Precision and accuracy of a point of care glucometer for detection of hypoglycaemia in horses.
Authors: Hughes Kristopher, Moore Claire, Woods Sophie, Wilkes Edwina
Journal: Veterinary journal (London, England : 1997)
Summary
# Editorial Summary Point-of-care glucometers are widely used in equine practice for rapid glucose assessment, yet their reliability during hypoglycaemic episodes (blood glucose <4 mmol/L) had not been formally validated until this 2024 analysis by Hughes and colleagues. The researchers compared POC glucometer readings against laboratory-based glucose measurement in hypoglycaemic samples, evaluating both precision (repeatability) and accuracy (agreement with laboratory values). The findings raise significant concerns: POC devices demonstrated a repeatability coefficient of 0.47 mmol/L compared to just 0.09 mmol/L for laboratory methods, with a coefficient of variation of 10% against 2.11%, and exhibited systematic bias with a mean underestimation of 0.26 mmol/L—critically, fewer than 70% of POC readings fell within 20% of the paired laboratory result. For practitioners relying on point-of-care glucometry to diagnose or manage hypoglycaemia in emergency or performance settings, these results suggest that individual device validation and establishment of hypoglycaemia-specific reference ranges are essential before clinical use, as current POC glucometers may lack the precision necessary for confident clinical decision-making when blood glucose is critically low.
Read the full abstract on PubMed
Practical Takeaways
- •Point-of-care glucometers have significant measurement error in hypoglycaemic horses and should not be relied upon as the sole diagnostic method for detecting low blood glucose
- •Before using any glucometer clinically, validate its diagnostic performance against laboratory methods and establish acceptable accuracy criteria specific to hypoglycaemic ranges
- •Consider laboratory confirmation of hypoglycaemia suspected from POC glucometry, particularly when clinical signs warrant accurate glucose assessment
Key Findings
- •Point-of-care glucometers showed poor repeatability (0.47 mmol/L) and higher coefficient of variation (10%) compared to laboratory methods (0.09 mmol/L and 2.11% respectively) for hypoglycaemic samples
- •Systemic bias of -0.26 mmol/L was present with POC method, with 95% limits of agreement ranging from -0.88 to 0.37 mmol/L
- •Less than 70% of POC glucometer measurements were within 20% of paired laboratory results for hypoglycaemic samples