title: Short-Term Thermal-Humidity Shock Affects Point-of-Care Glucose Testing: Implications for Health Professionals and Patients.
abstract: The objective was to assess the effects of short-term (≤1 hour) static high temperature and humidity stresses on the performance of point-of-care (POC) glucose test strips and meters. Glucose meters are used by medical responders and patients in a variety of settings including hospitals, clinics, homes, and the field. Reagent test strips and instruments are potentially exposed to austere environmental conditions. Glucose test strips and meters were exposed to a mean relative humidity of 83.0% (SD = 8.0%) and temperature of 42°C (107.6°F, SD = 3.2) in a Tenney BTRC environmental chamber. Stressed and unstressed glucose reagent strips and meters were tested with spiked blood samples (n = 40 measurements per time point for each of 4 trials) after 15, 30, 45, and 60 minutes of exposure. Wilcoxon's signed rank test was applied to compare measurements test strip and meter measurements to isolate and characterize the magnitude of meter versus test strip effects individually. Stressed POC meters and test strips produced elevated glucose results, with stressed meter bias as high as 20 mg/dL (17.7% error), and stressed test strip bias as high as 13 mg/dL (12.2% error). The aggregate stress effect on meter and test strips yielded a positive bias as high as 33 mg/dL (30.1% error) after 15 minutes of exposure. Short-term exposure (15 minutes) to high temperature and humidity can significantly affect the performance of POC glucose test strips and meters, with measurement biases that potentially affect clinical decision making and patient safety.
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: Mandy
authors.initials: M
authors.lastname: Lam
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA rflouie@ucdavis.edu.
authors.forename: Richard F
authors.initials: RF
authors.lastname: Louie
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: Corbin M
authors.initials: CM
authors.lastname: Curtis
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: William J
authors.initials: WJ
authors.lastname: Ferguson
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: John H
authors.initials: JH
authors.lastname: Vy
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: Anh-Thu
authors.initials: AT
authors.lastname: Truong
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: Stephanie L
authors.initials: SL
authors.lastname: Sumner
authors.affiliation: UC Davis POC Technologies Center, Point-of-Care Testing Center for Teaching and Research, Pathology and Laboratory Medicine, University of California, Davis, CA, USA.
authors.forename: Gerald J
authors.initials: GJ
authors.lastname: Kost
keywords: clinical decision making; environmental stress; glucose test strip and meter performance; measurement error; patient safety; quality assurance