Key result
Point-of-care HbA1c closely matches lab tests in overweight non-diabetics, yielding a minimal -0.05% bias.
Why the study?
Implementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist.
Does point-of-care HbA1c measurement agree with standard laboratory HbA1c testing for preoperative risk profiling in non-diabetic overweight or obese patients?
Observational (n=49)
No
Does point-of-care HbA1c measurement agree with standard laboratory HbA1c testing for preoperative risk profiling in non-diabetic overweight or obese patients?
Mean Difference: -0.05 (95% CI -0.39–0.28)
Point-of-care HbA1c measurements show high agreement with laboratory tests and are a valid, feasible tool for preoperative cardiometabolic risk screening in overweight or obese patients.
High agreement supports POC HbA1c for preoperative profiling in obese patients; leaves open need for larger trials before routine adoption.
Implementation of point-of-care HbA1c devices in the preoperative outpatient clinic might facilitate the early diagnosis of glycemic disturbances in overweight or obese patients undergoing surgery, but validation studies in this setting do not exist. We determined the level of agreement between a point-of-care and laboratory HbA1c test in non-diabetic patients visiting the outpatient clinic for preoperative risk profiling. Point-of-care HbA1c levels were measured in whole blood obtained by a finger prick (Siemens DCA Vantage HbA1c analyzer) and in hemolysed EDTA blood in the central laboratory (LAB). Bland Altman and Clarke’s error grid analysis were used to analyze the agreement between the point-of-care and laboratory measurements. Patients (n = 49) were 55 ± 11 years old, 47% were male with a body mass index (BMI) of 30.6 ± 3.4 kg/m2. The mean HbA1c was 38.1 ± 3.7 mmol/mol or 5.6 ± 0.3%. One patient was diagnosed with a HbA1c indicative for diabetes mellitus (6.7%). Bland Altman analysis revealed a bias of − 0.53 ± 1.81 mmol/mol with limits of agreement of − 4.09 to 3.03 mmol/mol and a bias of − 0.05 ± 0.17% with limits of agreement − 0.39 to 0.28%. The percentage error was 9.2% and 5.9% for HbA1c expressed in mmol/mol and %, respectively. Clarke’s error grid analysis showed that 48 out of 49 measurements were located in area A (98%). Point-of-care HbA1c measurements showed a high level of agreement with the laboratory test in the outpatient setting, and may be used for preoperative risk profiling in patients prone to cardiometabolic complications. Trial registration: Netherlands Trial Register NTR3057.
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Raalten et al. (2019) conducted an observational in Overweight or obese non-diabetic patients undergoing elective surgery (n=49). Point-of-care HbA1c measurement (Siemens DCA Vantage) vs. Laboratory HbA1c measurement was evaluated on Level of agreement between point-of-care and laboratory HbA1c measurements (bias in %) (bias of -0.05%, 95% CI -0.39 to 0.28). Point-of-care HbA1c measurements showed a high level of agreement with laboratory tests in overweight or obese non-diabetic patients, with a bias of -0.05% and limits of agreement of -0.39 to 0.28%.
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