Aug 2026· Apollo Medicine· 0 citations· 20 references
TL;DR
POCT glucose measurements show excellent correlation with laboratory auto-analyser results but exhibit systematic and proportional bias, particularly at higher glucose levels, particularly at higher glucose levels.
Abstract
Point-of-care testing (POCT) for blood glucose provides rapid results and is widely used in clinical practice; however, concerns remain regarding its accuracy and agreement with laboratory auto-analyser methods. The purpose of this study was to compare glucose measurements obtained using POCT and a laboratory auto-analyser in a secondary healthcare centre within a low-resource setting.
A comparison study was conducted using 120 paired blood glucose measurements obtained simultaneously by a POCT glucometer and a laboratory auto-analyser. Descriptive statistics were used to summarise glucose values. Pearson correlation and linear regression analyses assessed the relationship between methods, while agreement was evaluated using Bland-Altman analysis. Statistical significance was set at
P
< .05.
The mean glucose concentration measured by POCT was 6.59 ± 2.27 mmol/L, while that measured by the auto-analyser was 6.33 ± 2.93 mmol/L. A strong positive correlation was observed between the two methods (
r
= 0.971,
P
< .001). Linear regression analysis yielded the equation auto-analyser = 1.249 × POCT − 1.905 (
R
² = 0.943), indicating proportional bias. Bland-Altman analysis demonstrated a mean bias of −0.26 mmol/L, with 95% limits of agreement ranging from −2.03 to +1.50 mmol/L. Greater variability in differences was observed at higher glucose concentrations.
POCT glucose measurements show excellent correlation with laboratory auto-analyser results but exhibit systematic and proportional bias, particularly at higher glucose levels. While POCT is suitable for rapid glucose assessment and monitoring, laboratory auto-analyser methods remain the preferred reference for diagnostic and critical clinical decision-making.
Introduction: Point-of-care testing (POCT) for blood glucose measurement is increasingly used because it provides rapid results for clinical decision-making. However, its analytical performance must be evaluated before routine implementation. This study aimed to compare the precision, accuracy, and agreement of the Easy Touch and Emtech BG Max 1 POCT devices with the Glucose Oxidase–Peroxidase (GOD-PAP) reference method for blood glucose measurement.
Research Methodology: An observational analytic study with a cross-sectional design was conducted at the Buton Tengah Regional General Hospital Laboratory, Indonesia. Fifty venous blood samples were analyzed using the Easy Touch and Emtech BG Max 1 POCT devices and the GOD-PAP laboratory method as the reference standard. Precision was evaluated using the coefficient of variation (CV), accuracy was assessed through percentage bias and compliance with ISO 15197:2013, and agreement was determined using nonparametric Bland–Altman analysis.
Results: The CV values were 5.54% for Easy Touch, 1.76% for Emtech BG Max 1, and 0.80% for the GOD-PAP method. The mean bias was 7.74% for Easy Touch and −5.78% for Emtech BG Max 1. Compliance with ISO 15197:2013 was achieved in 62% of Easy Touch measurements and 90% of Emtech BG Max 1 measurements. Bland–Altman analysis demonstrated good agreement between both POCT devices and the reference method. However, Emtech BG Max 1 showed narrower limits of agreement and closer agreement with GOD-PAP than Easy Touch.
Conclusion: Both POCT devices demonstrated acceptable analytical agreement with the GOD-PAP method for blood glucose testing. However, Emtech BG Max 1 exhibited superior precision, lower analytical bias, and higher compliance with ISO 15197:2013, indicating greater reliability for routine clinical use. Periodic analytical performance evaluation is recommended to maintain the quality and accuracy of POCT-based blood glucose testing.
Muhammad Jalil Razak, N. Ismi, Marisca Jenice Sanakya et al.· Journal Interdisciplinary He...· 0 citations
Background:Diabetes mellitus is a growing global health concern, with rising prevalence particularly in low-and middle-income countries. Accurate blood glucose estimation is essential for diagnosis, monitoring, and prevention of complications. While glucometers provide rapid, convenient results at the point ofcare, laboratory autoanalyzer are considered more reliable. This study aimed to compare the accuracy and correlation between these two methods.Methodology: A comparative study was conducted on 150 patients above 18 years, including both diabetic and non-diabetic individuals. Capillary blood glucose was measured using a glucometer via finger prick, while venous blood samples were analysed using a laboratory autoanalyzer. Statistical analysis done by paired t-test.Result:The mean blood glucose level obtained from the glucometer was approximately 8.49 mg/dL higher than that of the autoanalyzer. A strong positive correlation was observed (r = 0.959), indicating that both methods follow a similar trend. However, the paired t-test (t = 4.68, p < 0.001) showed a statistically significant difference.Discussion:The findings indicate that glucometers tend to overestimate glucose levels, consistent with previous studies. This discrepancy may arise due to operational errors such as expired strips, improper sample handling, or device calibration issues. Such inaccuracies can lead to inappropriate clinical decisions, especially in critical glycemic conditions.Conclusion:Although glucometers are useful for routine monitoring and point-of-care testing, they are not fully interchangeable with laboratory methods due to significant bias. Laboratory autoanalyzers remain the gold standard for accurate glucose estimation.
Vaaruni Sharma, Ajay Puri· Asian Journal of Medical Res...· 0 citations
Accurate blood glucose measurement is essential for the diagnosis and management of diabetes mellitus. This study evaluated the precision and accuracy of three point-of-care testing (POCT) glucose analyzers—Accu-Chek, Accu-ANSWER, and VivaChek—against the standard laboratory glucose oxidase method. A total of 97 participants were recruited, and venous blood samples were analyzed using both POCT devices and the reference method. Results demonstrated that all three POCT devices consistently overestimated blood glucose levels, exhibiting a systematic positive bias ranging from +18.56 mg/dL to +19.99 mg/dL. Bland–Altman analysis revealed wide limits of agreement and evidence of proportional bias, with inaccuracies increasing at higher glucose concentrations. Only 39.18% of measurements met the ISO 15197:2013 accuracy criteria (±15%), while over 40% deviated by more than 25%. Among the devices, VivaChek showed relatively better precision, whereas Accu-Chek demonstrated the widest variability and lowest agreement with the reference method. Despite their convenience and rapid turnaround time, the findings indicate that these POCT devices have limited reliability for critical clinical decision-making. The study concludes that POCT glucose meters should be used cautiously and primarily for monitoring trends rather than definitive diagnosis or therapeutic decisions.
E. Nwobodo, Nneji Tochukwu Emmanuel· IOASD Journal of Medical and...· 0 citations
Background: The accuracy of portable blood glucose
monitoring systems is critical for the safe management
and follow-up of Diabetes Mellitus. This study evaluated the accuracy of a capillary glucose monitoring device
compared with laboratory-based spectrophotometric
analysis of venous blood according to ADA recommendations and selected ISO 15197:2015 accuracy limits.
Methods: A cross-sectional study was conducted using
133 paired venous and capillary blood samples. Glucose
concentrations were measured using the Humalyzer
2000 and Mindray BA-88A spectrophotometers and the
Prodigy AutoCode® glucometer. Data were analysed using Kruskal-Wallis and Spearman correlation tests, with
p<0.05 considered statistically significant.
Results: The glucometer reported slightly lower glucose
values than the laboratory-based spectrophotometric
methods. Correlation showed a weak association with the
Humalyzer 2000 (r=0.17) and a moderate association
with the Mindray BA-88A (r=0.415). Seventy-four per
cent of measurements were within the ISO 15197:2015
acceptance limits compared with the Humalyzer 2000,
whereas 92% were within the acceptance limits compared with the Mindray BA-88A for glucose concentrations <100 mg/dL. Bland–Altman analysis showed low
systematic bias versus both analysers (-0.44 to -3.89 mg/
dL), although agreement was more consistent with the
Mindray BA-88A because of narrower limits of agree ment. Greater variability was observed at higher glucose
concentrations, particularly with the Humalyzer 2000.
Conclusion: The glucometer demonstrated moderate
performance and partial agreement with selected ISO
15197:2015 accuracy limits compared with laboratory-based spectrophotometric methods. Increased variability at higher glucose concentrations limits its applicability
in settings requiring high analytical precision; therefore,
results should be interpreted with caution.
Pablo Letelier, Guido Fierro, K. Cuminao et al.· Journal of Medical Biochemis...· 0 citations
BACKGROUND
Rapid glucose assessment is essential in neonatal intensive care units (NICUs) for early detection of hypoglycemia. We evaluated the agreement between neonatal blood glucose levels measured using bedside blood gas analyzers (GasBS) and those measured in the central laboratory (LabBS), and identified factors associated with clinically significant discrepancies.
METHODS
We retrospectively analyzed 5436 paired specimens from 2105 infants admitted to the NICU. For the primary agreement analyses, 5375 specimens with GasBS > 20 mg/dL were included. Agreement between GasBS and LabBS was assessed using Bland-Altman analysis, correlation analysis, and linear mixed models. Factors associated with clinically significant discrepancies (absolute difference ≥ 10 mg/dL) were evaluated using generalized linear mixed models. Exploratory receiver operating characteristic analysis was performed to assess the ability of GasBS to detect LabBS < 40 mg/dL.
RESULTS
GasBS and LabBS showed good agreement, with a mean difference of 1.88 mg/dL (95% limits of agreement, -12.56 to 16.32 mg/dL) and a strong correlation (Spearman's ρ = 0.939, p < 0.001). Lower base excess, lower oxygenated hemoglobin, and higher postnatal age were associated with greater discrepancies, whereas higher hematocrit was associated with an increased risk of clinically significant discrepancies. GasBS also showed excellent performance in detecting LabBS < 40 mg/dL, with an area under the receiver operating characteristic curve of 0.985 and an optimal cutoff of 43.5 mg/dL.
CONCLUSIONS
Blood gas analyzers provide clinically useful glucose measurements in newborns. However, discrepancies from central laboratory measurements may occur under certain physiological conditions, and confirmatory testing remains essential when severe hypoglycemia is suspected.
I. Kurosawa, Hiroshi Miyabayashi, Yasue Goko et al.· Pediatrics International· 0 citations
Reliable INR monitoring is crucial for patients on warfarin to prevent thrombotic or bleeding events. This study evaluated the accuracy of the Wondfo POCT device compared to standard laboratory methods (Stago STA-R Max3 and ACL TOP 300) in a primary healthcare setting. The goal was to assess whether this point-of-care testing can provide timely and reliable results for better patient management in community-based clinics. In a prospective, cross-sectional study, samples from 74 patients on warfarin and 20 healthy controls were analyzed. Agreement was assessed using Bland-Altman plots, Deming regression, and CLSI POCT14-A criteria. Deming regression demonstrated strong linear correlations across all comparisons (r > 0.92, R² > 0.84). The mean bias for Wondfo (capillary) remained within CLSI POCT14-A agreement limits for all INR ranges when compared with both Stago and ACL TOP 300 platforms (all SE < AE). A very strong correlation was also observed between Wondfo venous and capillary results (r = 0.954, R² = 0.908). The study concludes that the Wondfo POCT device demonstrates acceptable agreement with standard laboratory testing within therapeutic ranges, thereby offering a viable alternative. It is a reliable and practical solution for rapid, decentralized INR monitoring, particularly in outpatient care, and can potentially improve patient management and safety.
Rosline Hassan, S. Iberahim, S. S. Mohd Yusoff et al.· Scientific Reports· 0 citations