title: Effect of hemoglobin concentration variation on the accuracy and precision of glucose analysis using tissue modulated, noninvasive, in vivo Raman spectroscopy of human blood: a small clinical study.
abstract: Tissue modulated Raman spectroscopy was used noninvasively to measure blood glucose concentration in people with type I and type II diabetes with HemoCue fingerstick measurements being used as reference. Including all of the 49 measurements, a Clarke error grid analysis of the noninvasive measurements showed that 72% were A range, i.e., clinically accurate, 20% were B range, i.e., clinically benign, with the remaining 8% of measurements being essentially erroneous, i.e., C, D, or E range. Rejection of 11 outliers gave a correlation coefficient of 0.80, a standard deviation of 22 mg/dL with p<0.0001 for N=38 and places all but one of the measurements in the A and B ranges. The distribution of deviations of the noninvasive glucose measurements from the fingerstick glucose measurements is consistent with the suggestion that there are at least two systematic components in addition to the random noise associated with shot noise, charge coupled device spiking, and human factors. One component is consistent with the known variation of fingerstick glucose concentration measurements from laboratory reference measurements made using plasma or whole blood. A weak but significant correlation between the deviations of noninvasive measurements from fingerstick glucose measurements and the test subject's hemoglobin concentration was also observed.
authors.affiliation: Syracuse University, Department of Chemistry, Syracuse, New York 13244-4100, USA. jchaiken@syr.edu
authors.forename: Joseph
authors.initials: J
authors.lastname: Chaiken
authors.forename: William
authors.initials: W
authors.lastname: Finney
authors.forename: Paul E
authors.initials: PE
authors.lastname: Knudson
authors.forename: Ruth S
authors.initials: RS
authors.lastname: Weinstock
authors.forename: Muhktar
authors.initials: M
authors.lastname: Khan
authors.forename: Rebecca J
authors.initials: RJ
authors.lastname: Bussjager
authors.forename: Douglas
authors.initials: D
authors.lastname: Hagrman
authors.forename: Pamela
authors.initials: P
authors.lastname: Hagrman
authors.forename: Yiwei
authors.initials: Y
authors.lastname: Zhao
authors.forename: Charles M
authors.initials: CM
authors.lastname: Peterson
authors.forename: Karen
authors.initials: K
authors.lastname: Peterson
mesh_terms: D000328:Adult; D000368:Aged; D016477:Artifacts; D015415:Biomarkers / Q000097:blood; D001774:Blood Chemical Analysis / Q000295:instrumentation / Q000379:methods*; D001786:Blood Glucose / Q000032:analysis*; D015190:Blood Glucose Self-Monitoring / Q000295:instrumentation / Q000379:methods; D003920:Diabetes Mellitus / Q000097:blood* / Q000175:diagnosis*; D005260:Female; D006454:Hemoglobins / Q000032:analysis*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013059:Spectrum Analysis, Raman / Q000295:instrumentation / Q000379:methods*
chemical_list: D015415:Biomarkers; D001786:Blood Glucose; D006454:Hemoglobins