Comparison of erythrocyte sedimentation rate results of test-1 and automatic westergren device with reference westergren method

Amaç: International Council of Standardization in Heamatology (ICSH) eritrosit sedimentasyon hızı (ESR) ölçümünde referens metod olarak Westergren yöntemini önerse de günümüzde farklı numune türleri kullanan, birçok modifiye yöntem ve cihaz bulunmaktadır. Biz de hastanemizde bulunan EDTAlı örnek kullanan Test-1 cihazı ile sitratlı örnek kullanan infrared tekniği ile çalışan otomatik westergren metodu ile uyumlu cihazı referans yöntem Westergren metodu ile karşılaştırmayı amaçladık. Yöntem: ESR ve hemogram testi için K2EDTA ve sodyum sitratlı tüplere eş zamanlı 7 ayrı günde toplamda 80 hastadan alınan kan örnekleri 2 saat içinde laboratuvarımıza ulaştıktan sonra Test-1 ve otomatik Westergren cihazlarında ve referans Westergren metodu ile çalışıldı. Her iki yöntem birbirleri ile ve referans metod ile istatistiksel olarak concordance correlation coefficient ve Passing-Bablok regresyon analiz yöntemi ile karşılaştırıldı. Bulgular: ESR sonucu 1-78 mm/saat aralığında dağılan değerlerde Test-1 ve otomatik Westergren cihazlarının referans metod Westergren ile korelasyonun analizinde R2 değerleri sırasıyla 0,86 (%95 Cl 0,801 to 0,913) ve 0,978 (%95 Cl 0,967 to 0,985) iken iki cihazın birbiri ile korelasyon analizinde R2 değeri 0,898 (%95 0,846 to 0,933) bulundu. Passing- Bablok analizinde ise cihazların referans yöntem ile regresyon analizinde Test-1 cihazı için intercept-0,5 (%95 Cl -2,42- 0) slope 1,09 (%95 Cl 1-1,21) (y=-0,5+1,09x), otomatik Westergren cihazı için intercept -0,25 (%95 Cl-1,26-0) slope 1,03 (%95 Cl1-1,08) (y=0,25+1,03x) her iki sistemin birbiri ile karşılaştırmasında ise intercept-0,14 (%95 Cl 1,01-0) slope 1,02 (%95 Cl 1-1,17) (y=-0,14+1,02x) bulunmuştur. Student t testi ile karşılaştırma yapıldığında, test sonuçlarında gruplar arası anlamlı bir farklılık izlenmedi (p>0,05). Sonuç: ESR ölçümü için Test-1 method ve otomatize westergren metod cihazları referans yöntemle karşılaştırıldığında rutin laboratuvarda güvenle kullanılabilirler. Test-1 cihazında yüksek ESR değerlerinde referans yönteme göre sapmalar olduğu izlenmiş ve bu değerlerde dikkatli olunması gerektiği bu konuyla ilgili olarak daha fazla hasta sayısıyla kapsamlı çalışmalara ihtiyaç olduğunu düşünmekteyiz.

Referans westergren metodu ile test-1 ve otomatik westergren cihazı eritrosit sedimentasyon hızı sonuçlarının karşılaştırılması

Aim: International Council of Standardization in Hematology (ICSH) suggests Westergren method as a reference method in erythrocyte sedimentation rate (ESR) measurement. There are lots of modified methods and devices which use different sample types recently. We investigated to compare the devices which are present in our hospital; Test-1 device that uses samples with EDTA and the device which is compatible with automatic Westergren method that uses infrared technique and studies with citrated samples; by using the reference method that is Westergren method. Method: From a total of 80 patients for ESR test, blood samples were taken at the same time into the tubes with K2EDTA and sodium citrate on 7 separate days; and after these blood samples arrived at our laboratory in 2 hours, they were studied with reference Westergren method and in Test-1 and automatic Westergren devices. These two methods were statistically compared with each other and also with the reference method by using concordance correlation coefficient and Passing-Bablok regression analysis method. Results: ESR result values were dispersed in the interval of 1-78 mm/hour, while R2 values in the correlation of reference Westergren method with Test- 1 and automatic Westergren devices were found as 0,86 (%95 Cl 0,801 to 20,913) and 0,978 (%95 Cl 0,967 to 0,985), respectively. R value in the correlation between two devices was found as 0,898 (%95 0,846 to 0,933). In the Passing Bablok analysis, in the regression analysis of devices with reference method, intercept for Test-1 device was found as -0,5 (%95 Cl - 2,42- 0) and the slope was 1,09 (%95 Cl 1-1,21) (y=-0,5+1,09x). Intercept for automatic Westergren device was found as -0,25 (%95 Cl -1,26-0) and the slope was 1,03 (%95 Cl 1-1,08) (y=0,25+1,03x). Intercept for comparison of these two systems was found as -0,14(%95 Cl 1,01-0) and the slope was 1,02 (%95 Cl 1-1,17) (y=-0,14+1,02x). There was no significant difference between the groups with student t-test (p>0,05). Conclusion: Test-1 method and automated Westergren method devices can be used reliably in the ESR measurement in routine laboratory as compared with reference Westergren method. At high ESR values Test-1 device has deviations from the reference method. We suggest that the evaluation of results of high sedimentation values be made carefully and for high ESR values comprehensive studies be supported by further research.

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