NT-proBNP on Cobas h 232 in point-of-care testing: Performance in the primary health care versus in the hospital laboratory

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. Materials and metho...

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Bibliographic Details
Published in:	Scandinavian journal of clinical and laboratory investigation Vol. 75; no. 7; pp. 602 - 609
Main Authors:	Gils, Charlotte, Ramanathan, Ramshanker, Breindahl, Torben, Brokner, Mette, Christiansen, Anne L., Eng, Øyvin, Hammer, Ida J., Herrera, Catherine B., Jansen, Aina, Langsjøen, Eva C., Løkkebo, Elisabeth S., Osestad, Toril, Schrøder, Anne D., Walther, Lisa
Format:	Journal Article
Language:	English
Published:	England Taylor & Francis 03-10-2015
Subjects:	biological markers Cardiac and Cardiovascular Systems Clinical Medicine Health Care Service and Management, Health Policy and Services and Health Economy Health Sciences heart disease Humans Hälso- och sjukvårdsorganisation, hälsopolitik och hälsoekonomi Hälsovetenskap Kardiologi Klinisk medicin Laboratories, Hospital Medical and Health Sciences Medicin och hälsovetenskap Natriuretic peptide Natriuretic Peptide, Brain - blood Peptide Fragments - blood point-of-care point-of-care systems Point-of-Care Testing - standards Primary Health Care Reproducibility of Results Sensitivity and Specificity systems validation studies biological markers point-of-care systems validation studies Natriuretic peptide heart disease
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Summary:	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. Materials and 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. Conclusion. 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.
Bibliography:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23
ISSN:	0036-5513 1502-7686 1502-7686
DOI:	10.3109/00365513.2015.1066846