A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose

• Published in: Diabetes care Vol. 23; no. 8; pp. 1143 - 1148
• Main Authors: PARKES, J. L, SLATIN, S. L, PARDO, S, GINSBERG, B. H
• Format: Journal Article
• Language: English
• Published: Alexandria, VA American Diabetes Association 01-08-2000
• Subjects: Adult; Biological and medical sciences; Blood Glucose - analysis; Blood Glucose Self-Monitoring - instrumentation; Blood Glucose Self-Monitoring - methods; Blood Glucose Self-Monitoring - standards; Blood sugar; Care and treatment; Diabetes Mellitus, Type 1 - blood; Diabetes Mellitus, Type 2 - blood; Diabetes. Impaired glucose tolerance; Endocrine pancreas. Apud cells (diseases); Endocrinopathies; Female; Humans; Male; Management. Various non-drug treatments. Langerhans islet grafts; Measurement; Medical sciences; Physicians; Regression Analysis; Reproducibility of Results; Software; Type 1 diabetes; Type 2 diabetes; United States; United States; Endocrinopathy; Human; Immunopathology; Error estimation; Insulin dependent diabetes; Autoimmune disease; Risk analysis; Non insulin dependent diabetes; Measurement error; Glycemia; Biological monitoring
• ISSN: 0149-5992; 1935-5548
• DOI: 10.2337/diacare.23.8.1143

A new consensus error grid to evaluate the clinical significance of inaccuracies in the measurement of blood glucose.
J L Parkes ,
S L Slatin ,
S Pardo and
B H Ginsberg
Becton Dickinson and Company, Franklin Lakes, New Jersey 07417, USA. [e-mail]
Abstract
OBJECTIVE: The objectives of this study were 1) to construct new error grids (EGs) for blood glucose (BG) self-monitoring
by using the expertise of a large panel of clinicians and 2) to use the new EGs to evaluate the accuracy of BG measurements
made by patients. RESEARCH DESIGN AND METHODS: To construct new EGs for type 1 and type 2 diabetic patients, a total of 100
experts of diabetes were asked to assign any error in BG measurement to 1 of 5 risk categories. We used these EGs to evaluate
the accuracy of self-monitoring of blood glucose (SMBG) levels in 152 diabetic patients. The SMBG data were used to compare
the new type 1 diabetes EG with a traditional EG. RESULTS: Both the type 1 and type 2 diabetes EGs divide the risk plane into
8 concentric zones with no discontinuities. The new EGs are similar to each other, but they differ from the traditional EG
in several significant ways. When used to evaluate a data set of measurements made by a sample of patients experienced in
SMBG, the new type 1 diabetes EG rated 98.6% of their measurements as clinically acceptable, compared with 95% for the traditional
EG. CONCLUSIONS: The consensus EGs furnish a new tool for evaluating errors in the measurement of BG for patients with type
1 and type 2 diabetes.