were obtained before and after cardiopulmonary bypass, respectively. Arterial hemoglobin concentration was analyzed using i-STAT CG8+ test cartridges (Abbott Point of Care, Princeton, NJ) routinely used in our operating rooms and those of other institutions. Linear regression and Bland-Altman analysis revealed a significant positive bias, wide limits of agreement, and low correlation coefficients between the non-invasive and arterial hemoglobin measurements. These findings were especially notable after compared with before cardiopulmonary bypass. Conclusions The results suggest that non-invasive measurement of hemoglobin overestimates arterial hemoglobin by almost 1 g/dL when compared to iSTAT. A lack of precision was also observed with non-invasive measurement of hemoglobin especially after cardiopulmonary bypass. These findings support the contention that sole reliance on non-invasive measurement of hemoglobin for transfusion decisions in cardiac surgery patients may be inappropriate.

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Validity of non-invasive point-of-care hemoglobin estimation in healthy and sick children—a method comparison study

Abstract: Non-invasive Hb estimation by SpHb monitor is reasonably accurate in healthy neonates and children. It can be used in critically ill children and neonates, but in conjunction with lab confirmation of Hb values.

Cited by 17 publications

References 28 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

An evaluation of hemoglobin measurement tools and their accuracy and reliability when screening for child anemia in Rwanda: A randomized study

Noninvasively Measured Hemoglobin Concentration Reflects Arterial Hemoglobin Concentration Before but Not After Cardiopulmonary Bypass in Patients Undergoing Coronary Artery or Valve Surgery

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