Research

The accuracy of a point-of-care test among different operators using the QBC Autoread Plus Analyzer for the measurement of a basic full blood count

W Laney, R Mawelele, S Omar

Abstract


Background. Major issues around the implementation of point-of-care testing (POCT) include: user type, regulatory control, ongoing quality monitoring and limited guideline adherence.59 December 2019, Print edition

Objectives. To determine if there are significant differences in the results of a POC full blood count test between different levels of healthcare and non-medical ‘lay’ users compared with laboratory users (technologists/pathologists).

Methods. This article retrospectively reviews the technical evaluation database of the intensive care unit (ICU), Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa. We searched for samples analysed by doctors, clerks and laboratory personnel. A minimum number of 60 comparisons were required. Bland-Altman plots, Spearman’s correlation and Passing-Bablok fit were used to analyse the dataset.

Results. There were 72 comparisons for haematocrit (Hct), 98 for white cell count (WCC) and 137 for platelets (Plt) between the clerk and laboratory personnel. The correlations were 0.91, 0.96 and 0.92, respectively. All were statistically significant. Using the Bland-Altman method, there was good agreement between results of the clerk and those of the laboratory staff, with a mean bias of 0.5% (Hct), 0.1 × 109/L (WCC) and 10 × 109/L (Plt). An insufficient number of tests were performed by medical doctors for statistical comparison.

Conclusions. With appropriate training, non-medical, non-healthcare lay users are able to perform a moderately complex POCT with similar accuracy as trained laboratory professionals. The focus should shift to equipment and quality management processes rather than the medical/technical qualification of the user.


Authors' affiliations

W Laney, Chris Hani Baragwanath Academic Hospital and Intensive Care Unit, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

R Mawelele, Intensive Care Unit, Chris Hani Baragwanath Academic Hospital, Johannesburg, South Africa

S Omar, Intensive Care Unit, Chris Hani Baragwanath Academic Hospital, and School of Clinical Medicine, Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa

Full Text

PDF (1994KB)

Keywords

Point-of-care diagnostics; Accuracy; Rapid tests

Cite this article

South African Medical Journal 2019;109(12):952-956. DOI:10.7196/SAMJ.2019.v109i12.13981

Article History

Date submitted: 2019-11-27
Date published: 2019-11-27

Article Views

Abstract views: 78
Full text views: 95

Comments on this article

*Read our policy for posting comments here