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2003, Number 3

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Rev Endocrinol Nutr 2003; 11 (3)

Inter-observers variability of the semiquantitative glucemia measurement, at emergency unit in a General Hospital

Esquivel-Molina CG, González-Ávila G, Madero-Fernández del Castillo MA, Velasco-Rodríguez VM

Language: Spanish
References: 25
Page: 112-119
PDF size: 98.71 Kb.


ABSTRACT

Background: Bedside blood glucose in uncontrolled diabetic patients has evolved from visual reading strips to more quantitative measurements aided by reflectometry. A high correlation (r2 0.97) of semiquantitative vs quantitative methods has been demonstrated reflecting association trend but not inter-observers agreement that could be more useful in clinical field. Objective: To assess inter-observers agreement for blood glucose measured by visual strip reading haemoglukotest 20-800 (HG 20-800) at emergency unit in a General Hospital setting. Design: Crossover. Material and methods: Capillary and venous samples (n = 151) were obtained from consecutive patients with diabetes. Agreement to visually read HG 20-800 strips was assessed among 15 members of nurse staff at emergency room, simultaneously capillary and venous blood glucose were measured and correlation calculated between this results. Nurses kept blinded to quantitative results. Random Kappa (κ) coefficient was calculated for ordinal variables, Pearson’s “r” for correlation, c2 for homogeneity. SPSS software v 8.0 was used. Results: Unstandardized agreement estimation by κ = 0.957 (IC 95% 0.900-1.013) p = 0.00. Standardized by HG 20-800 intervals κ = 0.963 (IC 95% 0.919-1.006) p = 0.00. When venous blood glucose was contrasted with HG 20-800, calculated κ dropped to 0.483 (IC 95% 0.300-0.665) p = 0.00. Conclusions: Agreement was “almost perfect”, with and without standardization of visual strips test, but comparing with plasma glucose results k value decrease to less than 50% which is interpreted as a “regular agreement” negatively affecting validity. This information stress poor usefulness of visual strip test as an indicator for diagnosis, treatment and follow-up of patients with diabetes at emergency room.


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