title: Use of 12x/month haemoglobin monitoring with a computer algorithm reduces haemoglobin variability.
abstract: BACKGROUND
  Haemoglobin variability may be associated with increased death. Frequent haemoglobin monitoring may allow earlier detection of trends in haemoglobin slopes, alerting staff to intercurrent events. The more frequent haemoglobin values may provide early evidence of response to erythropoietin (EPO) doses, and allow more appropriate anaemia management. Our objective is to assess whether frequent haemoglobin monitoring data (12x/month) using a computer algorithm (AMIE, Leeds, UK) will reduce haemoglobin variability compared with 1x/month monitoring.
  
  
  METHODS
  We performed an observational case-control study of 44 unselected patients, comprising one dialysis facility measuring Crit-Line haemoglobin, lab haemoglobin, standard deviation of residuals as surrogate of haemoglobin variability and EPO dosing.
  
  
  RESULTS
  Haemoglobin variability and 'percent in target haemoglobin range' significantly improved with 12x/month haemoglobin results using a computer algorithm. There was also a non-significant trend toward for lower EPO doses.
  
  
  CONCLUSIONS
  Use of a computer algorithm to analyse 12x/month haemoglobin values provides early evidence of haemoglobin trends and allows more appropriate anaemia management, with decreased haemoglobin variability, lower EPO doses and more patients achieving target haemoglobin.
authors.affiliation: Baystate Medical Center, Springfield, MA, USA. warren.ho@bhs.org
authors.forename: Warren R
authors.initials: WR
authors.lastname: Ho
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Germain
authors.forename: Jane
authors.initials: J
authors.lastname: Garb
authors.forename: Sue
authors.initials: S
authors.lastname: Picard
authors.forename: Molly-Kate
authors.initials: MK
authors.lastname: Mackie
authors.forename: Cherry
authors.initials: C
authors.lastname: Bartlett
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Will
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D000465:Algorithms; D000740:Anemia / Q000097:blood* / Q000188:drug therapy / Q000209:etiology; D016022:Case-Control Studies; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006397:Hematinics / Q000627:therapeutic use; D006454:Hemoglobins / Q000378:metabolism*; D006801:Humans; D007674:Kidney Diseases / Q000150:complications / Q000628:therapy; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic / Q000379:methods*; D006435:Renal Dialysis; D013813:Therapy, Computer-Assisted
chemical_list: D006397:Hematinics; D006454:Hemoglobins