title: Comparison of the Accu-Chek Aviva point-of-care glucometer with blood gas and laboratory methods of analysis of glucose measurement in equine emergency patients.
abstract: BACKGROUND
  More information is needed regarding accuracy of commonly used methods of glucose measurement in the critically ill horse.
  
  
  OBJECTIVE
  Glucometry will have good agreement with a laboratory standard. Glucometry with plasma will have better agreement than when performed with whole blood.
  
  
  METHODS
  Fifty sequentially admitted equine emergency patients, aged >1year.
  
  
  METHODS
  Venous blood was collected at admission and immediately analyzed by point-of-care glucometry on both whole blood (POC/WB) and plasma (POC/PL), a multielectrode blood gas analyzer with whole blood (BLG), and a standard laboratory method with plasma (CHEM). Paired data were compared using Lin's concordance correlation, Pearson's correlation, and robust regression. Bias and limits of agreement were tested by the Bland-Altman technique. Bivariate regression analysis was used to explore confounding factors.
  
  
  RESULTS
  Concordance was significant for all comparisons, and was strongest for CHEM-POC/PL (0.977) and weakest for POC/WB-POC/PL (0.668). Pearson's correlation was excellent for all comparisons except those with POC/WB. All comparisons had excellent robust regression coefficients except those with POC/WB.
  
  
  CONCLUSIONS
  POC glucometry with plasma had excellent agreement with a laboratory standard, as did blood gas analysis. POC glucometry with whole blood correlated poorly with a laboratory standard. These differences may be clinically important, and could affect decisions based on glucose concentrations.
authors.affiliation: School of Veterinary Medicine, University of Pennsylvania, New Bolton Center, Kennett Square, PA 19348, USA.
authors.forename: A R
authors.initials: AR
authors.lastname: Hollis
authors.forename: B L
authors.initials: BL
authors.lastname: Dallap Schaer
authors.forename: R C
authors.initials: RC
authors.lastname: Boston
authors.forename: P A
authors.initials: PA
authors.lastname: Wilkins
mesh_terms: D000818:Animals; D001784:Blood Gas Analysis / Q000662:veterinary*; D001786:Blood Glucose / Q000032:analysis*; D004630:Emergencies / Q000662:veterinary*; D005260:Female; D006734:Horse Diseases / Q000097:blood / Q000175:diagnosis*; D006736:Horses; D008297:Male; D019095:Point-of-Care Systems; D012044:Regression Analysis
chemical_list: D001786:Blood Glucose