Accuracy evaluation of two portable blood glucose meters in feline patients using whole blood samples

ABSTRACT: Using portable blood glucose meters (PBGMs) to measure blood glucose (BG) concentration is a common procedure in veterinary practice. Our objective was to evaluate the analytical and clinical accuracy of a human PBGM (Accu-Chek Performa®), (AC) and a veterinary PBGM (GlucoCalea®), (GC) in feline patients. Central venous blood samples were collected from 48 cats at a Brazilian Veterinary teaching hospital. Two devices from each model were used and compared to a reference method (RM). Analytical accuracy was assessed according to ISO 15197:2013 requirements for human PBGMs. Data were compared using Wilcoxon’s nonparametric test and represented by Bland-Altman plots. Hematocrit’s effect on BG measurements was evaluated by the Spearman correlation coefficient. Clinical accuracy was determined using error grid analysis (EGA). Values of BG were significantly higher in all PBGMs compared to the RM. Although ISO’s analytical accuracy requirements could not be met by any of the devices, AC meters were more accurate than GC meters. All AC measurements - but not GC ones - were within zones A and B of the EGA, meeting ISO requirements for clinical accuracy. Significant hematocrit interference was observed in all devices. Therefore, AC showed greater accuracy compared to GC using feline whole blood samples.

摘要：在兽医临床中，使用便携式血糖仪（portable blood glucose meters，PBGMs）检测血糖（blood glucose，BG）浓度是一项常规操作。本研究旨在评估人类用便携式血糖仪（Accu-Chek Performa®，AC）与兽用便携式血糖仪（GlucoCalea®，GC）在猫患者中的分析准确度与临床准确度。研究在巴西某兽医教学医院采集了48只猫的中心静脉血样，每个型号各使用两台设备，并以参考方法（reference method，RM）作为对照。分析准确度依据ISO 15197:2013人类便携式血糖仪的相关标准要求进行评估；数据采用Wilcoxon非参数检验进行比较，并以Bland-Altman图可视化呈现。采用Spearman相关系数评估血细胞比容对血糖检测结果的影响，临床准确度则通过误差网格分析（error grid analysis，EGA）进行判定。结果显示，所有PBGM的检测结果均显著高于参考方法。尽管所有设备均未达到ISO的分析准确度要求，但AC血糖仪的准确度优于GC血糖仪；所有AC的检测结果均落在EGA的A、B两区，符合ISO的临床准确度要求，而GC则未满足该标准。所有设备均观察到显著的血细胞比容干扰。因此，在猫全血样本检测中，AC的准确度优于GC。