title: NT-proBNP on Cobas h 232 in point-of-care testing: Performance in the primary health care versus in the hospital laboratory.
abstract: BACKGROUND
  NT-proBNP may be useful for ruling out heart failure in primary health care. In this study we examined the analytical quality of NT-proBNP in primary health care on the Cobas h 232 point-of-care instrument compared with measurements performed in a hospital laboratory.
  
  
  METHODS
  Blood samples requested for NT-proBNP were collected in primary health care (n = 95) and in a hospital laboratory (n = 107). NT-proBNP was measured on-site on Cobas h 232 instruments both in primary health care centres and at the hospital laboratory and all samples were also analyzed with a comparison method at the hospital. Precision, trueness, accuracy, and lot-variation were determined at different concentration levels and evaluated according to acceptance criteria. Furthermore user-friendliness was assessed by questionnaires.
  
  
  RESULTS
  For Cobas h 232 repeatability CV was 8.5-10.7% in the hospital setting and 5.3-10.0% in the primary health care and within the analytical quality specifications, but higher than with the comparison method (< 4%). NT-proBNP results obtained in primary health care were significantly higher than by the hospital comparison method (bias ranged from 14.3-23.7%), whereas there was no significant bias when Cobas h 232 was used in the hospital setting (bias ranged from - 4.9 to 7.0%). User-friendliness of Cobas h 232 was overall acceptable.
  
  
  CONCLUSIONS
  Cobas h 232 point-of-care instrument for measurement of NT-proBNP performed satisfactorily with regard to precision, user-friendliness, and lot-variation. A decrease in NT-proBNP levels observed in samples transported to a central laboratory needs further attention and investigation.
authors: a Department of Clinical Biochemistry and Pharmacology , Odense University Hospital , Odense , Denmark.
authors: Charlotte
authors: C
authors: Gils
authors: Ramshanker
authors: R
authors: Ramanathan
authors: Torben
authors: T
authors: Breindahl
authors: Mette
authors: M
authors: Brokner
authors: Anne L
authors: AL
authors: Christiansen
authors: Øyvin
authors: Ø
authors: Eng
authors: Ida J
authors: IJ
authors: Hammer
authors: Catherine B
authors: CB
authors: Herrera
authors: Aina
authors: A
authors: Jansen
authors: Eva C
authors: EC
authors: Langsjøen
authors: Elisabeth S
authors: ES
authors: Løkkebo
authors: Toril
authors: T
authors: Osestad
authors: Anne D
authors: AD
authors: Schrøder
authors: Lisa
authors: L
authors: Walther
mesh_terms: D006801:Humans; D007755:Laboratories, Hospital; D020097:Natriuretic Peptide, Brain / Q000097:blood*; D010446:Peptide Fragments / Q000097:blood*; D000067716:Point-of-Care Testing / Q000592:standards*; D011320:Primary Health Care; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity
chemical_list: D010446:Peptide Fragments; C109794:pro-brain natriuretic peptide (1-76); D020097:Natriuretic Peptide, Brain
keywords: Natriuretic peptide; biological markers; heart disease; point-of-care systems; validation studies