A computerized model for home glucose monitoring proficiency testing: efficacy of an innovative testing program.
A newly instituted computerized system for proficiency testing of home glucose monitoring was evaluated comparing accuracy of patient determination of glucose with serum values measured in the laboratory.



Patients returning for routine blood glucose testing ordered by their care provider brought their glucose monitoring equipment to the laboratory. They performed a finger-stick glucose check in the laboratory while the laboratory phlebotomist drew blood for glucose determination; both results were computer analyzed. Patients with a 25% or less variation from the laboratory were considered proficient, while those with greater than 25% variation were defined as nonproficient.



Over a 19-month period, 300 of the 3208 patients notified about the study completed proficiency testing at least once. Using the defined proficiency of 25% variation or less, 12% of the participants were nonproficient. Using a variation of 15% or less, 31% of patients were nonproficient.



An annual methodology evaluation such as the one in this study should become a standard of care to identify patients for remedial classes to correct the source of error. The goal must be to meet or exceed the American Diabetes Association standard of 15% total error in home glucose monitoring.
Schrot
R J
RJ
Department of Family Medicine, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Dr Schrot)
Foulis
P R
PR
Department of Pathol­ogy and Laboratory Medicine, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Dr Foulis)
Morrison
A D
AD
Department of Internal Medi­cine, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Drs Morrison and Farese)
Farese
R V
RV
Department of Internal Medi­cine, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Drs Morrison and Farese)|De­partment of Biochemistry/Molecular Biology, James A. Haley Veterans Administration Hospital, University of South Florida College of Medicine, Tampa, Florida (Dr  Farese)
D015982:Bias; D015190:Blood Glucose Self-Monitoring / Q000592:standards*; D002983:Clinical Competence / Q000592:standards*; D003663:Decision Trees; D003922:Diabetes Mellitus, Type 1 / Q000175:diagnosis / Q000378:metabolism*; D003936:Diagnosis, Computer-Assisted; D006801:Humans; D008838:Microcomputers; D010353:Patient Education as Topic / Q000592:standards*; D015397:Program Evaluation; D015203:Reproducibility of Results; D012648:Self Care / Q000592:standards*