NakedSignal

Change explorer · Haematology and immunology

Point-of-care haemoglobin meter B vs the laboratory, community clinic setting

Public dataBuilt from a published open-access study.

Laboratory haematology analyser (reference) compared with point of care haemoglobin meter B (community clinic setting): 100 paired results from a published study by Jaggernath et al. (2016), re-analysed by NakedSignal as if one laboratory had switched from the first system to the second. At 8, 12, 13 g/dL, 37 results fall in a different category on the second system than on the first, against about 62 expected from repeat testing alone. Here the count sits below the repeat-testing expectation, but that expectation uses the larger of the two systems’ measured imprecision, the new device’s own. Noise here means repeat testing on the old system, and at the old system’s own measured precision this reading does not hold, so this page does not read the comparison as below noise.

Haematology and immunology

Haemoglobin, g/dL

Laboratory haematology analyser (reference) compared with Point of care haemoglobin meter B (community clinic setting). 100 paired results.

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Comparison line

The new system reads 4.4% lower than the old system on average. The comparison line (Passing-Bablok) has a slope of 1.031 (95% interval 0.923 to 1.148) and an intercept of -0.624.

Public data
Comparison line, haemoglobin (g/dL)Comparison line with slope 1.031 (95% interval 0.923 to 1.148) and intercept -0.624, drawn against the line of no change. Decision limits drawn at 8, 12, 13 g/dL. Where the comparison line sits above the line of no change, the new system reads higher; below, lower.510155101581213No changeComparison lineOld system, g/dLNew system, g/dL

Fig. 1. The comparison line against the line of no change, over the range of the decision limits (8, 12, 13 g/dL). Dots mark where each line meets each limit; the gap between them is the bias at that limit.

Crossing each limit

Results that fall on the other side of a decision limit on the new system than on the old, read as if the new system had replaced the old, against the number repeat testing on one unchanged system would move. The program reports the count across all limits together.

All decision limits together (8, 12, 13 g/dL)

Crossed between the two systems: 37

Expected from repeat testing alone: about 62

Grade and warnings

  • Re-test band: full (at least the protocol minimum of pairs).
  • Band half-width around each limit: 1.16%.
  • Results re-tested on data the band was not fitted to, median: 13%.
  • Repeat-test imprecision: supplied by the study, precision file (patient-sample replicates, 5 per sample), the larger of the two systems. The replicates were run in the study's central laboratory phase and are applied here to the community clinic phase.
  • Note: Fewer than 5 results crossed beyond what repeat testing alone would move; excess caught is not meaningful here.

Source

Data: Huub Gelderblom (2016). Performance characteristics of three point of care hemoglobin meters in Durban-2.xlsx. figshare. doi:10.6084/m9.figshare.3119449 (opens in a new tab). Licence: CC BY 4.0 (opens in a new tab). Supplement to Jaggernath M, Naicker R, Madurai S, Brockman MA, Ndung'u T, Gelderblom HC (2016). PLoS One. doi:10.1371/journal.pone.0152184 (opens in a new tab); PMC4821624 (opens in a new tab). Re-analysed by NakedSignal. The deposit names the systems.

Show the numbers
All values for haemoglobin, Laboratory haematology analyser (reference) to Point of care haemoglobin meter B
FieldValue
Paired results used100
Comparison line slope1.030536
Slope, 95% interval0.923077 to 1.148194
Comparison line intercept-0.624068
Mean difference, new minus old, as % of old-4.415
Decision limits (g/dL)8, 12, 13
Crossed between the two systems37
Expected from repeat testing alone62.32
Band half-width (%)1.16
Re-tested, unseen data, median (%)13
Re-tested, unseen data, range (%)11 to 16
Excess caught, line and band (%)none
Excess caught, line alone (%)none

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