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Hughes K, Moore C, Woods S, Wilkes E. Precision and accuracy of a point of care glucometer for detection of hypoglycaemia in horses. Vet J 2024; 305:106109. [PMID: 38599544 DOI: 10.1016/j.tvjl.2024.106109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2021] [Revised: 04/04/2024] [Accepted: 04/08/2024] [Indexed: 04/12/2024]
Abstract
Point-of-care (POC) glucometry is commonly used in horses; however, measurement error with this method when analysing hypoglycaemic samples (<4 mmol/L) is unknown. The objective of this study was to determine the precision and accuracy of glucometry in hypoglycaemic horses in comparison to a laboratory method of glucose measurement (LAB). Repeatability coefficients were 0.47 mmol/L for POC and 0.09 mmol/L for LAB, and coefficients of variation were 10 % and 2.11 %, for the POC and LAB methods, respectively. Systemic bias with the POC method was present, with a mean bias of -0.26 mmol/L (95 % limits of agreement: -0.88 - 0.37) in comparison to LAB, and <70% of measurements were within 20 % of paired LAB results. Prior to use of glucometers, assessment of the diagnostic performance of the equipment is necessary, including determination of acceptable criteria and reference ranges for hypoglycaemic samples.
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Affiliation(s)
- Kristopher Hughes
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW 2678, Australia.
| | - Claire Moore
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW 2678, Australia
| | - Sophie Woods
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW 2678, Australia
| | - Edwina Wilkes
- School of Agricultural, Environmental and Veterinary Sciences, Charles Sturt University, Locked Bag 588, Boorooma Street, Wagga Wagga, NSW 2678, Australia
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2
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Dannemiller NG, Cray C, Westmoreland LS, Christiansen EF. Diagnostic agreement between three point-of-care glucose and β-hydroxybutyrate meters and reference laboratory methods in stingrays. Front Vet Sci 2023; 10:1254340. [PMID: 38173551 PMCID: PMC10761536 DOI: 10.3389/fvets.2023.1254340] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2023] [Accepted: 11/28/2023] [Indexed: 01/05/2024] Open
Abstract
Point-of-care (POC) glucose and β-hydroxybutyrate (β-HB) meters can potentially provide rapid insight into an elasmobranch's metabolic state in clinical and field research settings. This study evaluated the diagnostic agreement of three commercial POC meters against reference laboratory methods for glucose and β-HB concentrations in stingrays. Blood was collected during anesthetized exams from 28 stingrays representing four species: cownose rays (Rhinoptera bonasus), Atlantic stingrays (Hypanus sabina), southern stingrays (Hypanus americanus), and yellow stingrays (Urobatis jamaicensis). Glucose and β-HB concentrations were measured with each POC meter using whole blood and plasma; in parallel, plasma glucose and β-HB concentrations were measured via reference laboratory methods. Agreement between POC meters and reference laboratory methods was assessed using Bland-Altman methods, Passing-Bablok regression, observed total error, percent relative error, and linear mixed effect models. Plasma glucose and β-HB concentrations determined by reference laboratory methods ranged from <20-63 mg/dL to 0.05-5.38 mmol/L, respectively. One human POC meter-the Precision Xtra-showed the greatest agreement with reference laboratory methods when measuring glucose with whole blood [mean bias and 95% CI: 0 (-3-4) mg/dL] and β-HB with plasma [mean bias and 95% CI: 0.1 (-0.04-0.2) mmol/L]. Stingray sex, weight, buffy coat, and packed cell volume did not significantly affect the agreement between POC meters and reference laboratory methods. Across all three POC meters, mean bias and imprecision for plasma β-HB concentrations were relatively small (0-0.1 mmol/L and 0%, respectively). Utilizing POC meters to measure glucose and β-HB in stingrays may be viable when reference methods are unavailable.
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Affiliation(s)
- Nicholas G. Dannemiller
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- North Carolina Aquariums, Raleigh, NC, United States
| | - Carolyn Cray
- Division of Comparative Pathology, Department of Pathology and Laboratory Medicine, University of Miami Miller School of Medicine, Miami, FL, United States
| | - Lori S. Westmoreland
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- North Carolina Aquariums, Raleigh, NC, United States
| | - Emily F. Christiansen
- Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States
- North Carolina Aquariums, Raleigh, NC, United States
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3
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Peña LW, Flatland B, Behrend EN, Arzón-Pereira A, Cole JE, Raz ML. Impact on result interpretation of correct and incorrect selection of veterinary glucometer canine and feline settings. J Vet Diagn Invest 2023; 35:710-720. [PMID: 37608786 PMCID: PMC10621561 DOI: 10.1177/10406387231195386] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/24/2023] Open
Abstract
Veterinary glucometers should be correctly coded for the patient species; however, coding errors occur in clinical settings and the impact of such errors has not been characterized. We compared glucose concentrations in 127 canine and 37 feline samples using both canine and feline settings on a veterinary glucometer (AlphaTrak; Zoetis). All samples were measured first on the canine setting and then measured using the feline setting. Glucose concentration was also measured using a central laboratory biochemical analyzer (Cobas c311; Roche). Three data comparisons for each species were investigated: incorrectly coded glucometer vs. correctly coded glucometer, correctly coded glucometer vs. Cobas c311, and incorrectly coded glucometer vs. Cobas c311. For each comparison, the following analyses were conducted: Spearman rank correlation coefficient, Bland-Altman difference plot analysis, mountain plot analysis, and Deming regression. For clinical context, Clarke error grids were constructed. There was high positive correlation for all comparisons with both species. For all comparisons, mean difference was low (-0.7 to 0.5 mmol/L for canine samples, 1.0-2.0 mmol/L for feline samples). Incorrect glucometer coding resulted in proportional bias for canine samples and positive constant bias for feline samples, and individual differences could be large (-4.44 mmol/L for one dog, 6.16 mmol/L for one cat). Although the glucometer should be used per the manufacturer's recommendation, coding errors are unlikely to have severe adverse clinical consequences for most patients based on error grid analysis.
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Affiliation(s)
- Lydia W. Peña
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Bente Flatland
- Department of Biomedical and Diagnostic Sciences, College of Veterinary Medicine, University of Tennessee, Knoxville, TN, USA
| | | | | | - Janeva E. Cole
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
| | - Maggie L. Raz
- Department of Clinical Sciences, College of Veterinary Medicine, Auburn University, Auburn, AL, USA
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4
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Stern JK, Camus MS. Point-of-Care Instruments. Vet Clin North Am Small Anim Pract 2023; 53:17-28. [DOI: 10.1016/j.cvsm.2022.08.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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5
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Hiebert K, Reich S, Allender MC. Evaluation of the Agreement Between 2 Point-Of-Care Glucometers and a Laboratory Automated Analyzer in North American Raptors. J Avian Med Surg 2022; 36:278-286. [DOI: 10.1647/21-00006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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6
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Newman AW, Moller CA, Evans SJM, Viall A, Baker K, Schaefer DMW. American Society for Veterinary Clinical Pathology-Recommended Clinical Pathology Competencies for Graduating Veterinarians. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:641-649. [PMID: 34491154 DOI: 10.3138/jvme-2021-0004] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
Given the move toward competency-based veterinary education and the subsequent reevaluation of veterinary curricula, there is a need for specialties to provide guidance to veterinary college administrators and educators on the core knowledge and skills pertaining to their specialty to ensure their inclusion in revised or redesigned curricula. The American Society for Veterinary Clinical Pathology (ASVCP) Education Committee sought to create a list of competencies specific to clinical pathology expected of graduating veterinarians. The stimulus for this project was the American Veterinary Medical Association Council on Education Standards of Accreditation for Colleges of Veterinary Medicine, further driven by the 2018 publication of the Association of American Veterinary Medical Colleges Competency-Based Veterinary Education Working Group framework. The recommendations made in this document are the culmination of the 2016 ASVCP Education Forum for Discussion, multiple remote subcommittee communications, and feedback obtained from ASVCP membership. The final framework includes 8 clinical pathology-focused domains of competence with 20 clinical pathology competencies and 61 clinical pathology illustrative sub-competencies. The clinical pathology-focused domains of competence are: the pre-analytical phase of testing, laboratory medicine and instrumentation, principles of test selection and interpretation, hematology and hemostasis, chemistry, endocrinology, urinalysis, and cytology. These are not intended to replace the nine established AAVMC domains of competence with supportive competencies and illustrative sub-competencies but to guide institutions for how clinical pathology aligns within the competency-based veterinary education (CBVE) framework for the practice-ready veterinary graduate. This clinical pathology competency framework may prove useful and empowering during discussions of curriculum revisions and redesigns.
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Cournoyer A, Deschamps A, Bau-Gaudreault L, Dubreuil P, Benoit-Biancamano MO. Analytical validation of a portable human Accu-Chek glucometer in honeybee hemolymph. J Vet Diagn Invest 2022; 34:789-795. [PMID: 35993265 PMCID: PMC9446297 DOI: 10.1177/10406387221117233] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Glucose and trehalose are the main energy sources used by honeybees (Apis mellifera) for daily activities. However, there is no validated point-of-care method to reliably measure both sugars. We performed an analytical validation of a portable human glucometer (Accu-Chek; Roche) for glucose measurement in honeybee hemolymph compared to a reference method (GluCH, UniCel DxC 600; Beckman Coulter). We used 30 pooled hemolymph samples collected from the antennae of anesthetized honeybees and diluted 1:4 in 0.9% saline. We evaluated dilution linearity, spike recovery, and inter- and intra-assay imprecision. Glucose concentration was measured over time (2 h, 4 h, 8 h, 12 h, 1 d, 2 d, 3 d, 7 d, 21 d, 28 d) at various storage temperature (25°C, 4°C, -20°C, -80°C). The trehalose concentration was measured indirectly by trehalase hydrolyzation. Glucose concentrations measured by both instruments had a strong correlation (0.985, p < 0.0001) and a bias of -7.33 mmol/L (±1.96SD: 13.70 to -28.36), with linear agreement at <20 mmol/L (physiologic value: 100 mmol/L). The accuracy of the glucometer decreased at >20 mmol/L. Recovery of 115-130% of diluted spikes indicated good specificity. Inter- and intra-assay imprecision were 2.50% and 2.21%, respectively. Glucose concentrations fluctuated in stored samples dependent on time and temperature; however, glucose concentrations were constant with storage at -80°C for ≥28 d. The Accu-Chek glucometer is an adequate instrument to measure honeybee glucose concentration in hemolymph diluted with 0.9% NaCl, with good accuracy and precision at <20 mmol/L. Hemolymph storage at -80°C is suitable for long-term conservation of glucose.
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Affiliation(s)
- Antoine Cournoyer
- Groupe de recherche sur les maladies infectieuses en production animale (GREMIP), Université de Montréal, Saint-Hyacinthe, Québec, Canada.,Centre de diagnostic vétérinaire de l'Université de Montréal, Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | | | | | - Pascal Dubreuil
- Centre de diagnostic vétérinaire de l'Université de Montréal, Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
| | - Marie-Odile Benoit-Biancamano
- Groupe de recherche sur les maladies infectieuses en production animale (GREMIP), Université de Montréal, Saint-Hyacinthe, Québec, Canada.,Centre de diagnostic vétérinaire de l'Université de Montréal, Département de pathologie et microbiologie, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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Proulx MP, Vergneau-Grosset C, Hébert J, Bédard C, Maccolini É. Comparison of a handheld point-of-care analyzer with a benchtop point-of-care chemistry analyzer for measurement of blood glucose concentration in client-owned ferrets (Mustela putorius furo). J Exot Pet Med 2022. [DOI: 10.1053/j.jepm.2022.07.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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9
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REFERENCE VALUES AND COMPARISON OF BLOOD CHEMISTRY AND PLASMA PROTEIN VALUES BETWEEN GOLD STANDARD ANALYZERS AND FOUR POINT-OF-CARE DEVICES IN FREE-RANGING CANVASBACKS ( AYTHYA VALISINERIA). J Zoo Wildl Med 2022; 53:302-318. [PMID: 35758572 DOI: 10.1638/2021-0035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2021] [Indexed: 11/21/2022] Open
Abstract
Accurate, timely, and cost-effective blood chemistry analysis is an essential tool for directing emergency treatment, monitoring the health status of captive and free-ranging individuals and flocks, and improving the efficacy of conservation actions. Blood samples were obtained from 52 canvasbacks (Aythya valisineria) that were captured on San Francisco Bay, California, during December 2017 as part of a long-term study. Reference values and clinical agreement were determined for blood chemistry and plasma protein parameters among four commonly used point-of-care devices (VetScan® VS2, i-STAT®, AlphaTRAK®2 glucometer, refractometer) and two gold standard laboratory analyzers (Roche cobas® c501, Helena SPIFE 3000 system). Canvasback reference values were generally within expected ranges for Anatidae species with the exception of higher upper limits for sodium and chloride. Creatine kinase and aspartate transaminase values exceeded a published threshold for diagnosis of capture myopathy even though study birds were captured using low-stress techniques and successfully released. With the exception of higher alkaline phosphatase in hatch-year canvasbacks, no age or sex differences were observed for any analyte in this population that was captured during a nonbreeding period. Analysis of analyzer agreement found raw VetScan aspartate transaminase, calcium, glucose, and uric acid values; corrected VetScan albumin, potassium, sodium, and total protein values; raw i-STAT glucose and potassium values; and corrected i-STAT sodium and chloride values were clinically interchangeable with Roche cobas values. Raw VetScan and i-STAT glucose values were also interchangeable. However, none of the Roche or point-of-care analyzer plasma protein values were in clinical agreement with gold standard electrophoresis values. The findings of this study highlight the need for analyzer- or technique-specific reference values and provide biologists and veterinarians quantitative reference values using currently available analyzers to better assess and respond to the health of individuals and populations.
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Wolfenden G, James FE, Hung LHT, Bruce M, Thompson M. Comparative accuracy of two veterinary‐calibrated point‐of‐care glucometres for measurement of blood glucose concentration in dogs. J Small Anim Pract 2022; 63:512-519. [DOI: 10.1111/jsap.13491] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2021] [Revised: 01/23/2022] [Accepted: 02/05/2022] [Indexed: 11/27/2022]
Affiliation(s)
| | | | | | - M. Bruce
- School of Veterinary Medicine and Centre for Biosecurity and One Health Murdoch University Murdoch 6150 Australia
| | - M. Thompson
- Sydney School of Veterinary Science The University of Sydney Camperdown 2050 Australia
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11
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Ismail-Hamdi S, Romdane MN, Ben Romdhane S. Comparison of a human portable blood glucose meter and automated chemistry analyser for measurement of blood glucose concentrations in healthy dogs. Vet Med Sci 2021; 7:2185-2190. [PMID: 34352158 PMCID: PMC8604129 DOI: 10.1002/vms3.594] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Blood glucose measurement is one of the most commonly performed clinical diagnostic tests used to monitor glycaemia in several animal diseases. Usually, these laboratory analyses are performed on blood venous samples in remote laboratories, and the results are delayed, at best. The use of portable glucometers could evidently solve many constraints but veterinary‐use glucometers are not usually available. The present study aimed to compare blood glucose levels obtained by Bionime glucometer to the reference method using glucose oxidase. Venous blood was collected from a total number of 140 healthy dogs (72 males and 68 females), of different breeds (28 German Shepherd, 27 Pitt bull, 21 Boxer, 24 Rottweiler and 40 cross‐bred dogs) and different ages (range: 3 months–14 years) for glucose measurement using the reference laboratory method. Capillary blood samples were used to conduct a glucose measurement with a human‐use glucometer. Our results revealed that there was no significant difference between the mean capillary blood glucose (CBG) measured with the human‐use glucometer (5.06 ± 0.84 mmol/L) and the mean venous blood glucose (VBG) measured with the laboratory reference method (4.90 ± 0.73 mmol/L) (p = 0.42). Similarly, there was no significant difference of the mean CBG and VBG in male dogs (5.11 ± 0.88 and 4.97 ± 0.75 mmol/L, respectively) and female dogs (5.01 ± 0.81 and 5.07 ± 0.72 mmol/L, respectively) (p = 0.73 and 0.21, respectively), and no correlation to neither age (5.43 ± 0.90 and 5.20 ± 0.70 mmol/L in 3 to 6 month‐old dogs, 5.03 ± 0.82 and 4.94 ± 0.79 mmol/L in 6 months to 1 year‐old, 4.94 ± 0.67 and 5.13 ± 0.66 mmol/L in 1 to 4 year‐old dogs; 4.88 ± 0.94 and 4.80 ± 0.75 mmol/L in dogs older than 4 years, respectively, p < 0.05), nor to breed (4.94 ± 1.01 and 4.99 ± 0.79 mmol/L in German Shepherd, 5.13 ± 0.84 and 4.99 ± 0.79 mmol/L in Pitt Bull, 5.07 ± 0.94 and 5.07 ± 0.77 mmol/L in Boxer, 5.40 ± 0.59 and 5.48 ± 0.55 mmol/L in Rottweiler and 4.89 ± 0.75 and 4.77 ± 0.59 mmol/L in cross‐bred dogs, respectively, p < 0.05). The present study confirms that human glucometer can be used to measure glucose in dogs with a good accuracy.
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Affiliation(s)
- Sihem Ismail-Hamdi
- Laboratory of Biochemistry, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Sidi Thabet, Tunisia.,Laboratory of Bio-ecology and Evolutionary Systematic, Faculty of Mathematical, Physical and Natural Sciences of Tunis, University of Carthage, Tunis, Tunisia
| | - Mohamed Néjib Romdane
- Laboratory of Biochemistry, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Sidi Thabet, Tunisia
| | - Samir Ben Romdhane
- Laboratory of Biochemistry, National School of Veterinary Medicine of Sidi Thabet, University of Manouba, Sidi Thabet, Tunisia
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Perrault JR, Arendt MD, Schwenter JA, Byrd JL, Tuxbury KA, Stacy NI. Comparison of 2 glucose analytical methodologies in immature Kemp's ridley sea turtles: dry chemistry of plasma versus point-of-care glucometer analysis of whole blood. J Vet Diagn Invest 2021; 33:595-599. [PMID: 33739180 DOI: 10.1177/10406387211001830] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Blood glucose measurements provide important diagnostic information regarding stress, disease, and nutritional status. Glucose analytical methodologies include dry chemistry analysis (DCA) of plasma and point-of-care (POC) glucometer analysis of whole blood; however, these 2 methods differ in cost, required sample volume, and processing time. Because POC glucometers use built-in equations based on features of mammalian blood to convert whole blood measurements to plasma equivalent units, obtained glucose data must be compared and validated using gold-standard chemistry analytical methodology in reptiles. For in-water, trawl-captured, immature Kemp's ridley sea turtles (Lepidochelys kempii) from Georgia, USA, we observed significant, positive agreement between the 2 glucose determination methods; however, the glucometer overestimated glucose concentrations by 1.4 mmol/L on average in comparison to DCA and produced a wider range of results. The discordance of these results suggests that POC glucometer glucose data should be interpreted in the context of methodology- and brand-specific reference intervals along with concurrent packed cell volume data.
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Affiliation(s)
| | - Michael D Arendt
- Marine Resources Division, South Carolina Department of Natural Resources, Charleston, SC
| | - Jeffrey A Schwenter
- Marine Resources Division, South Carolina Department of Natural Resources, Charleston, SC
| | - Julia L Byrd
- South Atlantic Fishery Management Council, North Charleston, SC
| | - Kathryn A Tuxbury
- Animal Health Department, New England Aquarium, Central Wharf, Boston, MA
| | - Nicole I Stacy
- Aquatic, Amphibian, and Reptile Pathology Program, Department of Comparative, Diagnostic, and Population Medicine, College of Veterinary Medicine, University of Florida, Gainesville, FL
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Silva KG, Rotta I, Costa LB, Sotomaior CS. Comparison of 2 portable human glucometers for the measurement of blood glucose concentration in White New Zealand rabbits. J Vet Diagn Invest 2020; 32:683-688. [PMID: 32723169 DOI: 10.1177/1040638720946702] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
We compared measurements of blood glucose concentrations in 30 healthy adult White New Zealand rabbits using 2 commercial portable glucometers (PGM1 and PGM2) and a laboratory chemical analyzer. Results were analyzed with Pearson correlation, Passing-Bablok regression analysis, Bland-Altman analysis, and a modified error grid. Measurements with PGM1 were significantly correlated (r = 0.37) with those obtained from the laboratory reference method (RM); Bland-Altman and Passing-Bablok analyses indicated no significant systematic or proportional differences (mean difference of -0.26, 95% CI of mean difference of -0.54 to 0.01, and LOA of -1.70 to 1.17); and error grid resulted in 100% of measurements in zone A. No significant correlation (r = -0.05) was detected between PGM2 and RM; Bland-Altman and Passing-Bablok analyses results indicated a mean difference of 2.14, 95% CI of mean difference of 1.67-2.60, and limit of agreement of -0.32 to 4.59, which overestimated blood glucose concentration, with 53% of glucose measurements in error grid zone A and 47% in zone B. PGM1 was considered accurate in normoglycemic rabbits, whereas the use of PGM2 could result in overestimations of glycemia.
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Affiliation(s)
- Kassy G Silva
- Graduate Program in Animal Science (Silva, Costa, Sotomaior) and Undergraduate Program in Veterinary Medicine (Rotta), Pontifícia Universidade Católica do Paraná, Paraná, Brazil
| | - Isabella Rotta
- Graduate Program in Animal Science (Silva, Costa, Sotomaior) and Undergraduate Program in Veterinary Medicine (Rotta), Pontifícia Universidade Católica do Paraná, Paraná, Brazil
| | - Leandro B Costa
- Graduate Program in Animal Science (Silva, Costa, Sotomaior) and Undergraduate Program in Veterinary Medicine (Rotta), Pontifícia Universidade Católica do Paraná, Paraná, Brazil
| | - Cristina S Sotomaior
- Graduate Program in Animal Science (Silva, Costa, Sotomaior) and Undergraduate Program in Veterinary Medicine (Rotta), Pontifícia Universidade Católica do Paraná, Paraná, Brazil
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Karapinar T, Tumer KC, Buczinski S. Evaluation of the Freestyle Optium Neo H point-of-care device for measuring blood glucose concentrations in sick calves. J Vet Intern Med 2020; 34:1650-1656. [PMID: 32420677 PMCID: PMC7379022 DOI: 10.1111/jvim.15794] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/07/2019] [Revised: 04/23/2020] [Accepted: 04/28/2020] [Indexed: 12/27/2022] Open
Abstract
Background Data on the performance of a glucometer in calves with different diseases are currently lacking. Objective The primary objective of this study was to evaluate the reliability of a point of care glucometer in calves affected by different diseases relative to a traditional bench‐top autoanalyzer. Animals One hundred ninety‐six calves with different disorders in a referral hospital. Methods Prospective study. Venous blood samples were used for the determination of glucose concentrations in blood and plasma using the Freestyle Optium Neo H and autoanalyzer, respectively. Data were subjected to Passing‐Bablok regression and Bland‐Altman plots. The Freestyle Optium Neo H was the test method and the autoanalyzer was the reference method. The diagnostic performance of the glucometer relative to the autoanalyzer was assessed using 3 different plasma glucose concentrations. Results The Passing‐Bablok regression for the glucometer against the reference method revealed the presence of both proportional bias (1.12; 95% confidence interval [CI], 1.07‐1.18) and constant bias (−11.25; 95% CI, −16.0 to −7.70). The glucometer yielded 92.2%‐100% sensitivity and 86.4%‐96% specificity for the assessing glucose concentration based on different concentration thresholds. Conclusions and Clinical Importance The Freestyle Optium Neo H showed proportional and constant biases relative to the reference method. The glucometer showed poor performance according to criteria recommended by the International Standards Organization and the American Society for Veterinary Clinical Pathology. However, the glucometer determined hypoglycemia with high sensitivity and specificity therefore it might be used to diagnose hypoglycemia in calves with different diseases until calf‐specific POC glucometers are developed.
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Affiliation(s)
- Tolga Karapinar
- Department of Internal Medicine, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Kenan Cagri Tumer
- Department of Internal Medicine, Faculty of Veterinary Medicine, Firat University, Elazig, Turkey
| | - Sébastien Buczinski
- Département des sciences cliniques, Faculté de médecine vétérinaire, Université de Montréal, Saint-Hyacinthe, Québec, Canada
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Kunze PE, Perrault JR, Chang YM, Manire CA, Clark S, Stacy NI. Pre-/analytical factors affecting whole blood and plasma glucose concentrations in loggerhead sea turtles (Caretta caretta). PLoS One 2020; 15:e0229800. [PMID: 32126109 PMCID: PMC7053744 DOI: 10.1371/journal.pone.0229800] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2019] [Accepted: 02/13/2020] [Indexed: 11/29/2022] Open
Abstract
Blood glucose is vital for many physiological pathways and can be quantified by clinical chemistry analyzers and in-house point-of-care (POC) devices. Pre-analytical and analytical factors can influence blood glucose measurements. This project aimed to investigate pre-analytical factors on whole blood and plasma glucose measurements in loggerhead sea turtles (Caretta caretta) by evaluating the effects of storage (refrigeration) up to 48h after sampling and of packed cell volume (PCV) on whole blood glucose analysis by POC glucometer (time series n = 13); and by evaluating the effects of storage (room temperature and refrigeration) on plasma glucose concentrations using a dry slide chemistry analyzer (DCA) at various conditions: immediate processing and delayed plasma separation from erythrocytes at 24h and 48h (time series n = 14). The POC glucometer had overall strong agreement with the DCA (CCC = 0.76, r = 0.84, Cb = 0.90), but consistently overestimated glucose concentrations (mean difference: +0.4 mmol/L). The POC glucometer results decreased significantly over time, resulting in a substantial decline within the first 2h (0.41±0.47 mmol/L; 8±9%) that could potentially alter clinical decisions, thereby highlighting the need for immediate analysis using this method. The effects of PCV on glucose could not be assessed, as the statistical significance was associated with one outlier. Storage method significantly affected plasma glucose measurements using DCA, with room temperature samples resulting in rapid decreases of 3.57±0.89 mmol/L (77±9%) over the first 48h, while refrigerated samples provided consistent plasma glucose results over the same time period (decrease of 0.26±0.23 mmol/L; 6±5%). The results from this study provide new insights into optimal blood sample handling and processing for glucose analysis in sea turtles, show the suitability of the POC glucometer as a rapid diagnostic test, and confirm the reliability of plasma glucose measurements using refrigeration. These findings emphasize the need to consider pre-/analytical factors when interpreting blood glucose results from loggerhead sea turtles.
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Affiliation(s)
- Patricia E. Kunze
- Royal Veterinary College, University of London, London, United Kingdom
- Institute of Zoology, Zoological Society of London, London, United Kingdom
| | - Justin R. Perrault
- Loggerhead Marinelife Center, Juno Beach, Florida, United States of America
| | - Yu-Mei Chang
- Royal Veterinary College, University of London, London, United Kingdom
| | - Charles A. Manire
- Loggerhead Marinelife Center, Juno Beach, Florida, United States of America
| | - Samantha Clark
- Loggerhead Marinelife Center, Juno Beach, Florida, United States of America
| | - Nicole I. Stacy
- Department of Comparative, Diagnostic, and Population Medicine, Aquatic, Amphibian, and Reptile Pathology Program, College of Veterinary Medicine, University of Florida, Gainesville, FL, United States of America
- * E-mail:
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16
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Siegel A, M. Walton R. Hematology and Biochemistry of Small Mammals. FERRETS, RABBITS, AND RODENTS 2020. [PMCID: PMC7258700 DOI: 10.1016/b978-0-323-48435-0.00039-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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McQuinn ER, Viall AK, Hirschfield MA, Ward JL, Jeffery U, LeVine DN. Inaccurate point-of-care blood glucose measurement in a dog with secondary erythrocytosis. J Vet Emerg Crit Care (San Antonio) 2019; 30:81-85. [PMID: 31840932 DOI: 10.1111/vec.12909] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2017] [Revised: 01/29/2018] [Accepted: 03/13/2018] [Indexed: 01/02/2023]
Abstract
BACKGROUND Point-of-care (POC) portable blood glucose meters (PBGMs) are convenient and inexpensive tools for assessing patient blood glucose concentrations. They are often used to quickly diagnose hypoglycemia or collect serial glucose readings in diabetic patients. However, POC meters have been previously identified in human and veterinary literature to be inaccurate when utilized in patients with abnormal HCT. This problem may not be reflected in manufacturer guidelines referenced by practitioners in the POC setting. KEY FINDINGS A 1.5-year-old dog, previously diagnosed with multiple congenital cardiac malformations, right-to-left cardiac shunting and secondary erythrocytosis, presented to a veterinary emergency center minimally responsive and without detectable pulses. PBGM measurement identified hypoglycemia. Following stabilization of the dog, serial glucose assessments showed discordant results between PBGMs and the reference laboratory biochemistry analyzer. A pathological cause for hypoglycemia was not identified and PBGM readings were determined to be erroneously low due to the dog's abnormally high HCT. SIGNIFICANCE This case demonstrates the limitations of using PBGMs to assess blood glucose in a dog with secondary erythrocytosis. The report emphasizes the need for judicious use of PBGMs in critically ill patients and that these glucometers may not be reliable in patients with abnormal HCT values.
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Affiliation(s)
- Erin R McQuinn
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA
| | | | | | - Jessica L Ward
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA
| | - Unity Jeffery
- Veterinary Microbiology and Preventative Medicine, Iowa State University, Ames, IA
| | - Dana N LeVine
- Department of Veterinary Clinical Sciences, Iowa State University, Ames, IA
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Lopes RB, Valldecabres A, Silva-Del-Río N. Technical note: Glucose concentration in dairy cows measured using 6 handheld meters designed for human use. J Dairy Sci 2019; 102:9401-9408. [PMID: 31378495 DOI: 10.3168/jds.2018-15688] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/13/2018] [Accepted: 06/04/2019] [Indexed: 11/19/2022]
Abstract
The objective was to evaluate the precision and accuracy of 6 handheld glucose meters, designed for human use [Accu-Chek Aviva Plus (AC), Roche Diabetes Care, Mannheim, Germany; Aga Matrix (AM), AgaMatrix Inc., Salem, NH; Contour Next (CT), Bayer HealthCare LLC, Leverkusen, Germany; FreeStyle Precision Neo (FS), Abbott Diabetes Care Ltd., Alameda, CA; Nova Max Plus (NM), Nova Biomedical Corporation, Waltham, MA; and Precision Xtra (PX), Abbott Diabetes Care Ltd., Witney, UK] to measure blood glucose concentration in dairy cows. Blood samples from Jersey and Jersey × Holstein crossbreed cows (n = 97 for all; except CT, n = 71) were collected and analyzed in triplicate using the 6 handheld glucose meters evaluated. Plasma glucose was also measured with the laboratory reference method (hexokinase glucose-6-phosphate dehydrogenase). Based on the intra-assay coefficient of variation (CV), precision varied across handheld glucose meters: AC (2.2%), CT (4.0%), PX (4.7%), FS (5.6%), AM (6.2%), and NM (6.7%). Lin's concordance correlation coefficients between handheld glucose meters and the reference method were 0.75 for FS, 0.74 for PX, 0.62 for AC, 0.55 for CT, 0.53 for NM, and 0.48 for AM. Based on Passing-Bablok regression, the AM and PX meters showed bias in the measurements of blood glucose. Bland-Altman plots indicated a negative bias (FS = -0.25 mmol/L; CT = -0.60 mmol/L) or a positive bias (AM = 0.29 mmol/L; PX = 0.33 mmol/L; NM = 0.52 mmol/L; AC = 0.65 mmol/L) between handheld glucose meters and the reference method. All handheld glucose meters evaluated had wide limits of agreement (LoA) ranging from -0.18 to 1.47 mmol/L (AC, narrowest LoA) to -1.25 to 1.82 mmol/L (AM, widest LoA). Bias was the major contributor to the total observed error (TEobs), accounting for 81.5% of the TEobs in AC, 72.0% in CT, 64.9% in AM, 61.1% in NM, 57.8% in PX, and 56.2% in FS. Overall, although some handheld meters (AC, CT, and PX) showed satisfactory precision, none were accurate measuring glucose. Future studies should evaluate whether incorporating algorithms designed for cattle can improve accuracy and precision of handheld glucose meters.
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Affiliation(s)
- R B Lopes
- Veterinary Medicine Teaching and Research Center, 18830 Road 112, Tulare, CA 93274
| | - A Valldecabres
- Veterinary Medicine Teaching and Research Center, 18830 Road 112, Tulare, CA 93274
| | - N Silva-Del-Río
- Veterinary Medicine Teaching and Research Center, 18830 Road 112, Tulare, CA 93274; Department of Population Health and Reproduction, School of Veterinary Medicine, University of California, Davis 95616.
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Precision and accuracy of a point-of-care glucometer in horses and the effects of sample type. Vet J 2019; 252:105359. [PMID: 31554585 DOI: 10.1016/j.tvjl.2019.105359] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Revised: 08/15/2019] [Accepted: 08/20/2019] [Indexed: 11/21/2022]
Abstract
Point-of-care glucometry is used commonly in clinical and research settings; however, accuracy and precision of this method are concerns. The objectives of this study were to determine the accuracy of glucometry in adult horses and the precision of duplicate measurements. Blood samples were collected from 62 horses into one plain syringe, one EDTA tube and three fluoride oxalate (FO) tubes. Immediately after collection, glucose concentrations in whole blood were determined, in duplicate, by glucometry from the syringe (plain whole blood [WB] group), EDTA tube (EDTA group) and one FO tube (FO group). One FO sample was used to measure plasma glucose concentration by a laboratory chemistry analyser (LAB group) ≤1 h after collection. The third FO tube was used to measure plasma glucose concentration by glucometry after 3 h storage (FO3hr group). Adequate precision was present for all groups (coefficient of variation: 0.7-3.5%) except WB (5.5-9.4%). Between groups, correlations were significant (P < 0.05; except for WB-EDTA), varied with group comparison, and tended to be lowest for comparisons involving WB. Mean bias was lowest for WB-LAB and greatest for FO-LAB and FO3hr-LAB; however, the limits of agreement were ≥4.65 mmol/L for WB-LAB and ≤2.75 mmol/L for most other comparisons. For the glucometer used, performance was influenced by sample type: WB was unsuitable, while FO or EDTA samples resulted in adequate precision and accuracy, provided under-estimation of glucose concentrations is accounted for by using method-specific reference ranges. Glucometer performance and optimal sample type(s) should be determined prior to use in horses.
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Nishi Y, Murakami Y, Otsuka M, Tsukano K, Ajito T, Suzuki K. Accuracy of the point-of-care glucose meter for use in calves. J Vet Med Sci 2019; 81:1301-1304. [PMID: 31308294 PMCID: PMC6785606 DOI: 10.1292/jvms.19-0272] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The aim of this study was to evaluate the accuracy and precision of portable blood glucose meters, such as i-STAT 1 and Precision Xceed, for use in calves. Whole blood and plasma samples
were obtained from eleven calves that received 2.5 or 5.0% dextrose-containing polyelectrolyte isotonic solutions. Measurements using the i-STAT 1 (r2=0.99,
P<0.0001) and Precision Xceed (r2=0.96, P<0.0001) were well correlated with those by the hexokinase method, which is the
gold standard. Although the accuracy of i-STAT 1 was equivalent to that of the hexokinase method, there was an autocorrelation in the residuals between the results from the Precision Xceed
and the hexokinase method. Thus, the i-STAT 1 can be used to measure the blood glucose concentration in cattle.
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Affiliation(s)
- Yasunobu Nishi
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midorimachi, Bunnkyoudai, Ebetsu, Hokkaido 069-8501, Japan
| | - Yoshiki Murakami
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midorimachi, Bunnkyoudai, Ebetsu, Hokkaido 069-8501, Japan
| | - Marina Otsuka
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midorimachi, Bunnkyoudai, Ebetsu, Hokkaido 069-8501, Japan
| | - Kenji Tsukano
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midorimachi, Bunnkyoudai, Ebetsu, Hokkaido 069-8501, Japan
| | - Tadaharu Ajito
- School of Veterinary Medicine, Nippon Veterinary and Life Science University, 1-7-1 Kyounancho, Musashino, Tokyo 180-0023, Japan
| | - Kazuyuki Suzuki
- School of Veterinary Medicine, Rakuno Gakuen University, 582 Midorimachi, Bunnkyoudai, Ebetsu, Hokkaido 069-8501, Japan
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COMPARISON OF WHOLE BLOOD AND PLASMA GLUCOSE CONCENTRATIONS IN GREEN TURTLES ( CHELONIA MYDAS) DETERMINED USING A GLUCOMETER AND A DRY CHEMISTRY ANALYZER. J Wildl Dis 2017; 54:196-199. [PMID: 29087774 DOI: 10.7589/2017-08-198] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
: We compared glucose concentrations in whole blood and plasma from green turtles ( Chelonia mydas) using a glucometer with plasma glucose analyzed by dry chemistry analyzer. Whole blood glucose (glucometer) and plasma glucose (dry chemistry) had the best agreement ( rs=0.85) and a small negative bias (-0.08 mmol/L).
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Abstract
This literature review covers approximately 35 years of veterinary medicine. This article develops the current state of knowledge in pet ferret medicine regarding the most common diseases according to evidence-based data and gives insight into further axis of research. Literature review was conducted through identification of keywords (title + ferret) with Web-based database searching. To appreciate the methodological quality and the level of evidence of each article included in the review, full-text versions were reviewed and questions addressed in the articles were formulated. Analysis of the articles' content was performed by the authors, and relevant clinical information was extracted.
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Affiliation(s)
- Minh Huynh
- Exotic Department, Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France.
| | - Lucile Chassang
- Exotic Department, Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France
| | - Graham Zoller
- Exotic Department, Centre Hospitalier Vétérinaire Frégis, 43 Avenue Aristide Briand, Arcueil 94110, France
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Doss GA, Mans C, Hoey S, Di Girolamo N, Stepien RL, Waller KR. Vertebral heart size in chinchillas (Chinchilla lanigera) using radiography and CT. J Small Anim Pract 2017; 58:714-719. [DOI: 10.1111/jsap.12715] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Revised: 05/24/2017] [Accepted: 06/16/2017] [Indexed: 11/28/2022]
Affiliation(s)
- G. A. Doss
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin 53706 USA
| | - C. Mans
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin 53706 USA
| | - S. Hoey
- School of Veterinary Medicine; University College Dublin; Belfield Dublin 4 Ireland
| | | | - R. L. Stepien
- Department of Medical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin 53706 USA
| | - K. R. Waller
- Department of Surgical Sciences, School of Veterinary Medicine; University of Wisconsin-Madison; Madison Wisconsin 53706 USA
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Camus MS. Quality control for the in-clinic veterinary laboratory and pre-analytic considerations for specialized diagnostic testing. Vet J 2016; 215:3-9. [PMID: 27017052 DOI: 10.1016/j.tvjl.2016.02.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2015] [Revised: 02/08/2016] [Accepted: 02/28/2016] [Indexed: 11/25/2022]
Abstract
This review, aimed primarily at general practitioners, focuses on quality assurance/quality control principles for all three phases of clinical pathology testing: preanalytic, analytic, and postanalytic. Specific emphasis is placed on the preanalytic phase of diagnostic modalities for identifying neoplastic cells, specifically flow cytometry, PCR for antigen receptor rearrangement, and immunocytochemistry. Recommendations for establishing an in-clinic quality assurance system are provided.
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Affiliation(s)
- Melinda S Camus
- Department of Pathology, University of Georgia College of Veterinary Medicine, Athens, GA, USA.
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